孕婦血清鄰苯二甲酸單酯水平與甲狀腺功能關(guān)聯(lián)研究
發(fā)布時(shí)間：2018-09-17 11:59
【摘要】：背景鄰苯二甲酸酯（PAEs）的大量使用，可通過消化道、呼吸道、皮膚等途徑進(jìn)入體內(nèi)，導(dǎo)致人體及動(dòng)物的廣泛暴露。孕婦作為易感人群，其體內(nèi)的暴露不僅會(huì)影響自身健康還會(huì)導(dǎo)致胎兒的宮內(nèi)暴露，產(chǎn)生生殖和發(fā)育的直接損害，新近的研究還發(fā)現(xiàn)PAEs對(duì)甲狀腺功能的干擾作用，提示孕期PAEs暴露潛在的胎兒神經(jīng)系統(tǒng)發(fā)育損害和出生后智力與行為損傷。然而，在我國(guó)目前關(guān)于大樣本的孕婦PAEs暴露對(duì)甲狀腺功能的研究缺乏。 目的描述安徽省馬鞍山市孕婦孕期血清鄰苯二甲酸單酯的一般水平及其隨孕周發(fā)生的變化，分析孕期母體血清鄰苯二甲酸單酯水平的影響因素，探討孕期母體鄰苯二甲酸單酯水平與甲狀腺功能之間的關(guān)聯(lián)，從而進(jìn)一步為人群隊(duì)列研究提供實(shí)驗(yàn)和理論基礎(chǔ)。 方法在中國(guó)安徽出生隊(duì)列（China-Anhui Birth Cohort Study，C-ABCS）的馬鞍山市樣本人群中選取1492名孕產(chǎn)婦進(jìn)行研究。該研究的現(xiàn)場(chǎng)調(diào)查于2008年10月－2010年12月進(jìn)行，孕婦報(bào)告了社會(huì)人口統(tǒng)計(jì)學(xué)資料；妊娠史和既往疾病史；孕早期職業(yè)與生活環(huán)境以及生活方式等信息。檢驗(yàn)科的專業(yè)人員采集孕婦空腹外周靜脈血樣本。該研究的實(shí)驗(yàn)室檢測(cè)于2011年12月－2013年08月進(jìn)行，用固相萃�。咝б合啻�(lián)質(zhì)譜法（HPLC-MS）測(cè)定孕婦血清中的鄰苯二甲酸單乙酯（MEP），鄰苯二甲酸單丁酯（MBP）和鄰苯二甲酸單（2-乙基己基）酯（MEHP）的水平，評(píng)估其暴露特點(diǎn)及相應(yīng)變化。使用2檢驗(yàn)和多因素Logistic回歸分析安徽省孕婦鄰苯二甲酸單酯暴露的影響因素。Pearson相關(guān)和多元線性回歸模型用于分析鄰苯二甲酸單酯與甲狀腺功能的關(guān)聯(lián)。 結(jié)果MEP、MBP和MEHP的檢出率分別為86.7%、99.8%和100.0%，其中位數(shù)濃度分別為0.16ng/mL，5.97ng/mL和5.94ng/mL。多因素Logistic回歸結(jié)果顯示孕期高M(jìn)EP水平的影響因素為孕5～8周；高M(jìn)BP水平的影響因素為孕5～8周，本科以上教育程度，流產(chǎn)史，，婦科感染性疾病史和孕前半年滅蚊劑的使用史；高M(jìn)EHP水平的影響因素為孕5～8周，孕婦年齡30歲以上，城鎮(zhèn)居住地，孕前滅蚊劑的使用史。孕5～8周時(shí)，孕婦血清中MEP、MBP和MEHP的中位數(shù)分別為0.19、6.55和8.70ng/mL，MEP分別與MBP和MEHP呈正相關(guān)（r＝0.20，P0.001；r＝0.28，P＜0.001），MBP與MEHP呈正相關(guān)（r＝0.35，P＜0.001）；孕9～12周時(shí)，孕婦血清中MEP、MBP和MEHP的中位數(shù)分別為0.15、5.75和5.94ng/mL，MEP分別與MBP和MEHP呈正相關(guān)（r＝0.12，P＜0.01；r＝0.14，P＜0.001），MBP與MEHP呈正相關(guān)（r＝0.26，P＜0.001）；孕≥13周時(shí)，孕婦血清中MEP、MBP和MEHP的中位數(shù)分別為0.17、5.90和5.11ng/mL，MEP與MBP和MEHP呈正相關(guān)（r＝0.15，P＜0.001；r＝0.10，P＜0.05），MEHP與MBP呈正相關(guān)（r＝0.33，P＜0.001）。在不同孕周組中，MBP和MEHP均與總甲狀腺素（TT4）呈負(fù)相關(guān)，相關(guān)具有顯著統(tǒng)計(jì)學(xué)意義。多元線性回歸模型中，控制潛在影響因素后，孕5～8周時(shí)，MBP與TT4的回歸系數(shù)為-0.020（95%CI：-0.043～0.002；P＝0.079），MEHP與TT4的回歸系數(shù)為-0.030（95%CI：-0.054～-0.005；P＜0.05）；孕周為9～12周時(shí)，MBP與TT4的回歸系數(shù)為-0.032（95%CI：-0.049～-0.014；P＜0.001），MEHP與TT4的回歸系數(shù)為-0.042（95%CI：-0.062～-0.022；P＜0.001）；孕周≥13周時(shí)，MBP與TT4的回歸系數(shù)為-0.026（95%CI：-0.045～-0.008；P＜0.01），MEHP與TT4的回歸系數(shù)為-0.044（95%CI：-0.066～-0.021；P＜0.001）。 結(jié)論孕期婦女已經(jīng)普遍暴露于鄰苯二甲酸單酯，孕周越大的孕婦，鄰苯二甲酸單酯水平越低。孕期不同的鄰苯二甲酸單酯暴露水平影響因素不同，需要關(guān)注不良妊娠史和家庭化學(xué)品的使用與PAEs的關(guān)系，教育準(zhǔn)備妊娠的婦女避免和減少塑料制品的使用。孕婦血清的鄰苯二甲酸單酯水平與母體TT4濃度呈負(fù)相關(guān)。本研究結(jié)果為PAEs類物質(zhì)的管理和其造成的效應(yīng)提供了基礎(chǔ)資料，但其具體的暴露途徑與劑量評(píng)估及其對(duì)甲狀腺功能干擾作用機(jī)制等，還需要多學(xué)科協(xié)作研究。
[Abstract]:Background Phthalate esters (PAEs) are widely used and can enter the body through the digestive tract, respiratory tract, skin and other channels, resulting in extensive exposure of human beings and animals. As a susceptible group, pregnant women exposed in vivo not only affect their own health, but also lead to fetal exposure in utero, resulting in direct damage to reproduction and development. Recent studies also It was found that PAEs interfered with thyroid function, suggesting that PAEs exposure during pregnancy may lead to potential fetal nervous system development impairment and postnatal intellectual and behavioral impairment.
Objective To describe the general level of serum monophthalate and its changes with gestational weeks in pregnant women in Maanshan City, Anhui Province, and to analyze the influencing factors of maternal serum monophthalate levels during pregnancy, and to explore the relationship between maternal monophthalate levels and thyroid function during pregnancy, so as to be a cohort study. Research provides experimental and theoretical basis.
Methods A total of 1 492 pregnant and lying-in women in Ma'anshan, Anhui Birth Cohort Study (C-ABCS) were selected for the study. Laboratory tests were carried out from December 2011 to August 2013 to determine monoethyl phthalate (MEP) and monobutyl phthalate (MBP) in maternal serum by solid phase extraction-high performance liquid chromatography-mass spectrometry (HPLC-MS). Pearson correlation and multivariate linear regression models were used to analyze the relationship between monophthalate and thyroid function.
Results The detection rates of MEP, MBP and MEHP were 86.7%, 99.8% and 100.0% respectively, and the median concentrations were 0.16 ng/mL, 5.97 ng/mL and 5.94 ng/mL, respectively. The influencing factors of high MEHP level were 5-8 weeks of gestation, age of pregnant women over 30 years old, residence in cities and towns, and use history of mosquito killers before pregnancy.The median of MEP, MBP and MEHP in serum of pregnant women were 0.19, 6.55 and 8.70 ng/mL at 5-8 weeks of gestation, and MEP was positively correlated with MBP and MEHP respectively (r = 0.20, P 0.001). Medians of serum MEP, MBP and MEHP were 0.15, 5.75 and 5.94 ng/mL at 9-12 weeks gestation, and MEP was positively correlated with MBP and MEHP (r = 0.12, P < 0.01; r = 0.14, P < 0.001), and MBP was positively correlated with MEHP (r = 0.26, P < 0.001) at 13 weeks gestation. Median values of MEP, MBP and MEHP were 0.17, 5.90 and 5.11 ng/mL, respectively. MEP was positively correlated with MBP and MEHP (r = 0.15, P < 0.001; r = 0.10, P < 0.05), and MEHP was positively correlated with MBP (r = 0.33, P < 0.001). MBP and MEHP were negatively correlated with total thyroid hormone (TT4) in different gestational weeks, with significant correlation. In the model, the regression coefficients of MBP and TT4 were - 0.020 (95% CI: - 0.043 - 0.002; P = 0.079) and - 0.030 (95% CI: - 0.054 - 0.005; P < 0.05) at 5 to 8 weeks of gestation and - 0.032 (95% CI: - 0.049 - 0.014; P The regression coefficients of MBP and TT4 were - 0.026 (95% CI: - 0.045 ~ - 0.008; P < 0.01) and - 0.044 (95% CI: - 0.066 ~ - 0.021; P
Conclusion Pregnant women have been generally exposed to monophthalate, the greater the gestational age, the lower the level of monophthalate. Different exposure levels of monophthalate during pregnancy have different influencing factors. It is necessary to pay attention to the relationship between adverse pregnancy history and the use of family chemicals and PAEs. The results of this study provide basic information for the management of PAEs and their effects, but the specific exposure pathway and dose assessment and its mechanism of thyroid function disturbance need to be studied by multi-disciplinary collaboration.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R714.256
本文編號(hào)：2245843
[Abstract]:Background Phthalate esters (PAEs) are widely used and can enter the body through the digestive tract, respiratory tract, skin and other channels, resulting in extensive exposure of human beings and animals. As a susceptible group, pregnant women exposed in vivo not only affect their own health, but also lead to fetal exposure in utero, resulting in direct damage to reproduction and development. Recent studies also It was found that PAEs interfered with thyroid function, suggesting that PAEs exposure during pregnancy may lead to potential fetal nervous system development impairment and postnatal intellectual and behavioral impairment.
Objective To describe the general level of serum monophthalate and its changes with gestational weeks in pregnant women in Maanshan City, Anhui Province, and to analyze the influencing factors of maternal serum monophthalate levels during pregnancy, and to explore the relationship between maternal monophthalate levels and thyroid function during pregnancy, so as to be a cohort study. Research provides experimental and theoretical basis.
Methods A total of 1 492 pregnant and lying-in women in Ma'anshan, Anhui Birth Cohort Study (C-ABCS) were selected for the study. Laboratory tests were carried out from December 2011 to August 2013 to determine monoethyl phthalate (MEP) and monobutyl phthalate (MBP) in maternal serum by solid phase extraction-high performance liquid chromatography-mass spectrometry (HPLC-MS). Pearson correlation and multivariate linear regression models were used to analyze the relationship between monophthalate and thyroid function.
Results The detection rates of MEP, MBP and MEHP were 86.7%, 99.8% and 100.0% respectively, and the median concentrations were 0.16 ng/mL, 5.97 ng/mL and 5.94 ng/mL, respectively. The influencing factors of high MEHP level were 5-8 weeks of gestation, age of pregnant women over 30 years old, residence in cities and towns, and use history of mosquito killers before pregnancy.The median of MEP, MBP and MEHP in serum of pregnant women were 0.19, 6.55 and 8.70 ng/mL at 5-8 weeks of gestation, and MEP was positively correlated with MBP and MEHP respectively (r = 0.20, P 0.001). Medians of serum MEP, MBP and MEHP were 0.15, 5.75 and 5.94 ng/mL at 9-12 weeks gestation, and MEP was positively correlated with MBP and MEHP (r = 0.12, P < 0.01; r = 0.14, P < 0.001), and MBP was positively correlated with MEHP (r = 0.26, P < 0.001) at 13 weeks gestation. Median values of MEP, MBP and MEHP were 0.17, 5.90 and 5.11 ng/mL, respectively. MEP was positively correlated with MBP and MEHP (r = 0.15, P < 0.001; r = 0.10, P < 0.05), and MEHP was positively correlated with MBP (r = 0.33, P < 0.001). MBP and MEHP were negatively correlated with total thyroid hormone (TT4) in different gestational weeks, with significant correlation. In the model, the regression coefficients of MBP and TT4 were - 0.020 (95% CI: - 0.043 - 0.002; P = 0.079) and - 0.030 (95% CI: - 0.054 - 0.005; P < 0.05) at 5 to 8 weeks of gestation and - 0.032 (95% CI: - 0.049 - 0.014; P The regression coefficients of MBP and TT4 were - 0.026 (95% CI: - 0.045 ~ - 0.008; P < 0.01) and - 0.044 (95% CI: - 0.066 ~ - 0.021; P
Conclusion Pregnant women have been generally exposed to monophthalate, the greater the gestational age, the lower the level of monophthalate. Different exposure levels of monophthalate during pregnancy have different influencing factors. It is necessary to pay attention to the relationship between adverse pregnancy history and the use of family chemicals and PAEs. The results of this study provide basic information for the management of PAEs and their effects, but the specific exposure pathway and dose assessment and its mechanism of thyroid function disturbance need to be studied by multi-disciplinary collaboration.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R714.256
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 俞洋;郝加虎;黃錕;蘇普玉;許韶君;童世廬;陶芳標(biāo);;安徽省婦女孕前家用化學(xué)品使用情況及影響因素[J];環(huán)境與健康雜志;2013年09期
本文編號(hào)：2245843
本文鏈接：http://sikaile.net/yixuelunwen/fuchankeerkelunwen/2245843.html
最近更新
教材專著
