生育中心女性尿液中的对羟基苯甲酸酯浓度与卵巢衰老。
Urinary paraben concentrations and ovarian aging among women from a fertility center.
机构信息
Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA.
出版信息
Environ Health Perspect. 2013 Nov-Dec;121(11-12):1299-305. doi: 10.1289/ehp.1205350. Epub 2013 Aug 2.
BACKGROUND
Parabens are preservatives commonly used in personal care products, pharmaceuticals, and foods. There is documented widespread human exposure to parabens, and some experimental data suggest that they act as estrogenic endocrine disruptors. As far as we are aware, no epidemiologic studies have assessed female reproductive health effects in relation to paraben exposure.
OBJECTIVE
We examined the association of urinary paraben concentrations with markers of ovarian reserve in a prospective cohort study of women seeking fertility treatment at Massachusetts General Hospital, Boston, Massachusetts.
METHODS
Measures of ovarian reserve were day-3 follicle-stimulating hormone (FSH), antral follicle count (AFC), and ovarian volume. Paraben concentrations [methylparaben (MP), propylparaben (PP), and butylparaben (BP)] were measured in spot urine samples collected prior to the assessment of outcome measures. We used linear and Poisson regression models to estimate associations of urinary paraben concentrations (in tertiles) with ovarian reserve measures.
RESULTS
Of the women enrolled in 2004-2010, 192 had at least one ovarian reserve outcome measured (mean age ± SD, 36.1 ± 4.5 years; range, 21.0-46.7 years). MP and PP were detected in > 99% of urine samples and BP in > 75%. We found a suggestive trend of lower AFC with increasing urinary PP tertiles [mean percent change (95% CI) for tertiles 2 and 3 compared with tertile 1, respectively, were -5.0% (-23.7, 18.4) and -16.3% (-30.8, 1.3); trend p-value (ptrend) = 0.07] as well as higher day-3 FSH with higher urinary PP tertiles [mean change (95% CI) for tertiles 2 and 3 compared with tertile 1 were 1.16 IU/L (-0.26, 2.57) and 1.02 IU/L (-0.40, 2.43); ptrend = 0.16]. We found no consistent evidence of associations between urinary MP or BP and day-3 FSH or AFC, or between urinary MP, PP, or BP and ovarian volume.
CONCLUSIONS
PP may be associated with diminished ovarian reserve. However, our results require confirmation in further studies.
背景
对羟基苯甲酸酯是一种常用的防腐剂，存在于个人护理产品、药品和食品中。目前已有大量文献记录了人类广泛接触对羟基苯甲酸酯，并且一些实验数据表明它们具有类雌激素内分泌干扰物的作用。据我们所知，目前还没有流行病学研究评估过对羟基苯甲酸酯暴露与女性生殖健康之间的关系。
目的
我们在马萨诸塞州综合医院（波士顿，马萨诸塞州）接受生育治疗的女性前瞻性队列研究中，检测了尿液中对羟基苯甲酸酯浓度与卵巢储备标志物之间的关系。
方法
卵巢储备标志物包括基础卵泡刺激素（FSH）、窦卵泡计数（AFC）和卵巢体积。在评估结果之前，收集了 2004-2010 年入组女性的晨尿样本，并测量了对羟基苯甲酸酯浓度（以对羟基苯甲酸甲酯（MP）、对羟基苯甲酸丙酯（PP）和对羟基苯甲酸丁酯（BP）表示）。我们使用线性和泊松回归模型来估计尿液中对羟基苯甲酸酯浓度（按三分位数）与卵巢储备标志物之间的关联。
结果
在 2004-2010 年入组的女性中，有 192 名至少有一项卵巢储备结果（平均年龄 ± 标准差，36.1 ± 4.5 岁；范围，21.0-46.7 岁）。MP 和 PP 在>99%的尿液样本中被检测到，BP 在>75%的尿液样本中被检测到。我们发现，随着尿液中 PP 三分位数的增加，AFC 呈下降趋势[三分位数 2 和 3 与三分位数 1 相比，平均百分比变化（95%CI）分别为-5.0%（-23.7，18.4）和-16.3%（-30.8，1.3）；趋势 p 值（ptrend）=0.07]，同时，随着尿液中 PP 三分位数的增加，基础 FSH 也呈上升趋势[三分位数 2 和 3 与三分位数 1 相比，平均变化（95%CI）分别为 1.16IU/L（-0.26，2.57）和 1.02IU/L（-0.40，2.43）；ptrend=0.16]。我们没有发现尿液中 MP 或 BP 与基础 FSH 或 AFC 之间，或尿液中 MP、PP 或 BP 与卵巢体积之间存在一致的关联证据。
结论
PP 可能与卵巢储备减少有关。然而，我们的结果需要在进一步的研究中得到证实。
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