不同孕期尿双酚A与孕妇甲状腺功能指标关联的初步研究  

Primary study on associations between urinary bisphenol A and indices of thyroid function among pregnant women during different trimesters of pregnancy

作　　者：何欣[1] 廖萍[1] 郑杨[1] 徐继英[1] 刘茶珍[1] 王文静[1] 

机构地区：[1]上海市疾病预防控制中心慢性非传染病与伤害防治所,上海200336

出　　处：《环境与职业医学》2017年第7期571-576,共6页Journal of Environmental and Occupational Medicine

基　　金：上海市卫生计生委面上项目(编号:201440617);第四轮公共卫生三年行动计划重点学科(编号:15GWZK0801)

摘　　要：[目的]探讨上海市不同孕期孕妇的双酚A(BPA)暴露现状及其与甲状腺功能指标的关联。[方法]收集上海市7个区共210名孕妇(孕早、中、晚期各三分之一)的尿样,采用固相萃取-高效液相色谱串联质谱法(HPLC-MS/MS)测定尿液总BPA质量浓度,并检测血清中5个甲状腺功能指标的水平:游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)。了解不同孕期孕妇的BPA暴露水平,采用Pearson相关及多元线性回归分析尿BPA与血清甲状腺功能指标的关联。[结果]被检孕妇的尿液BPA检出率为95.7%,质量浓度范围为未检出~11.99μg/L,整体水平呈偏态分布,经尿比重校正后BPA质量浓度M(P_(25),P_(75))为0.53(0.36,0.83)μg/L,孕早、中、晚期BPA质量浓度差异无统计学意义。通过Pearson相关分析发现,孕早、晚期经尿比重校正的尿BPA质量浓度与血清TGAb水平呈正相关(r=0.396,P=0.002;r=0.440,P=0.000)。调整年龄、孕中BMI、孕周这些协变量后,两者仍呈正相关(b=0.369,95%CI:0.206~0.532,P=0.000)。尿BPA与其他甲状腺功能指标无相关性。[结论]上海市孕妇普遍存在BPA暴露,孕期BPA暴露可能影响血清TGAb水平。[ Objective ] To assess the status of bisphenol A （BFA） exposure among pregnant women during different trimesters of pregnancy in Shanghai and the relationship between urinary BPA and indices of thyroid function. [ Mothods ] The study participants included 210 （70 for each trimester） pregnant women from seven districts of Shanghai, China. Maternal urinary total BPA was detected by solid phase extraction-high performance liquid chromatography tandem mass spectrometry （HPLC-MS/MS）. Serum indices of thyroid function including free triiodothyronine （FT3）, free thyroxine （FT4）, thyroid stimulating hormone （TSH）, thyroglobulin antibody （TGAb） and thyroid peroxidase antibody （TPOAb） were detected. Associations between urinary BPA and serum indices of thyroid function were estimated by Pearson correlation analysis and multiple linear regression analysis. [ Results ] The positive rate of urinary BPA of studied pregnant women was 95.7%. The mass concentrations of urinary BPA ranged from undetected to 11.99μg/L, and showed a skewed distribution. The median （P25, P75） of urinary BPA mass concentration after adjusting for urine specific gravity was 0.53 （0.36, 0.83） μg/L. There was no significant difference of urinary BPA mass concentrations among the pregnant women grouped by different trimesters of pregnancy. The results of Pearson correlation analysis showed that adjusted urinary BPA mass concentration was positively related to serum TGAb level in the first and third trimesters, respectively （r=0.396, P=0.002; r=-0.440, P=0.000）. After adjusting for age, body mass index in pregnancy, and gestational weeks,the results of multiple linear regression analysis suggested that they were still positively related （b=0.369, 95%CI： 0.206-0.532, P=0.000）. There was no significant association between urinary BPA and other selected thyroid function indices. [ Conclusion ] Shanghai pregnant women are exposed to BPA generally. BPA exposure during pregnancy may affect the level of serum T

关 键 词：双酚A 高效液相色谱串联质谱 甲状腺激素 甲状腺球蛋白抗体 

分 类 号：R173[医药卫生—妇幼卫生保健]