Department of Clinical Epidemiology, Institute of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics of Ministry of Education (Zhejiang University), Key Laboratory of Women's Reproductive Health of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
BMJ Open. 2018 Oct 17;8(10):e019707. doi: 10.1136/bmjopen-2017-019707.
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy of women at reproductive age. Although the aetiology of PCOS remains unclear, potential effects of environmental endocrine-disrupting compounds on the development of PCOS have drawn increasing attention. The aim of the current study was to examine the association between triclosan (TCS) and PCOS, and explore possible mechanisms on how TCS may contribute to the development of clinical manifestations of PCOS.
Cross-sectional study.
This study was conducted in one tertiary-level hospital located in Zhejiang, China.
A total of 674 infertile women at 18-45 years of age were recruited in 2014-2015. Participants with (n=84) and without (n=212) PCOS with urinary TCS concentration available were included in the analyses.
Urinary TCS concentration was measured using a high-performance liquid chromatography-electrospray ionisation tandem mass spectrometry. Logistic regression model was used to examine the association between TCS and PCOS. Fractional polynomial regression models were built to fit the potential non-linear relationship between TCS concentrations and luteinising hormone (LH) and LH/follicle stimulate hormone (FSH).
The PCOS group had significantly higher level of TCS concentration than the non-PCOS group (the median of TCS (IQR), μg/g creatinine: 1.49 (0.68-3.80) vs 1.06 (0.52-3.02), p=0.0407). Compared with the lowest tertile, the highest tertile of TCS concentration was associated with an increased odd of PCOS (OR 2.12, 95% CI 1.12 to 3.99). After adjusting for potential confounders, the significant association remained (OR 1.99, 95% CI 1.05 to 3.79). Positive relationships were found between TCS levels and LH and LH/FSH ratio in non-PCOS participants.
TCS exposure at a relatively low level is associated with PCOS in Chinese women. Further epidemiological studies are needed to confirm our finding, which may have important public health implications.
多囊卵巢综合征(PCOS)是育龄妇女最常见的内分泌疾病。尽管 PCOS 的病因尚不清楚,但环境内分泌干扰化合物对 PCOS 发展的潜在影响引起了越来越多的关注。本研究旨在探讨三氯生(TCS)与 PCOS 的关系,并探讨 TCS 如何导致 PCOS 临床表现的可能机制。
横断面研究。
本研究于 2014 年至 2015 年在中国浙江的一家三级医院进行。
共招募了 674 名 18-45 岁的不孕妇女。纳入了尿液 TCS 浓度可用的患有(n=84)和不患有(n=212)PCOS 的参与者。
使用高效液相色谱-电喷雾串联质谱法测量尿 TCS 浓度。使用逻辑回归模型检查 TCS 与 PCOS 之间的关联。建立分数多项式回归模型,以拟合 TCS 浓度与黄体生成素(LH)和 LH/卵泡刺激素(FSH)之间的潜在非线性关系。
PCOS 组的 TCS 浓度明显高于非 PCOS 组(TCS 的中位数(IQR),μg/g 肌酐:1.49(0.68-3.80)比 1.06(0.52-3.02),p=0.0407)。与最低三分位相比,TCS 浓度最高三分位与 PCOS 的发生几率增加相关(OR 2.12,95%CI 1.12 至 3.99)。调整潜在混杂因素后,这种显著关联仍然存在(OR 1.99,95%置信区间 1.05 至 3.79)。在非 PCOS 参与者中,TCS 水平与 LH 和 LH/FSH 比值之间存在正相关关系。
在中国女性中,TCS 的低水平暴露与 PCOS 相关。需要进一步的流行病学研究来证实我们的发现,这可能具有重要的公共卫生意义。