Li Xuanxuan, Xiao Changchun, Liu Jintao, Wei Ning, Song Jian, Yuan Jiajun, Liu Li, Song Rong, Yi Weizhuo, Pan Rubing, Cheng Jian, Wang Shusi, Su Hong
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China.
Center for Big Data and Population Health of IHM, Hefei, Anhui 230032, China.
Environ Health (Wash). 2024 Jul 5;2(11):750-765. doi: 10.1021/envhealth.4c00046. eCollection 2024 Nov 15.
Di(2-ethylhexyl) phthalate (DEHP), an environmental endocrine disruptor, has hormone-like activity and endocrine-disrupting effects. However, the types of reproductive hormones associated with DEHP vary across the studies. Thus, we conducted a systematic review and meta-analysis to pool existing epidemiological evidence. We searched three databases up to January 31, 2024, for eligible original studies to ultimately include 37 studies from eight countries with a total of 28 911 participants. DEHP exposure was evaluated with urinary metabolites. Since the main types, production sites, blood concentrations, and functions of reproductive hormones differ between men and women, we reported the combined effect values by gender. Subgroup analyses were conducted by age, subfertility status, and the national sociodemographic index (SDI) level. Furthermore, the effect of maternal exposure during pregnancy on children's reproductive hormone levels was analyzed separately. Overall, in general, in men, DEHP was positively correlated with sex hormone binding-globulin (SHBG) and adversely correlated with total testosterone (TT), free androgen index (FAI), and follicle-stimulating hormone (FSH). Results indicated that among men of reproductive age, DEHP exposure was associated with more significant hormonal suppression in infertile men compared with fertile men. Notably, age subgroup analysis among women revealed that postmenopausal women were more vulnerable to DEHP, which was related to lower TT and estradiol (E). However, this study did not observe a significant association between prenatal DEHP metabolites and reproductive hormone levels in children. Our research identifies the most susceptible hormones (androgen suppression) after DEHP exposure and suggests that infertile men and postmenopausal women are in great need of more attention as sensitive populations.
邻苯二甲酸二(2-乙基己基)酯(DEHP)是一种环境内分泌干扰物,具有类激素活性和内分泌干扰作用。然而,不同研究中与DEHP相关的生殖激素类型各不相同。因此,我们进行了一项系统综述和荟萃分析,以汇总现有的流行病学证据。我们检索了截至2024年1月31日的三个数据库,寻找符合条件的原始研究,最终纳入了来自八个国家的37项研究,共有28911名参与者。通过尿液代谢物评估DEHP暴露情况。由于男性和女性的生殖激素主要类型、产生部位、血液浓度和功能不同,我们按性别报告了合并效应值。按年龄、亚生育状态和国家社会人口指数(SDI)水平进行亚组分析。此外,还单独分析了孕期母亲暴露对儿童生殖激素水平的影响。总体而言,一般来说,在男性中,DEHP与性激素结合球蛋白(SHBG)呈正相关,与总睾酮(TT)、游离雄激素指数(FAI)和卵泡刺激素(FSH)呈负相关。结果表明,在育龄男性中,与生育男性相比,不育男性暴露于DEHP与更显著的激素抑制有关。值得注意的是,女性年龄亚组分析显示,绝经后女性更容易受到DEHP的影响,这与较低的TT和雌二醇(E)有关。然而,本研究未观察到产前DEHP代谢物与儿童生殖激素水平之间存在显著关联。我们的研究确定了DEHP暴露后最易受影响的激素(雄激素抑制),并表明不育男性和绝经后女性作为敏感人群急需更多关注。