School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, PR China.
MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, PR China.
Environ Pollut. 2019 Apr;247:824-831. doi: 10.1016/j.envpol.2019.01.039. Epub 2019 Jan 11.
Perfluoroalkyl substances (PFASs) are a family of synthetic, fluorinated organic compounds. They have been widely used in industrial applications and consumer products and widespread in the environment, wildlife and human. Experimental and epidemiologic evidence suggested that PFASs are capable of interfering with endocrine processes and have potential reproductive and developmental toxicities. Polycystic ovarian syndrome (PCOS), one of the main reasons of female infertility, is a common endocrine disorder in reproductive age women. We performed a case-control study to evaluate associations between PCOS-related infertility and PFASs concentrations in plasma. A total of 180 infertile PCOS-cases and 187 healthy controls were recruited from the Center for Reproductive Medicine of Shandong University. Blood specimens were collected at enrollment and analyzed for ten PFASs using liquid chromatography-tandem mass spectrometry. Multivariable logistic regression procedure was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for each PFAS. Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) were the dominant PFASs in the plasma of participants, with the median concentration of 5.07 ng/mL and 4.05 ng/mL, respectively. The median levels of individual PFAS were not significantly different between PCOS-cases and controls. While adjusted for the potential confounders (age, BMI, household income, education level, employment status, age at menarche, menstrual volume), the plasma concentration of perfluorododecanoic acid (PFDoA), a 12 carbons lengths of perfluorocarboxylic acids, was associated with a significantly increased risk of PCOS-related infertility (medium vs low tertile: OR = 2.36, 95% CI: 1.12, 4.99, P = 0.02; high vs low tertile: OR = 3.04, 95% CI: 1.19, 7.67, P = 0.02), with the P trend 0.01. No significant relationship was observed between PCOS-related infertility and other PFAS analytes in the adjusted model, despite perfluoroundecanoic acid showed a negative association (P trend 0.03). The potential reproductive health effects of PFASs and the underlying mechanisms merit further investigation in the future.
全氟烷基物质 (PFASs) 是一类合成的含氟有机化合物。它们已被广泛应用于工业应用和消费产品中，并广泛存在于环境、野生动物和人类中。实验和流行病学证据表明，PFASs 能够干扰内分泌过程，具有潜在的生殖和发育毒性。多囊卵巢综合征 (PCOS) 是女性不孕的主要原因之一，是育龄妇女常见的内分泌紊乱。我们进行了一项病例对照研究，以评估多囊卵巢综合征相关不孕与血浆中 PFASs 浓度之间的关系。共有 180 名来自山东大学生殖医学中心的不孕 PCOS 病例和 187 名健康对照被招募。在入组时采集血样，并使用液相色谱-串联质谱法分析十种 PFASs。多变量逻辑回归程序用于估计每种 PFAS 的比值比 (OR) 和 95%置信区间 (CI)。全氟辛酸 (PFOA) 和全氟辛烷磺酸 (PFOS) 是参与者血浆中主要的 PFASs，其中位数浓度分别为 5.07ng/mL 和 4.05ng/mL。病例组和对照组的单个 PFAS 中位数水平无显著差异。在调整了潜在混杂因素 (年龄、BMI、家庭收入、教育水平、就业状况、初潮年龄、月经血量) 后，长链全氟羧酸中的 12 个碳原子的全氟十二烷酸 (PFDoA) 的血浆浓度与多囊卵巢综合征相关不孕的风险显著增加相关 (中 tert 与低 tert 相比：OR=2.36，95%CI：1.12，4.99，P=0.02；高 tert 与低 tert 相比：OR=3.04，95%CI：1.19，7.67，P=0.02)，趋势检验 P 值为 0.01。在调整模型中，尽管全氟壬酸呈负相关 (趋势检验 P 值为 0.03)，但多囊卵巢综合征相关不孕与其他 PFAS 分析物之间未观察到显著关系。PFASs 的潜在生殖健康影响及其潜在机制值得进一步研究。
