中枢性性早熟患者内分泌干扰物分析。
The analysis of endocrine disruptors in patients with central precocious puberty.
机构信息
Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
出版信息
BMC Pediatr. 2019 Sep 7;19(1):323. doi: 10.1186/s12887-019-1703-4.
BACKGROUND
A few studies have reported a positive association between phthalate exposure and pubertal timing, but several conflicting reports exist. The main objective of the study was to determine whether phthalate exposure was associated with central precocious puberty in girls.
METHODS
This was a multicenter case-control study wherein 47 girls with central precocious puberty (CPP) and 47 controls (26 pre-pubertal girls and 21 pubertal girls) were enrolled. No obese girls were included. Five phthalate metabolites (creatinine adjusted) and bisphenol A (BPA) were measured in the first spot urine samples of these 94 girls in the early morning.
RESULTS
The median values of monobenzyl phthalate (MBzP), mono-2-ethyl-5-carboxypentyl phthalate (MECPP), mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP), mono-2-ethyl-5-oxohexyl phthalate (MEOHP), and mono-n-butyl phthalate (MnBP) were 3.1, 29.3, 18.0, 15.4, and 25.2 μg/g creatinine in the CPP group, 4.3, 53.7, 35.7, 29.1, and 66.0 μg/g creatinine in the pre-pubertal control group, and 1.7, 28.7, 21.4, 12.1, and 33.3 μg/g creatinine in the pubertal control group, respectively. The urinary concentration of the five phthalates was significantly lower in the CPP group than in the pre-pubertal control group (P < 0.001). Conversely, there was no significant difference in the urinary concentration of the five phthalates between the CPP and pubertal control groups (P values: 0.077 for MBzP, 0.733 for MECPP, 0.762 for MEHHP, 0.405 for MEOHP, and 0.981 for MnBP). In addition, the BPA level was not significantly different between the CPP and pubertal control groups (BPA median values: 0.63 μg/g creatinine, the CPP group; 1.7 μg/g creatinine, the pubertal control group; P value = 0.092).
CONCLUSIONS
Our study showed that there was no significant difference in the urinary phthalate levels between the CPP and pubertal control groups. Moreover, phthalate metabolites were significantly lower in the CPP group than in the pre-pubertal control group. Further investigation about endocrine disruptors and pubertal progression is needed.
背景
一些研究报告称邻苯二甲酸酯暴露与青春期提前之间存在正相关，但也存在一些相互矛盾的报告。本研究的主要目的是确定邻苯二甲酸酯暴露是否与女孩的中枢性性早熟有关。
方法
这是一项多中心病例对照研究，共纳入 47 例中枢性性早熟（CPP）女孩和 47 例对照（26 例青春期前女孩和 21 例青春期女孩）。不包括肥胖女孩。94 名女孩于清晨采集首次尿样，测定 5 种邻苯二甲酸酯代谢物（肌酐校正）和双酚 A（BPA）。
结果
CPP 组中单苄基邻苯二甲酸酯（MBzP）、单-2-乙基-5-羧基戊基邻苯二甲酸酯（MECPP）、单-2-乙基-5-羟基己基邻苯二甲酸酯（MEHHP）、单-2-乙基-5-氧己基邻苯二甲酸酯（MEOHP）和单正丁基邻苯二甲酸酯（MnBP）的中位数分别为 3.1、29.3、18.0、15.4 和 25.2μg/g 肌酐，青春期前对照组为 4.3、53.7、35.7、29.1 和 66.0μg/g 肌酐，青春期对照组为 1.7、28.7、21.4、12.1 和 33.3μg/g 肌酐。CPP 组中 5 种邻苯二甲酸酯的尿浓度明显低于青春期前对照组（P<0.001）。相反，CPP 组与青春期对照组 5 种邻苯二甲酸酯尿浓度无显著差异（P 值：MBzP 为 0.077，MECPP 为 0.733，MEHHP 为 0.762，MEOHP 为 0.405，MnBP 为 0.981）。此外，CPP 组与青春期对照组的 BPA 水平无显著差异（BPA 中位数：CPP 组为 0.63μg/g 肌酐，青春期对照组为 1.7μg/g 肌酐；P 值=0.092）。
结论
本研究表明 CPP 组与青春期对照组的尿邻苯二甲酸酯水平无显著差异。此外，CPP 组中邻苯二甲酸酯代谢物的浓度明显低于青春期前对照组。需要进一步研究内分泌干扰物与青春期进展的关系。
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