State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 211166, Jiangsu, China; Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, China.
State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, Jiangsu, China.
Sci Total Environ. 2024 Jun 1;927:172185. doi: 10.1016/j.scitotenv.2024.172185. Epub 2024 Apr 2.
Phthalate exposure can adversely impact ovarian reserve, yet investigation on the influence of its alternative substance, the non-phthalate plasticizer diisononyl-cyclohexane-1,2-dicarboxylate (DINCH), on ovarian reserve is very sparce. We aimed to investigate the associations of phthalate and DINCH exposure as well as their combined mixture with ovarian reserve. This present study included 657 women seeking infertility care in Jiangsu, China (2015-2018). Urine samples during enrollment prior to infertility treatment were analyzed using high-performance liquid chromatography-isotope dilution tandem mass spectrometry (UPLC-MS/MS) to quantify 17 phthalate metabolites and 3 DINCH metabolites. Multivariate linear regression models, Poisson regression models and weighted quantile sum (WQS) regression were performed to access the associations of 17 urinary phthalate metabolites and 3 DINCH metabolites with ovarian reserve markers, including antral follicle count (AFC), anti-Mullerian hormone (AMH), and follicle-stimulating hormone (FSH). We found that the most conventional phthalates metabolites (DMP, DnBP, DiBP, DBP and DEHP) were inversely associated with AFC, and the DINCH metabolites were positively associated with serum FSH levels. The WQS index of phthalate and DINCH mixtures was inversely associated with AFC (% change = -8.56, 95 % CI: -12.63, -4.31) and positively associated with FSH levels (% change =7.71, 95 % CI: 0.21, 15.78). Our findings suggest that exposure to environmental levels of phthalate and DINCH mixtures is inversely associated with ovarian reserve.
邻苯二甲酸酯暴露会对卵巢储备产生不利影响，但关于其替代物质、非邻苯二甲酸酯增塑剂二异壬基环己烷-1,2-二羧酸酯（DINCH）对卵巢储备的影响的研究却非常有限。本研究旨在探讨邻苯二甲酸酯和 DINCH 暴露及其混合物与卵巢储备的关系。本研究纳入了 2015-2018 年在中国江苏寻求不孕治疗的 657 名女性。在接受不孕治疗前，通过高效液相色谱-同位素稀释串联质谱法（UPLC-MS/MS）分析尿液样本，以定量检测 17 种邻苯二甲酸代谢物和 3 种 DINCH 代谢物。采用多元线性回归模型、泊松回归模型和加权数量和（WQS）回归来评估 17 种尿液邻苯二甲酸代谢物和 3 种 DINCH 代谢物与卵巢储备标志物（包括窦卵泡计数（AFC）、抗苗勒管激素（AMH）和卵泡刺激素（FSH））之间的关联。结果发现，最常见的邻苯二甲酸酯代谢物（DMP、DnBP、DiBP、DBP 和 DEHP）与 AFC 呈负相关，而 DINCH 代谢物与血清 FSH 水平呈正相关。邻苯二甲酸酯和 DINCH 混合物的 WQS 指数与 AFC 呈负相关（%变化=-8.56，95%CI：-12.63，-4.31），与 FSH 水平呈正相关（%变化=7.71，95%CI：0.21，15.78）。研究结果表明，环境水平的邻苯二甲酸酯和 DINCH 混合物暴露与卵巢储备呈负相关。
