目的 调查常见的环境激素在女童性早熟的发病机制中可能起到的作用,为阜阳地区儿童环境激素的暴露情况积累基础数据。方法 随机选取2020年10月—2021年4月在阜阳市人民医院生长发育专科门诊就诊的初诊为性早熟的女童,包括中枢性(CPP组)、外周性(PPP组)性早熟各30例,以及23例健康女童(正常对照组)作为研究对象,并就日常生活中可能接触到环境激素的途径填写相关内容调查问卷。应用超高效液相色谱串联质谱法测定3组女童尿液中15种环境激素的暴露水平,以及测定CPP组及PPP组女童的血清基础性激素、甲状腺激素水平,并完善性腺彩超等检查,进行3组女童尿液中环境激素暴露水平研究及相关性分析。结果 正常组、CPP及PPP 3组女童在使用塑料水杯方面、尿液中邻苯二甲酸单乙基己酯(MEHP)、邻苯二甲酸单丁基酯(MBP)的暴露水平分布差异具有统计学意义(χ2=8.111,F=3.741、5.672,P<0.05);CPP组与正常组女童尿MEHP、MBP暴露水平差异无统计学意义(P＞0.05),但PPP与CPP组、PPP与正常组女童的尿MEHP、MBP暴露水平分布差异有统计学意义(P＜0.05);PPP组内MEHP的分布水平与E2呈正相关关系(r=0.688,P＜0.05)。结论 频繁使用塑料制品可能促进性早熟的发病;安徽阜阳地区女童普遍受到环境激素的污染;邻苯二甲酸单乙基己酯、邻苯二甲酸单丁基酯的暴露可能在外周性性早熟的病因中发挥着重要的作用,并且干扰体内性激素的分泌。
Abstract
Objective To investigate the possible role of common environmental hormones in the pathogenesis mechanism of precocious puberty of girls, in order to provide data for further researches on children's exposure to environmental hormones in Fuyang area. Methods Precocious puberty girls visited in Fuyang People's Hospital were randomly selected into this study from October 2020 to April 2021, including central precocious puberty(CPP) group (n=30), peripheral precocious puberty (PPP) group (n=30).Meanwhile, 23 cases healthy girls were selected into the normal control group. A questionnaire survey was conducted on the related ways of environmental hormone exposure. The exposure levels of 15 environmental hormones in urine samples of girls among the three groups were determined by ULTRA performance liquid chromatography-tandem mass spectrometry, and the serum levels of basic sex hormones and thyroid hormones in CPP and PPP groups were determined. Then the exposure levels of environmental hormones in urine samples of girls were analyzed among the three groups. Results There were significance differences in the use of plastic cups,the levels of MEHP and MBP in urine samples among girls in the three groups (χ2=8.111, F=3.741,5.672, P＜0.05). There were no significant differences in the exposure levels of MEHP and MBP in urine between CPP group and normal group (P > 0.05), but significant differences existed in the distribution of exposure levels of MEHP and MBP in urine between PPP and CPP groups, PPP and normal groups (P <0.05). The distribution of MEHP in PPP groups was positively correlated with E2 level (r=0.688, P< 0.05). Conclusions Frequent use of plastic products may lead to the onset of precocious puberty. Girls in Fuyang are generally affected by environmental hormones. Exposure to MEHP and MBP may play an important role in the pathogenesis of PPP and interfere with the secretion of sex hormones of individuals.
关键词
外周性性早熟 /
环境激素 /
邻苯二甲酸单乙基己酯 /
邻苯二甲酸单丁基酯
Key words
peripheral precocity /
environmental hormone /
monoethyl hexyl phthalate /
mono-butyl phthalate
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基金
2020年阜阳市自筹经费科技项目(FK202081037)
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