Department of Endocrinology, Shenzhen Children's Hospital, Shenzhen, Guangdong, China.
Department of Endocrinology, Fujian Children's Hospital, Fuzhou, Fujian, China.
Sci Rep. 2023 Apr 5;13(1):5560. doi: 10.1038/s41598-023-32768-1.
Phthalate esters (PAEs) may act as estrogen receptor agonists, and their relationship with precocious puberty is a global health concern. However, their role in isolated premature thelarche (IPT) progression remains unclear. We conducted a cohort study investigating the relationship between IPT progression and urinary PAE metabolites. Girls with IPT aged 6-8 years were regularly followed up every three months for one year. Clinical data and urine PAE metabolite levels were collected. Participants who progressed to central precocious puberty (CPP) or early puberty (EP) had significantly higher ovarian volume, breast Tanner stage, and levels of the creatinine-adjusted urinary secondary oxidized di-2-ethylhexyl phthalate (DEHP) metabolites (ΣDEHP). Breast Tanner stage (odds ratio [OR] = 7.041, p = 0.010), ovarian volume (OR = 3.603, p = 0.019), and ΣDEHP (OR = 1.020, p = 0.005) were independent risk factors for IPT progression. For each 10 µg/g/Cr increase in the urine level of ΣDEHP, the risk of progression from IPT to CPP/EP within one year increased by 20%. This study demonstrated that the breast Tanner stage, ovarian volume, and ΣDEHP in urine were independent risk factors for IPT progression, and ΣDEHP may be associated with the progression of IPT to CPP or EP.
邻苯二甲酸酯（PAEs）可能作为雌激素受体激动剂，其与性早熟的关系是全球关注的健康问题。然而，它们在单纯性早熟（IPT）进展中的作用尚不清楚。我们进行了一项队列研究，调查了 IPT 进展与尿中 PAE 代谢物之间的关系。年龄在 6-8 岁的 IPT 女孩每三个月定期随访一年。收集临床数据和尿 PAE 代谢物水平。进展为中枢性性早熟（CPP）或早期青春期（EP）的参与者卵巢体积、乳房 Tanner 分期和肌酐校正的尿中二乙基己基邻苯二甲酸酯（DEHP）代谢物（ΣDEHP）水平显著升高。乳房 Tanner 分期（比值比 [OR] = 7.041，p = 0.010）、卵巢体积（OR = 3.603，p = 0.019）和 ΣDEHP（OR = 1.020，p = 0.005）是 IPT 进展的独立危险因素。尿中 ΣDEHP 水平每增加 10μg/g/Cr，一年内从 IPT 进展为 CPP/EP 的风险增加 20%。本研究表明，乳房 Tanner 分期、卵巢体积和尿中 ΣDEHP 是 IPT 进展的独立危险因素，ΣDEHP 可能与 IPT 进展为 CPP 或 EP 有关。
