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多囊卵巢综合征:环境内分泌干扰物是否起作用?

Polycystic ovary syndrome: do endocrine-disrupting chemicals play a role?

机构信息

Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry.

Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York.

出版信息

Semin Reprod Med. 2014 May;32(3):166-76. doi: 10.1055/s-0034-1371088. Epub 2014 Apr 8.

Abstract

Polycystic ovary syndrome (PCOS) is a heterogeneous disorder characterized by multiple endocrine disturbances, and its underlying causes, although uncertain, are likely to be both genetic and environmental. Recently, there has been interest in whether endocrine-disrupting chemicals (EDCs) in the environment, particularly Bisphenol A (BPA), may contribute to the disorder. In animal models, exposure to BPA during the perinatal period dramatically disrupts ovarian and reproductive function in females, often at doses similar to typical levels of human exposure. BPA also appears to have obesogenic properties, disrupting normal metabolic activity and making the body prone to overweight. In humans, cross-sectional data suggest that BPA concentrations are higher in women with PCOS than in reproductively healthy women, but the direction of causality has not been established. As this research is in its infancy, additional work is needed to understand the mechanisms by which EDCs may contribute to PCOS as well as the critical periods of exposure, which may even be transgenerational. Future research should also focus on translating the promising work in animal models into longitudinal human studies and determining whether additional EDCs, beyond BPA, may be important to consider.

摘要

多囊卵巢综合征(PCOS)是一种表现为多种内分泌紊乱的异质性疾病,其根本原因虽不明确,但可能既有遗传因素也有环境因素。最近,人们开始关注环境内分泌干扰物(EDCs),尤其是双酚 A(BPA),是否会导致这种疾病。在动物模型中,围产期接触 BPA 会严重破坏雌性的卵巢和生殖功能,其剂量通常与人类的典型接触水平相似。BPA 似乎还具有致肥胖特性,会破坏正常的代谢活动,使身体容易超重。在人类中,横断面数据表明,多囊卵巢综合征患者的 BPA 浓度高于生殖健康的女性,但尚未确定因果关系的方向。由于这项研究还处于起步阶段,需要开展更多的工作来了解 EDCs 如何导致 PCOS 以及暴露的关键时期,甚至可能具有跨代效应。未来的研究还应重点关注将动物模型中很有前景的研究成果转化为纵向的人类研究,并确定除 BPA 之外,是否还有其他 EDC 值得关注。

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