Mínguez-Alarcón Lidia, Hauser Russ, Gaskins Audrey J
Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts; Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Fertil Steril. 2016 Sep 15;106(4):864-70. doi: 10.1016/j.fertnstert.2016.07.1118. Epub 2016 Aug 4.
Bisphenol A (BPA) is a ubiquitous environmental toxicant with endocrine-disrupting properties and is suspected to affect human reproduction. The objective of this review was to summarize the potential effects of male exposure to BPA on markers of testicular function and couple reproductive outcomes. Five epidemiologic studies on BPA and reproductive hormones all found significant associations with at least one reproductive hormone; however, no consistent relationships were observed across studies. Six epidemiologic studies evaluated the relation between BPA and semen parameters, and although the majority reported negative associations with various parameters, there were few consistent trends across studies. Finally, three epidemiologic studies examined BPA and couple reproductive outcomes, and only one found an association. Overall, the evidence supporting an association between BPA exposure and adverse male reproductive health outcomes in humans remains limited and inconclusive. Reasons for the discrepancies in results could include, but are not limited to, differences in study populations (e.g., fertile vs. subfertile men), BPA urinary concentrations (occupationally vs. nonoccupationally exposed), misclassification of BPA exposure (e.g., using one urine sample to characterize exposure vs. multiple samples), sample sizes, study design (e.g., cross-sectional vs. prospective), and residual confounding (e.g., due to diet and lifestyle factors). It is also possible that some of the statistically significant findings were due to chance alone. Clearly, further studies are needed to further clarify the role of this ubiquitous endocrine-disrupting chemical on male reproductive health.
双酚A(BPA)是一种普遍存在的具有内分泌干扰特性的环境毒物,被怀疑会影响人类生殖。本综述的目的是总结男性接触双酚A对睾丸功能标志物和夫妇生殖结局的潜在影响。五项关于双酚A与生殖激素的流行病学研究均发现与至少一种生殖激素存在显著关联;然而,各项研究之间未观察到一致的关系。六项流行病学研究评估了双酚A与精液参数之间的关系,尽管大多数研究报告了与各种参数的负相关,但各项研究之间几乎没有一致的趋势。最后,三项流行病学研究考察了双酚A与夫妇生殖结局的关系,只有一项研究发现了关联。总体而言,支持双酚A暴露与人类男性生殖健康不良结局之间存在关联的证据仍然有限且尚无定论。结果差异的原因可能包括但不限于研究人群的差异(例如,生育能力正常与生育能力低下的男性)、双酚A尿液浓度(职业暴露与非职业暴露)、双酚A暴露的错误分类(例如,使用一份尿液样本表征暴露情况与多份样本)、样本量、研究设计(例如,横断面研究与前瞻性研究)以及残余混杂因素(例如,由于饮食和生活方式因素)。也有可能一些具有统计学意义的发现仅仅是由于偶然因素。显然,需要进一步的研究来进一步阐明这种普遍存在的内分泌干扰化学物质对男性生殖健康的作用。