卵泡液中内分泌干扰化学物质对卵巢储备功能下降可能性的混合及单一效应：一项病例对照研究。

Mixed and single effects of endocrine disrupting chemicals in follicular fluid on likelihood of diminished ovarian reserve: A case-control study.

作者信息

Tian Tian, Hao Yongxiu, Wang Yuanyuan, Xu Xiaofei, Long Xiaoyu, Yan Liying, Zhao Yue, Qiao Jie

机构信息

Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, 100191, China; Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing, 100191, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, 100191, China.

出版信息

Chemosphere. 2023 Jul;330:138727. doi: 10.1016/j.chemosphere.2023.138727. Epub 2023 Apr 20.

DOI:10.1016/j.chemosphere.2023.138727

PMID:37086983

Abstract

Endocrine-disrupting chemicals (EDCs) are a group of the most widely spread pollutants. Their impacts on reproductive health have become public concerns. Diminished ovarian reserve (DOR) is a disorder of ovarian function. Associations between EDC and DOR have been inconsistent. Very little research investigated the joint effects of multiple EDCs. Here, we performed a case-control study among 64 DOR women and 86 controls. Twenty-one EDC chemicals were assessed in follicular fluid, including parabens, phenols, phthalates and poly-fluoroalkyl substances. Both mixed and single effects of EDCs on DOR were evaluated and validated with a Bayesian kernel machine and logistic regressions. We found that the likelihood of DOR significantly increased with rising levels of the 21-EDC mixture, with an odds ratio (OR) and 95% confidence interval (CI) of 2.12 (1.17-3.83) for the 75th percentile compared to its median level. The overall effect was higher than effects of each subgroup. BP4, MECPP, and PFHxA were driving the association to the mixture, and their single effects were validated, with individual ORs of 8.25 (95%CI:3.45-12.21), 1.92 (95%CI:1.02-4.09), and 1.84 (95%CI:1.08-3.86), respectively. In conclusion, we provided new pollutant markers for DOR and emphasized the importance of the effects of EDC mixtures on female reproductive health.

摘要

内分泌干扰化学物质（EDCs）是一类分布最为广泛的污染物。它们对生殖健康的影响已成为公众关注的问题。卵巢储备功能减退（DOR）是一种卵巢功能紊乱疾病。EDC与DOR之间的关联并不一致。很少有研究调查多种EDC的联合效应。在此，我们对64名DOR女性和86名对照者进行了一项病例对照研究。在卵泡液中评估了21种EDC化学物质，包括对羟基苯甲酸酯、酚类、邻苯二甲酸酯和多氟烷基物质。使用贝叶斯核机器和逻辑回归对EDC对DOR的混合效应和单一效应进行了评估和验证。我们发现，随着21种EDC混合物水平的升高，DOR的可能性显著增加，与其中位数水平相比，第75百分位数的优势比（OR）和95%置信区间（CI）为2.12（1.17 - 3.83）。总体效应高于每个亚组的效应。BP4、MECPP和PFHxA推动了混合物的这种关联，并且它们的单一效应得到了验证，各自的OR分别为8.25（95%CI：3.45 - 12.21）、1.92（95%CI：1.02 - 4.09）和1.84（95%CI：1.08 - 3.86）。总之，我们为DOR提供了新的污染物标志物，并强调了EDC混合物对女性生殖健康影响的重要性。