目的 分析学龄女童接触双酚A(BPA)与特发性中枢性性早熟(ICPP)之间的关系,为预防女童特发性性早熟提供依据。方法 选取2016年7月-2018年9月于扬州大学附属医院就诊且被诊断为ICPP的110例6～9岁女童为研究对象。根据女童的年龄和体重指数(BMI)相匹配,选取110名健康女童作为对照组。检测所有女童尿BPA浓度,并测试其与ICPP风险的关系。实验室检查包括血清雌二醇(E2)水平,基础和促性腺激素释放激素(GnRH)刺激的促黄体激素(LH),促卵泡激素(FSH)水平,骨龄(BA),子宫和卵巢大小。结果 ICPP组和对照组的尿BPA中位数浓度分别为6.25 μg/g Cr和1.07 μg/g Cr(Z=-3.845,P<0.001)。调整混杂因素后,与BPA浓度最低的女童相比,最高浓度女童ICPP风险是其9.07倍(OR=9.07,95％CI:2.82～29.14) 。在ICPP组中,尿BPA浓度与FSH基础水平(r=-0.235,P=0.005)或FSH峰值水平(r=-0.171,P=0.044)呈负相关。结论 BPA暴露与学龄女童ICPP风险升高有关,潜在的机制可能归因于相对较低的FSH水平。
Abstract
Objectives To analyze the relationship between exposure to bisphenol A (BPA) and idiopathic central precocious puberty (ICPP) in school-age girls,thus to provide a basis for preventing ICPP in girls. Methods Totally 110 school-age children diagnosed with ICPP in the Affiliated Hospital of Yangzhou University were enrolled in this study from July 2016 and September 2018,meanwhile 110 healthy girls were selected as controls matched with age and body mass index (BMI).Urinary BPA concentrations of all girls were tested and its association with the risk of ICPP was analyzed.Laboratory examinations including serum estradiol (E2) level,basal and gonadotropin-releasing hormone (GnRH) stimulated luteinizing hormone(LH),and follicle-stimulating hormone (FSH) levels,bone age (BA),and uterine and ovarian sizes were conducted in ICPP girls. Results Median concentrations of urinary BPA in ICPP group and control group were 6.25 μg/g Cr and 1.07 μg/g Cr,respectively (Z=-3.845,P＜0.001).After adjustment for confounders,the risk of ICCP in girls with highest concentrations of BPA was 9.07 times higher than those with the lowest concentrations of BPA(OR=9.07,95%CI:2.82-29.14).Moreover,negative correlations were found between urinary BPA concentrations and basal FSH level (r=-0.235,P=0.005) or peak FSH level (r=-0.171,P=0.044) in girls with ICCP. Conclusion BPA exposure is associated with an increasing risk of ICPP in school-age girls,and the potential mechanism may be attributed to the relatively low level of FSH.
关键词
尿双酚A /
特发性中枢性性早熟 /
女童
Key words
urine bisphenol A /
idiopathic central precocious puberty /
school-age girls
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