Yunus Fakir Md, Rahman Musarrat Jabeen, Alam Md Zahidul, Hore Samar Kumar, Rahman Mahfuzar
BRAC Research and Evaluation Division, BRAC Centre, 75 Mohakhali, Dhaka 1212, Bangladesh.
BMC Public Health. 2014 May 2;14:419. doi: 10.1186/1471-2458-14-419.
Chronic exposure to arsenic is associated with neoplastic, cardiovascular, endocrine, neuro-developmental disorders and can have an adverse effect on women's reproductive health outcomes. This study examined the relationship between arsenic skin lesions (a hallmark sign of chronic arsenic poisoning) and age of natural menopause (final menopausal period) in populations with high levels of arsenic exposure in Bangladesh.
We compared menopausal age in two groups of women--with and without arsenic skin lesions; and presence of arsenic skin lesions was used as an indicator for chronic arsenic exposure. In a cross-sectional study, a total of 210 participants were randomly identified from two ongoing studies--participants with arsenic skin lesions were identified from an ongoing clinical trial and participants with no arsenic skin lesions were identified from an ongoing cohort study. Mean age of menopause between these two groups were calculated and compared. Multivariable linear regression was used to estimate the relationship between the status of the arsenic skin lesions and age of natural menopause in women.
Women with arsenic skin lesions were 1.5 years younger (p <0.001) at the time of menopause compared to those without arsenic skin lesions. After adjusting with contraceptive use, body mass index, urinary arsenic level and family history of premature menopause, the difference between the groups' age at menopause was 2.1 years earlier (p <0.001) for respondents with arsenic skin lesions.
The study showed a statistically significant association between chronic exposure to arsenic and age at menopause. Heavily exposed women experienced menopause two years earlier than those with lower or no exposure.
长期接触砷与肿瘤、心血管、内分泌、神经发育障碍有关,并且会对女性生殖健康结局产生不利影响。本研究调查了孟加拉国高砷暴露人群中砷皮肤病变(慢性砷中毒的标志性体征)与自然绝经年龄(最后绝经期)之间的关系。
我们比较了两组女性的绝经年龄——有和没有砷皮肤病变的女性;并将砷皮肤病变的存在作为慢性砷暴露的指标。在一项横断面研究中,从两项正在进行的研究中随机选取了210名参与者——有砷皮肤病变的参与者来自一项正在进行的临床试验,没有砷皮肤病变的参与者来自一项正在进行的队列研究。计算并比较了这两组之间的平均绝经年龄。采用多变量线性回归来估计女性砷皮肤病变状况与自然绝经年龄之间的关系。
有砷皮肤病变的女性在绝经时比没有砷皮肤病变的女性年轻1.5岁(p<0.001)。在对避孕措施使用情况、体重指数、尿砷水平和早绝经家族史进行调整后,有砷皮肤病变的受访者绝经年龄组间差异提前2.1岁(p<0.001)。
该研究显示长期接触砷与绝经年龄之间存在统计学上的显著关联。高暴露女性比低暴露或无暴露女性提前两年进入绝经。