Thurston S W, Mendiola J, Bellamy A R, Levine H, Wang C, Sparks A, Redmon J B, Drobnis E Z, Swan S H
Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, USA.
Division of Preventive Medicine and Public Health, Department of Health and Social Sciences, School of Medicine, University of Murcia, Espinardo (Murcia), IMIB-Arrixaca, Spain.
Andrology. 2016 Jul;4(4):632-8. doi: 10.1111/andr.12124. Epub 2015 Nov 24.
Several experimental and observational studies have demonstrated the antiandrogenicity of several phthalates. However, there is limited evidence of an association between phthalate exposure in adult life and semen quality. The aim of this study was to examine phthalate exposure during adulthood in relation to semen quality in fertile US men. This multi-center cross-sectional study included 420 partners of pregnant women who attended a prenatal clinic in one of five US cities during 1999-2001. Nine phthalate metabolites [mono (2-ethylhexyl) phthalate (MEHP), mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono (2-ethyl-5-oxohexyl) phthalate (MEOHP), and mono (2-ethyl-5-carboxypentyl) phthalate (MECPP)], as well as mono-n-butyl phthalate (MBP) and mono-isobutyl phthalate (MiBP), mono (three carboxypropyl) phthalate (MCPP), monobenzyl phthalate (MBzP), and monoethyl phthalate (MEP)] were measured in urine collected at the same time as the semen sample. We regressed natural log-transformed (ln) sperm concentration, ln(total sperm count), ln(total motile sperm count), percent motile spermatozoa, and percent spermatozoa with normal morphology on each of the nine natural log-transformed metabolite concentrations and on the molar-weighted sum of DEHP metabolites in separate models. We fit unadjusted models and models that adjusted for confounders determined a priori. In unadjusted models, ln(MiBP) was significantly and positively associated with motility and ln(MBzP) significantly negatively associated with ln(total sperm count). In adjusted linear models, urinary metabolite concentrations of DEHP, DBP, DEP, and DOP were not associated with any semen parameter. We found an inverse association between ln(MBzP) concentrations and sperm motility (β = -1.47, 95% CI: -2.61, -0.33), adjusted for ln(creatinine concentration), geographic location, age, race, smoking status, stress, recent fever, time from sample collection and time to complete analysis. Several sensitivity analyses confirmed the robustness of these associations. This study and the available literature suggest that impacts of adult exposure to phthalates at environmental levels on classical sperm parameters are likely to be small.
多项实验研究和观察性研究已证实了几种邻苯二甲酸酯具有抗雄激素性。然而,关于成年期邻苯二甲酸酯暴露与精液质量之间关联的证据有限。本研究的目的是调查成年期美国可育男性邻苯二甲酸酯暴露与精液质量之间的关系。这项多中心横断面研究纳入了1999年至2001年期间在美国五个城市之一的产前诊所就诊的420名孕妇的伴侣。在采集精液样本的同时收集尿液,检测其中9种邻苯二甲酸酯代谢物[邻苯二甲酸单(2-乙基己基)酯(MEHP)、邻苯二甲酸单(2-乙基-5-羟基己基)酯(MEHHP)、邻苯二甲酸单(2-乙基-5-氧代己基)酯(MEOHP)、邻苯二甲酸单(2-乙基-5-羧基戊基)酯(MECPP)],以及邻苯二甲酸单正丁酯(MBP)、邻苯二甲酸单异丁酯(MiBP)、邻苯二甲酸单(三羧丙基)酯(MCPP)、邻苯二甲酸单苄酯(MBzP)和邻苯二甲酸单乙酯(MEP)]。在单独的模型中,我们将自然对数转换后的(ln)精子浓度、ln(总精子数)、ln(总活动精子数)、活动精子百分比和正常形态精子百分比分别与9种自然对数转换后的代谢物浓度以及DEHP代谢物的摩尔加权总和进行回归分析。我们拟合了未调整模型以及针对事先确定的混杂因素进行调整的模型。在未调整模型中,ln(MiBP)与精子活力显著正相关,ln(MBzP)与ln(总精子数)显著负相关。在调整后的线性模型中,DEHP、DBP、DEP和DOP的尿液代谢物浓度与任何精液参数均无关联。在对ln(肌酐浓度)、地理位置、年龄、种族、吸烟状况、压力、近期发热、样本采集时间和分析完成时间进行调整后,我们发现ln(MBzP)浓度与精子活力之间存在负相关(β = -1.47,95% CI:-2.61,-0.33)。多项敏感性分析证实了这些关联的稳健性。本研究及现有文献表明,成年期环境水平邻苯二甲酸酯暴露对经典精子参数的影响可能较小。