玉米赤霉烯酮污染与女童性早熟的相关性  

Correlation of zearalenone pollution with precocious puberty girls

作　　者：顾威[1] 沈卫星[2] 石星[1] 周巧利[1] 

机构地区：[1]南京医科大学附属南京儿童医院内分泌科,210008 [2]南京中医药大学第一临床医学院

出　　处：《中华实用儿科临床杂志》2014年第12期923-926,共4页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的观察玉米赤霉烯酮（ZEA）与女童性早熟发病的相关性。方法取71例性早熟女童及50例健康女童外周静脉血血清，以高效液相色谱仪检测ZEA水平，结合研究对象的骨龄、体质量指数（BMI）、子宫与卵巢体积、雌二醇（E2）、促黄体生成素（LH）和促卵泡刺激素（FSH）水平等实验室检查结果，以及研究对象的居住区域等要素，综合分析ZEA与性早熟的相关性。结果（1）71例性早熟患儿中，特发性中枢性性早熟患儿52例，乳房早发育患儿19例。（2）71例性早熟患儿中，51例患儿外周血清检出ZEA，未检出20例。（3）性早熟患儿外周血清ZEA质量浓度为（318±34）ng／g，显著高于健康对照组儿童[（143±35）ng／L]，差异有统计学意义（P=0．002）；而在特发性中枢性性早熟组与乳房早发育组间外周血清ZEA水平比较差异无统计学意义（P=0．326）。（4）性早熟儿童中，ZEA检出组患儿的子宫体积为（2．972±0．180）cm^3，显著大于ZEA未检出组患儿的子宫体积（1．975±0．150）cm^3，差异有统计学意义（P=0．01）；但ZEA检出组中患儿BMI超重率仅为31．4％（16／51例），显著低于ZEA未检出组中BMI超重率[65．0％（13／20例）]，差异有统计学意义（P=0．01）；乳房直径、骨龄与实际年龄差、E2、LH及FSH的峰值均呈现出ZEA检出组高于未检出组的趋势，但组间比较差异均无统计学意义（P均〉0．05）。（5）南京城区患儿的外周血清ZEA检出率为53．3％（16／30例），显著低于南京郊区的患儿的检出率[82．9％（34／41例）]，二者比较差异有统计学意义（P=0．007）。结论ZEA污染与女童性早熟的发生存在相关性，可能是引起女童性早熟的原因之一，应予以重视。Objective To explore the relationship of zearalenone （ZEA） and precocious puberty in girls. Methods The peripheral serums from 71 cases of precocious puberty girls and 50 cases of healthy girls were collected respectively and concentrations of ZEA were detected by high performance liquid chromatography. Bone age, body mass index （BMI） , volume of uterus and ovaries, concentrations of estradiol （ E2 ）, luteinizing hormone （LH） and folliclestimulating hormone （FSH） were detected, and the residence of each subject was recorded as well. Results （ 1 ） In 71 patients ,52 patients were diagnosed as idiopathic central precocious puberty, others were diagnosed as premature thelarehe. （2） In 71 patients, serum ZEA was detected from 51 patients, and undetected in 20 patients. （ 3 ） Concentration of ZEA in precocious puberty girls [ （318 ±34） ng/L ]was significantly increased than that in healthy girls [ （143 ±35） ng/L,P=0. 0025 ,but no distinct difference existed between ICPP group and PT group（P =0. 326）. （4）Compared with uterus volume of ZEA in the undetected patients （ 1. 975 ±0. 150） cm3 ,the uterus volume of ZEA detected patients （2. 972 ± 0. 180） cm3 , which was significantly enlarged, there was significant difference （ P = 0.01 ） ; Percentage of overweight girls in ZEA detected patients （31.4% , 16/51 cases） was lower than which in ZEA undetected patients （65.0% , 13/20 cases,P = 0.01 ） ; Although there was no statistical differences in the breast diameter, bone age, value of E2, LH and FSH between ZEA detected patients and undetected patients （ all P 〉 0.05 ） , but the increased tendency in ZEA detected patients existed. （5） ZEA in serum was detected in 53.3% （ 16/30 cases） patients living in the cities, and the rate was obviously lower than 82.9% of the patients （34/41 cases） living in the countryside,there was significant difference （ P = 0. 007 ）. Conclusions ZEA is correlated with precocious puberty in girls. ZEA pollut

关 键 词：性早熟 环境内分泌干扰因子 玉米赤霉烯酮 食品卫生 

分 类 号：R725.8[医药卫生—儿科]