血液中酚类环境雌激素与子宫肌瘤关联性的病例对照研究-东南大学学报医学版

血液中酚类环境雌激素与子宫肌瘤关联性的病例对照研究

单位：1. 张家港市第一人民医院妇产科, 江苏张家港 215600;
2. 东南大学附属中大医院妇产科, 江苏南京 210009;
3. 南通市妇幼保健院, 江苏南通 226000;
4. 东南大学公共卫生学院, 江苏南京 210009;
5. 东南大学医学院, 江苏南京 210009

关键词：酚类环境雌激素双酚A 辛基酚壬基酚子宫肌瘤

分类号：R711.74

出版年·卷·期（页码）：2016·35·第四期（506-510）

摘要：

目的：通过对人体血浆中环境雌激素含量的检测，从临床流行病学角度探讨其与子宫肌瘤的关联性。方法：以张家港及南京地区汉族子宫肌瘤患者为病例组，非子宫肌瘤者为对照组，进行一般人口学调查，采集血液标本，应用高效液相串联质谱法（HPLC-MS）对血浆中双酚A（BPA）、辛基酚（OP）、壬基酚（NP）等酚类环境雌激素进行定量检测，分析比较两组间差异。结果：病例组214例，对照126例。两组间酚类环境雌激素暴露水平、准确检出人数及浓度分布范围等存在不同。Logistic分析发现，NP暴露水平（OR为1.059，95%CI为1.002～1.120）与子宫肌瘤发病率的关联性具有统计学意义（P<0.05）。结论：NP暴露可能是子宫肌瘤发病的危险因素，酚类环境雌激素的人体暴露水平与子宫肌瘤的发生存在一定的相关性。

Objective:To investigate whether environmental estrogens (EEs) of human plasma are associated with potential reduced risk of uterine fibroids. Methods:We collected plasma samples and investigated general demographic data from a case control study conducted in the No.1 People's Hospital of Zhangjiagang and Zhongda Hospital of Southeast University. High performance liquid chromatography tandem mass spectrometry (HPLC-MS) was used for quantitative detection of bisphenol A (BPA), octylphenol (OP), nonylphenol (NP) and other phenolic compounds in the blood. The differences between the case group and the control group were analyzed and compared. Results:We collected 214 cases of uterine myoma patients as case group, and 126 cases of non-uterine myoma subjects as control group. The results showed that there were some differences in the exposure to environmental estrogens, the exactly detected number of people and the range of concentration between the two groups. Logistic regression analysis showed that NP exposure (OR 1.059, 95%CI 1.002-1.120) was associated with the onset of uterine fibroids. Conclusion:NP exposure may be the risk factor of uterine fibroids. The exposure to environmental estrogen has certain correlation with the occurrence of uterine fibroids.

参考文献：

[1] DUHAN N,SIROHIWAL D.Uterine myomas revisited[J].Eur J Obstet Gynecol Reprod Biol,2010,152(2):119-125.
[2] ISLAM M S,PROTIC O,GIANNUBILO S R,et al.Uterine leiomyoma:available medical treatments and new possible therapeutic options[J].J Clin Endocrinol Metab,2013,98(3):921-934.
[3] CALAFAT A M,YE X,WONG L Y,et al.Exposure of the U.S.population to bisphenol A and 4-tertiary-octylphenol:2003-2004[J].Environ Health Perspect,2008,116(1):39-44.
[4] MARUO T,OHARA N,WANG J,et al.Sex steroidal regulation of uterine leiomyoma growth and apoptosis[J].Hum Reprod Update,2004,10(3):207-220.
[5] DEKANT W,VOLKEL W.Human exposure to bisphenol A by biomonitoring:methods,results and assessment of environmental exposures[J].Toxicol Appl Pharmacol,2008,228(1):114-134.
[6] KAWAGUCHI M,SAKUI N,OKANOUCHI N,et al.Stir bar sorptive extraction with in situ derivatization and thermal desorption-gas chromatography-mass spectrometry for measurement of phenolic xenoestrogens in human urine samples[J].J Chromatogr B Analyt Technol Biomed Life Sci,2005,820(1):49-57.
[7] CALAFAT A M,KUKLENYIK Z,REIDY J A,et al.Urinary concentrations of bisphenol A and 4-nonylphenol in a human reference population[J].Environ Health Perspect,2005,113(4):391-395.
[8] YE X,KUKLENYIK Z,NEEDHAM L L,et al.Automated on-line column-switching HPLC-MS/MS method with peak focusing for the determination of nine environmental phenols in urine[J].Anal Chem,2005,77(16):5407-5413.
[9] KAWAGUCHI M,ITO R,HAYATSU Y,et al.Stir bar sorptive extraction with in situ de-conjugation and thermal desorption gas chromatography-mass spectrometry for measurement of 4-nonylphenol glucuronide in human urine sample[J].J Pharm Biomed Anal,2006,40(1):82-87.
[10] KUKLENYIK Z,EKONG J,CUTCHINS C D,et al.Simultaneous measurement of urinary bisphenol A and alkylphenols by automated solid-phase extractive derivatization gas chromatography/mass spectrometry[J].Anal Chem,2003,75(24):6820-6825.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录