McClam Maria, Liu Jihong, Fan Yihan, Zhan Tingjie, Zhang Qiang, Porter Dwayne E, Scott Geoffrey I, Xiao Shuo
Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
Arch Public Health. 2023 Aug 25;81(1):161. doi: 10.1186/s13690-023-01172-6.
Cadmium (Cd), lead (Pb), and mercury (Hg) have been shown to exhibit endocrine disrupting properties. Their effects on women's reproductive health, however, remain elusive. Here, we investigated associations between blood concentrations of Pb, Cd, Hg, and their mixture and infertility and long-term amenorrhea in women aged 20-49 years using the US National Health and Nutrition Examination Survey (NHANES) 2013-2018 cross-sectional survey.
A total of 1,990 women were included for the analysis of infertility and 1,919 women for long-term amenorrhea. The methods of log-transformation and use of quartiles were used to analyze blood heavy metal concentrations. Statistical differences in the covariates between the outcome groups were evaluated using a chi-squared test for categorical variables and a t-test for continuous variables. Multiple logistic regression models were used to examine the associations.
The blood concentrations of Pb and heavy metal mixtures were significantly higher in ever-infertile women than pregnant women, but the concentrations of Cd and Hg were comparable. After full adjustment, multiple logistic regression analyses revealed a significant and dose-dependent positive association between blood Pb concentrations and women's historical infertility, a negative association between Cd and women's long-term amenorrhea, and no associations between Hg and heavy metal mixture and women's infertility or long-term amenorrhea.
Our study suggests that exposure to heavy metals exhibit differential associations with history of infertility and amenorrhea, and Pb may adversely impact women's reproduction and heighten the risks of infertility and long-term amenorrhea.
镉（Cd）、铅（Pb）和汞（Hg）已被证明具有内分泌干扰特性。然而，它们对女性生殖健康的影响仍不明确。在此，我们利用美国国家健康与营养检查调查（NHANES）2013 - 2018年横断面调查，研究了20 - 49岁女性血液中铅、镉、汞及其混合物的浓度与不孕不育和长期闭经之间的关联。
共有1990名女性纳入不孕不育分析，1919名女性纳入长期闭经分析。采用对数转换和四分位数方法分析血液重金属浓度。使用卡方检验分析分类变量结局组间协变量的统计差异，使用t检验分析连续变量的差异。采用多因素逻辑回归模型检验关联。
既往不孕女性的血液铅浓度和重金属混合物浓度显著高于孕妇，但镉和汞浓度相当。经过全面调整后，多因素逻辑回归分析显示血液铅浓度与女性既往不孕不育之间存在显著的剂量依赖性正相关，镉与女性长期闭经之间存在负相关，汞和重金属混合物与女性不孕不育或长期闭经之间无关联。
我们的研究表明，重金属暴露与不孕不育史和闭经存在不同的关联，铅可能对女性生殖产生不利影响，并增加不孕不育和长期闭经的风险。
