塑化剂DEHP暴露人群血清甲状腺激素水平变化的Meta分析  

Changes of serum thyroid hormone levels in DEHP exposure population:A Meta-analysis

作　　者：孙迪[1] 王琪[1] 陈怀基 许峰[1] 张月竹[1] 张天融 刘洪泊 叶琳[1] 

机构地区：[1]吉林大学公共卫生学院劳动卫生与环境卫生学教研室,吉林长春130021

出　　处：《吉林大学学报（医学版）》2017年第1期66-72,共7页Journal of Jilin University：Medicine Edition

基　　金：国家自然科学基金资助课题(81573184)

摘　　要：目的:系统评价塑化剂邻苯二甲酸二乙基己酯(DEHP)暴露人群血清甲状腺激素水平的变化,为探索甲状腺疾病的病因提供科学依据。方法:计算机检索PubMed、EMbase、中文期刊全文数据库(CNKI)、万方数据库和维普数据库,查找建库至2016年7月1日前国内外发表的人群DEHP暴露与血清甲状腺激素水平关系的全部中、英文文献。2位研究者按照纳入与排除标准筛选文献、提取资料后,采用RevMan 5.2软件进行Meta分析。结果:最终纳入文献7篇,均为英文文献,其中高质量文献1篇,中质量文献6篇,样本量共计5 692例。Meta分析,尿邻苯二甲酸单乙基己基酯(MEHP)水平每升高1μg·L^(-1),血清促甲状腺激素(TSH)水平降低10%(OR=0.10,95%CI:0.02~0.44,P=0.002),血清游离四碘甲状腺原氨酸(FT4)水平降低6%(OR=0.06,95%CI:0~0.81,P=0.03),血清四碘甲状腺原氨酸(T4)水平降低7%(OR=0.07,95%CI:0.01~0.39,P=0.002),血清三碘甲状腺原氨酸(T3)水平无明显变化(P=0.11)。结论:DEHP人群暴露水平增加可不同程度地降低血清甲状腺激素水平。Objective： To systematically evaluate the changes of serum thyroid hormone levels in di-2-ethylhexyl phthalate （DEHP） exposure population,and to provide a scientific evidence for the study on pathogenesis of thyroid disease.Methods： The studies about the association between DEHP exposure and thyroid hormone levels published with Chinese and English were electronically searched in PubMed,EMbase,CNKI database,WanFang database and VIP Chinese Journal Database up to July 1,2016. According to the inclusion and exclusion criteria,the data was extracted and screened by two researchers.The results of Meta-analysis were performed using RevMan 5.2 software.Results： Seven studies were finally screened,including one high-quality and six medium-quality studies.All studies were published with English,involving 5 692 samples.The results of Meta-analysis showed that the levels of serum TSH,FT4 and T4 were reduced respectively by 10% （OR=0.10,95%CI：0.02-0.44,P=0.002）,6% （OR=0.06,95%CI,0.00-0.81, P=0.03）,and 7% （OR=0.07,95%CI：0.01-0.39,P=0.002）,with the increasing of urine mono-2-ethylhexyl phthalate （MEHP） level with 1 μg·L-1, whereas the relation between DEHP and T3 had no statistical significance （P=0.11）.Conclusion： Human DEHP exposure can reduce the levels of thyroid hormones in different degrees.

关 键 词：甲状腺激素 邻苯二甲酸二乙基己酯 人群暴露 META分析 

分 类 号：R12[医药卫生—环境卫生学]