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邻苯二甲酸酯对生育力的影响男女有别

Phthalate effect on fecundity varies according to gender
来源:爱思唯尔 2013-10-17 11:22点击次数:431发表评论

波士顿——据国际生殖协会联盟(IFFS)和美国生殖医学会(ASRM)联合会议上发布的一篇报告,男性暴露于环境中的邻苯二甲酸酯类化合物可能会使生育力降低20%,但女性暴露于类似化学物质却可能使生育力有所提高。


这项以备孕夫妇为对象的研究显示,暴露于邻苯二甲酸酯(一种邻苯二甲酸的酯类,广泛用于塑料、肥皂和化妆品)会使男性的生育力比值比(fecundity odds ratio,FOR)降到0.77~0.82,这意味着将需要更长的时间才能使配偶怀孕。相比而言,暴露于邻苯二甲酸酯的女性的生育力比值比则为1.09~1.20,这表示生育力有提高。然而,暴露于BPA(双酚基丙烷,一种仿雌激素塑化剂)与男、女性生育力均无关联。


上述发现表明了在判断生育问题时对配偶双方均进行评估的重要性。“如果报告作者们仅检查女性,会认为邻苯二甲酸酯增强了生育力;而如果仅观察男性,则会认为邻苯二甲酸酯降低了生育力。”


Michael S. Bloom博士


报告者为纽约州立大学奥尔巴尼分校环境健康科学系的助理教授Michael S. Bloom博士,他未参与此项研究,但代表Germaine Buck Louis博士展示了这些数据,后者是尤尼斯·肯尼迪·施莱佛美国国立儿童健康与人类发育研究所的流行病学家,因联邦政府关闭而未能出席会议。


之前的研究已经显示,多氯联苯(PCB)和全氟辛烷磺酰胺(PFOSA)这类持久性环境化学物质与夫妻生育力降低有关,也是以备孕时间较长来衡量的。尽管BPA和邻苯二甲酸酯这样的非持久化学物质存在于从婴儿奶瓶到洗发液等各种用品中,但人们仍未就其对人类生育力的影响进行广泛调查。不过,最近得到的证据表明BPA与男性精液质量下降及激素水平异常有关联,同时也与女性排卵和胚胎着床问题有关;邻苯二甲酸酯与到生育门诊就诊的男性及普通人精子受损和精子活动能力下降有关,同时也与女性妊娠丢失增长3倍有关。


在本研究中,研究者们观察了包括501对配偶的前瞻性队列,这些配偶已确定男女关系并停止避孕。女性配偶年龄介于18~44岁之间。基线时进行了面谈和体检,采集血样和尿样以评估环境暴露度,并要求配偶们每天记录性生活、生活方式、女性配偶月经和验孕结果的日记。对这些配偶进行随访,直到其通过人绒毛膜促性腺激素(HCG)检查确定怀孕或在其经历了12个生育周期后仍未怀孕为止。


在对比年龄、体重指数、血清可替宁和肌酐水平、研究地点和结束避孕时长的多变量分析中,他们发现BPA与两性的生育力均无明显关联。相比而言,邻苯二甲酸单(3-羧基丙基)酯(mCPP)与女性1.20的FOR数值显著相关,邻苯二甲酸单(多辛基)酯(mOP)与男性1.09的FOR数值相关,三种邻苯二甲酸酯——邻苯二甲酸单甲基酯、邻苯二甲酸单乙二醇酯、邻苯二甲酸单苄基酯——分别与0.80、0.82和0.77的FOR数值相关。这些相关性均具有统计学意义。


研究者表示,尽管没有发现BPA与两性生育力的关联,但有迹象显示暴露于BPA可能对女性产生不利影响,如样本量较大,该相关性可能会具有统计学意义。


该研究得到尤尼斯·肯尼迪·施莱佛美国国立儿童健康与人类发育研究所(NICHD)内部研究计划的支持。Buck Louis博士是NICHD的研究员。Bloom博士报告称无相关利益冲突。


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By: NEIL OSTERWEIL, Internal Medicine News Digital Network


BOSTON – Men exposed to environmental phthalate compounds may have about a 20% reduction in fertility, but women exposed to similar chemicals may have an increase in fecundity, investigators reported at the conjoint meeting of the International Federation of Fertility Societies and the American Society for Reproductive Medicine.


A study of couples trying to conceive showed that for men, exposure to some phthalates – esters of phthalic acid used widely in plastics, soaps, and cosmetics – resulted in a fecundity odds ratio (FOR) ranging from 0.77 to 0.82, indicating that a longer than normal time would be required to achieve a pregnancy. In contrast, women exposed to phthalates had an FOR ranging from 1.09 to 1.20, indicating increased fertility.


The investigators found, however, no associations between exposure to bisphenol A (BPA), an estrogen-mimicking plasticizing compound, and fertility in either men or women.
 
The findings show the importance of assessing both partners when trying to determine the source of reproductive problems, said Michael S. Bloom, Ph.D., assistant professor of environmental health sciences at the University at Albany, The State University of New York.


"If the authors had just measured women, they would be thinking that phthalates enhanced fecundity, as measured by a shorter time to pregnancy; had only men been observed, they would be thinking that phthalates diminished fecundity, as measured by a longer time to pregnancy," said Dr. Bloom.


Dr. Bloom was not involved in the study, but he presented the data on behalf of Dr. Germaine Buck Louis, an epidemiologist at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, who was unable to attend due to the federal government shutdown.


Previous studies have shown that persistent environmental chemicals such as polychlorinated biphenyls (PCBs) and perfluorooctanesulfonamide (PFOSA) are associated with diminished fecundity in couples as measured by a longer time to pregnancy. Yet despite their presence in everything from baby bottles to shampoo, short-lived chemicals such as BPA and phthalates have not been widely investigated for their effects on human fertility, Dr. Bloom said.


Nonetheless, emerging evidence suggests that BPA is associated with decreased semen quality and hormonal abnormalities in men, and with ovulatory and embryo implantation problems in women. Similarly, phthalates have been associated with sperm damage and decreased sperm motility among men attending fertility clinics and in the general population, and with a threefold increase in pregnancy loss among women, he noted.


The investigators looked at a prospective cohort of 501 couples in committed relationships who were stopping contraception. The female partners ranged in age from 18 to 44 years. The authors conducted a baseline interview; conducted anthropometric assessments; collected blood and urine samples at baseline to assess environmental exposures; and asked the couples to keep a daily journal on sexual intercourse and lifestyles, the female partner’s menstruation, and pregnancy test results.


The couples were followed until they either achieved a pregnancy confirmed by a positive human chorionic gonadotropin (HCG) or had 12 reproductive cycles without a pregnancy.


In multivariate analyses controlling for age, body mass index, serum cotinine and creatinine levels, research site, and time off contraception, they found that BPA was not significantly associated with fecundity in either sex.


In contrast, mono-(3-carboxypropyl) phthalate (mCPP) was significantly associated) with an FOR of 1.20 in women, and mono-n-octyl phthalate (mOP) was associated with an FOR of 1.09.


Among men, three phthalates – monomethyl phthalate, monobutyl phthalate, and monobenzyl phthalate – were associated with respective FORs of 0.80, 0.82, and 0.77. All these associations were statistically significant.


Although the authors did not find an association between BPA and fecundity in either sex, there was a data signal that suggested a possible negative effect of BPA exposure in women, and that with a large sample size the association might be statistically significant, the investigators said.


The study was supported by the Intramural Research Program at the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Dr. Buck Louis is a senior investigator at the NICHD. Dr. Bloom reported having no relevant disclosures.
 


学科代码:妇产科学 泌尿外科学 职业病与环境医学   关键词:邻苯二甲酸酯 生育力
来源: 爱思唯尔
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