Department of Pediatrics, CHA Ilsan Medical Center, CHA University School of Medicine, Goyang, Korea.
Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
Eur J Pediatr. 2024 Apr;183(4):1675-1682. doi: 10.1007/s00431-023-05416-z. Epub 2024 Jan 11.
Antiandrogenic effect of phthalates have been reported; however, results regarding the effect of phthalate exposure in pubertal children have been inconsistent. We aimed to investigate the relationship between phthalate exposure and pubertal development, especially whether high molecular weight phthalates (HMWP) and low molecular weight phthalates (LMWP) are differently associated in boys and girls. Urinary phthalate metabolites (4 HMWPs and 3 LMWPs) in Korean children (236 boys and 202 girls, aged 10 to 12 years) were measured. The association between phthalate levels and pubertal development (pubertal stages self-reported by parents and sex steroid levels) was analyzed by generalized linear regression after adjusting for age, body mass index z score, and premature birth and/or low birth weight. Both the highest quartile of HMWP (Q4 vs Q1, adjusted odds ratio [OR], 0.238; 95% confidence interval [CI], 0.090-0.627; p = 0.004) and LMWP (Q4 vs Q1, adjusted OR, 0.373; 95% CI, 0.151-0.918; p = 0.032) were inversely associated with pubertal stages in boys, whereas the highest quartile of LMWP (Q4 vs Q1, adjusted OR, 2.431; 95% CI, 1.024-5.768; p = 0.044) was significantly related to advanced pubertal stages in girls. Testosterone levels in boys were significantly lower at the highest quartile of HMWP (adjusted β = - 0.251; 95% CI, - 0.476 to - 0.027; p = 0.028). However, in girls, we could not find any significant relationship between HMWP or LMWP and estradiol levels.
Our results suggest that phthalate exposure, especially exposure to the HMWP, may have inverse association with male pubertal development. Further investigation is required to verify the relationship of phthalate exposure and pubertal development in girls.
• Exposure to phthalates may have antiandrogenic effects. • Studies on the association between phthalates and pubertal development have yielded inconsistent results.
• Phthalate levels were inversely associated with self-reported pubertal stages in boys. • Exposure to phthalates might have a negative influence on male pubertal development.
探讨邻苯二甲酸酯（PA）暴露与青春期发育的关系，特别是高分子量邻苯二甲酸酯（HMWP）和低分子量邻苯二甲酸酯（LMWP）在男孩和女孩中是否存在不同的相关性。
我们测量了韩国儿童（236 名男孩和 202 名女孩，年龄 10 至 12 岁）的尿液中邻苯二甲酸代谢物（4 种 HMWP 和 3 种 LMWP）。在调整年龄、体重指数 z 分数、早产和/或低出生体重后，采用广义线性回归分析邻苯二甲酸水平与青春期发育（父母报告的青春期阶段和性激素水平）之间的关系。
男孩中 HMWP（Q4 与 Q1，调整后的比值比 [OR]，0.238；95%置信区间 [CI]，0.090-0.627；p=0.004）和 LMWP（Q4 与 Q1，调整后的 OR，0.373；95%CI，0.151-0.918；p=0.032）的最高四分位数与青春期阶段呈负相关，而女孩中 LMWP（Q4 与 Q1，调整后的 OR，2.431；95%CI，1.024-5.768；p=0.044）的最高四分位数与青春期阶段提前显著相关。男孩的 HMWP 最高四分位数时睾酮水平显著降低（调整后的β=-0.251；95%CI，-0.476 至-0.027；p=0.028）。然而，在女孩中，我们没有发现 HMWP 或 LMWP 与雌二醇水平之间存在任何显著关系。
我们的结果表明，邻苯二甲酸酯暴露，尤其是 HMWP 暴露，可能与男性青春期发育呈负相关。需要进一步的研究来验证邻苯二甲酸酯暴露与女孩青春期发育的关系。
• 邻苯二甲酸酯的暴露可能具有抗雄激素作用。• 关于邻苯二甲酸酯与青春期发育关系的研究结果不一致。
• HMWP 水平与男孩自述的青春期阶段呈负相关。• 邻苯二甲酸酯的暴露可能对男性青春期发育有负面影响。
