双酚 A 暴露与中国上海学龄期女童特发性中枢性性早熟（CPP）的关系。

Association between bisphenol a exposure and idiopathic central precocious puberty (ICPP) among school-aged girls in Shanghai, China.

机构信息

MOE and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Endocrinology and Genetic Diseases, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

MOE and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Neonatology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Environ Int. 2018 Jun;115:410-416. doi: 10.1016/j.envint.2018.02.041. Epub 2018 Apr 9.

DOI:10.1016/j.envint.2018.02.041

PMID:29650233

Abstract

BACKGROUND

Bisphenol A (BPA) is a well-known and widely used endocrine disrupter, but data on its association with childhood reproductive development are limited.

OBJECTIVES

We investigated the possible relationship between exposure to BPA and idiopathic central precocious puberty (ICPP) in school-aged girls.

METHODS

We conducted a 1:1 matched case-control study in Shanghai, China, between July 2011 and September 2012. This study included 136 school-aged (6 to 9 years old) girls diagnosed with ICPP and 136 controls matched for age and body mass index (BMI). We measured the urinary BPA concentrations of all the girls and examined the association with odds of having ICPP. Laboratory examinations including serum estradiol (E2) levels, basal and gonadotropin-releasing hormone (GnRH)-stimulated luteinizing hormone (LH), and follicle-stimulating hormone (FSH) levels, bone ages (BA), and uterine and ovarian sizes were conducted in the ICPP girls.

RESULTS

Median concentrations of urinary BPA in the ICPP and control groups were 6.35 and 1.17 μg/g creatinine (Cr), respectively (p < 0.001). After adjustment for confounders, compared to those with the lowest concentrations of BPA, the highest concentrations were associated with a 9.08-fold increased odds of having ICPP [odds ratio (OR) = 9.08, (95% confidence interval (CI): 2.83-29.15)]. In the ICPP group, modest negative correlation was present between urinary BPA concentrations (μg/g Cr) and peak FSH levels [β = -0.090 (95% CI: -0.178, -0.003), p = 0.044].

CONCLUSIONS

Our findings suggest that BPA exposure is associated with increased odds of having ICPP in school-aged girls, and the potential mechanism may be attributable to the relatively low FSH levels.

摘要

背景

双酚 A（BPA）是一种广为人知且用途广泛的内分泌干扰物，但有关其与儿童生殖发育关系的数据有限。

目的

我们研究了 BPA 暴露与学龄期女孩特发性中枢性性早熟（ICPP）之间的可能关系。

方法

我们在中国上海进行了一项 1:1 匹配的病例对照研究，时间为 2011 年 7 月至 2012 年 9 月。该研究纳入了 136 名被诊断为 ICPP 的学龄期（6-9 岁）女孩和 136 名年龄和体重指数（BMI）匹配的对照组。我们测量了所有女孩的尿液 BPA 浓度，并检验了其与 ICPP 发生几率的关联。对 ICPP 女孩进行了实验室检查，包括血清雌二醇（E2）水平、基础和促性腺激素释放激素（GnRH）刺激促黄体生成素（LH）和促卵泡激素（FSH）水平、骨龄（BA）以及子宫和卵巢大小。

结果

ICPP 组和对照组尿液 BPA 的中位数浓度分别为 6.35 和 1.17μg/g 肌酐（Cr）（p<0.001）。在校正混杂因素后，与 BPA 浓度最低者相比，浓度最高者发生 ICPP 的几率增加了 9.08 倍[比值比（OR）=9.08，95%置信区间（CI）：2.83-29.15]。在 ICPP 组，尿液 BPA 浓度（μg/g Cr）与峰值 FSH 水平之间呈适度负相关[β=-0.090（95%CI：-0.178，-0.003），p=0.044]。