Channing Division of Network Medicine, Harvard Medical School & Brigham and Women's Hospital, USA; Departments of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA.
Departments of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA; Departments of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, USA.
Int J Hyg Environ Health. 2021 Aug;237:113825. doi: 10.1016/j.ijheh.2021.113825. Epub 2021 Aug 10.
To investigate the association of hair mercury (Hg) levels with antral follicle count (AFC), as a marker of ovarian reserve, and evaluate whether this relationship differed among women with high vs. low total intake of long chain omega-3 polyunsaturated fatty acids (n3PUFA) from foods and supplements.
We included 353 women attending an academic fertility center (2007-2019) who had data on hair Hg levels, total n3PUFA intake, and AFC.
Hair Hg levels were assessed using a Direct Mercury Analyser, total n3PUFA intake was estimated using an extensively validated food frequency questionnaire, and AFC was assessed by transvaginal ultrasonography. Poisson regression models adjusted for potential confounders were used to evaluate the association of hair Hg levels (divided into tertiles, and as above vs below EPA reference (1 ppm)) with AFC. Associations were also evaluated after stratification by median n3PUFA intake (≤0.124% vs. >0.125% calories/week).
Women's median hair Hg level was 0.60 ppm (range = 0.001-8.60 ppm), with more than 30% > 1 ppm (EPA reference level). Hair Hg was positively related to AFC after adjusting for age, BMI, smoking status, infertility diagnosis, and alcohol intake. However, associations became attenuated after adjustment for intake of total n3PUFA. The positive associations of hair Hg and AFC were observed only among women above the median total n3PUFA intake. Specifically, women who consumed >0.125% calories/week of total n3PUFA had mean AFCs of 11.9, 13.2 and 14.1, respectively, across increasing tertiles of hair Hg (p,trend = 0.004). Similar results were found when hair Hg was divided above vs below EPA reference (mean AFC = 12.7 vs. 14.1, p = 0.008).
In these women, positive associations of hair Hg with AFC may be reflective of beneficial effects of n3PUFA on ovarian reserve rather than a beneficial effect of Hg per se. Our findings highlight the importance of considering diet when exploring Hg effects on women's reproductive health in urban settings.
研究头发汞（Hg）水平与窦卵泡计数（AFC）的关联，AFC 作为卵巢储备的标志物，并评估这种关系是否在食物和补充剂中总摄入长链 ω-3 多不饱和脂肪酸（n3PUFA）较高和较低的女性中存在差异。
我们纳入了 2007 年至 2019 年在一家学术生育中心就诊的 353 名女性，这些女性的数据包括头发 Hg 水平、总 n3PUFA 摄入量和 AFC。
使用直接汞分析仪评估头发 Hg 水平，使用经过广泛验证的食物频率问卷估计总 n3PUFA 摄入量，通过阴道超声评估 AFC。使用调整潜在混杂因素的泊松回归模型评估头发 Hg 水平（分为三分位，并与 EPA 参考值（1ppm）相比）与 AFC 的关系。还按 n3PUFA 摄入量中位数（≤0.124% vs. >0.125% 卡路里/周）进行分层后评估关联。
女性头发 Hg 中位数为 0.60ppm（范围=0.001-8.60ppm），超过 30%的女性>1ppm（EPA 参考值）。在校正年龄、BMI、吸烟状况、不孕诊断和饮酒量后，头发 Hg 与 AFC 呈正相关。然而，在调整总 n3PUFA 摄入量后，相关性减弱。头发 Hg 与 AFC 的正相关仅在总 n3PUFA 摄入量高于中位数的女性中观察到。具体来说，总 n3PUFA 摄入量>0.125%卡路里/周的女性，其头发 Hg 三分位的 AFC 均值分别为 11.9、13.2 和 14.1（p,趋势=0.004）。当头发 Hg 分为 EPA 参考值以上 vs 以下时，也得到了类似的结果（AFC 均值=12.7 vs. 14.1，p=0.008）。
在这些女性中，头发 Hg 与 AFC 的正相关可能反映了 n3PUFA 对卵巢储备的有益影响，而不是 Hg 本身的有益影响。我们的研究结果强调了在探索城市环境中 Hg 对女性生殖健康的影响时，考虑饮食的重要性。
