Orta Olivia R, Wesselink Amelia K, Bethea Traci N, Claus Henn Birgit, Weuve Jennifer, Fruh Victoria, McClean Michael D, Sjodin Andreas, Baird Donna D, Wise Lauren A
Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts.
Office of Minority Health and Health Disparities Research, Georgetown Lombardi Comprehensive Cancer Center, Washington, D.C.
Environ Epidemiol. 2021 Jan 27;5(1):e127. doi: 10.1097/EE9.0000000000000127. eCollection 2021 Feb.
Uterine leiomyomata (UL) are hormone-responsive benign neoplasms. Brominated flame retardants and organochlorine pesticides (OCPs) can disrupt hormones involved in UL etiology.
The Study of Environmental, Lifestyle, and Fibroids is a Detroit-area prospective cohort of 1693 Black women 23-35 years of age. At baseline and approximately every 20 months for 5 years, women completed questionnaires and underwent transvaginal ultrasounds. Using a case-cohort study design, we selected 729 UL-free participants at baseline and analyzed baseline plasma samples for polybrominated diphenyl ethers (PBDEs), a polybrominated biphenyl ether (PBB-153), and OCPs. We used Cox proportional hazard models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
Compared with total PBDE plasma concentrations <50th percentile, adjusted HRs for the 50th-74th, 75th-89th, and ≥90th percentiles were 1.00 (95% CI = 0.68, 1.47), 1.04 (95% CI = 0.63, 1.68), and 0.85 (95% CI = 0.48, 1.50), respectively. HRs for PBB-153 plasma concentrations were generally similar to total PBDE plasma concentrations. Compared with total OCP plasma concentrations <50th percentile, HRs for the 50th-74th, 75th-89th, and ≥90th percentiles were 0.86 (95% CI = 0.57, 1.29), 0.73 (95% CI = 0.43, 1.22), and 0.58 (95% CI = 0.32, 1.04), respectively. HRs for individual PBDEs and OCPs were similar to their respective totals.
We found little support for an association between brominated flame retardant plasma concentrations and UL incidence, and some evidence of lower UL incidence with the highest OCP plasma concentrations.
子宫平滑肌瘤（UL）是激素反应性良性肿瘤。溴化阻燃剂和有机氯农药（OCPs）可干扰与UL病因相关的激素。
环境、生活方式与肌瘤研究是底特律地区一项针对1693名23 - 35岁黑人女性的前瞻性队列研究。在基线时以及之后5年中大约每20个月，女性完成问卷调查并接受经阴道超声检查。采用病例队列研究设计，我们在基线时选取了729名无UL的参与者，并分析其基线血浆样本中的多溴二苯醚（PBDEs）、一种多溴联苯（PBB - 153）和OCPs。我们使用Cox比例风险模型来估计风险比（HRs）和95%置信区间（CIs）。
与血浆总PBDE浓度低于第50百分位数相比，第50 - 74、75 - 89和≥90百分位数的校正HR分别为1.00（95% CI = 0.68, 1.47）、1.04（95% CI = 0.63, 1.68）和0.85（95% CI = 0.48, 1.50）。PBB - 153血浆浓度的HR通常与血浆总PBDE浓度相似。与血浆总OCP浓度低于第50百分位数相比，第50 - 74、75 - 89和≥90百分位数的HR分别为0.86（95% CI = 0.57, 1.29）、0.73（95% CI = 0.43, 1.22）和0.58（95% CI = 0.32, 1.04）。单个PBDEs和OCPs的HR与它们各自的总量相似。
我们几乎没有发现支持血浆中溴化阻燃剂浓度与UL发病率之间存在关联的证据，并且有一些证据表明OCP血浆浓度最高时UL发病率较低。
