健康成年人群尿中对硝基酚水平对甲状腺功能的影响——基于美国NHANES数据库  

Effect of para-nitrophenol concentration in urine of healthy adults on thyroid function based on US NHANES

作　　者：史书晓 张妍[1] 肖萍[2] 田英[1] SHI Shuxiao;ZHANG Yan;XIAO Ping;TIAN Ying(Department of Environmental Health,School of Public Health,Shanghai Jiao Tong University,Shanghai 200025,China;Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China)

机构地区：[1]上海交通大学公共卫生学院环境与健康系,上海200025 [2]上海市疾病预防控制中心,上海200336

出　　处：《环境与职业医学》2021年第12期1350-1355,共6页Journal of Environmental and Occupational Medicine

基　　金：上海市公共卫生体系建设三年行动计划重点学科建设(GWV-10.1-XK11);上海交通大学多学科交叉项目(YG2019ZDA29)。

摘　　要：[背景]对硝基酚(PNP)是有机磷农药对硫磷和甲基对硫磷主要的特异性代谢产物。既往的研究发现对硫磷和甲基对硫磷可能具有内分泌干扰作用,但证据较为有限。[目的]探讨健康成年人群尿中PNP浓度与甲状腺功能的相关性及是否存在性别差异。[方法]基于2007—2008年美国国家营养与健康调查,将1071例同时具有尿PNP、血清甲状腺功能指标的20~64岁健康成年人纳入本研究。收集血清甲状腺刺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4)、总三碘甲状腺原氨酸(TT3)、总甲状腺激素(TT4)、甲状腺球蛋白(TG)、甲状腺球蛋白抗体(TG-Ab)数据以评估甲状腺功能。采用广义线性模型分析尿PNP与血清甲状腺功能指标的关系及剂量-反应关系,并分析性别差异。[结果]总人群中尿PNP的检出率为92.5%,肌酐校正后质量分数中位数为0.62μg·g^(-1)。男性和女性肌酐校正后尿PNP质量分数中位数分别是0.60、0.66μg·g^(-1)。总人群中主要甲状腺功能指标TSH、FT3、FT4、TT3、TT4的活性或质量浓度中位数分别为1500.00μIU·L^(-1)、3200.00 pg·L^(-1)、8.00 ng·L^(-1)、1140.00 ng·L^(-1)、76.00μg·L^(-1)。在总人群中,尿PNP每增加一个对数单位,血清FT3、FT4、TT3分别下降1050.00 pg·L^(-1)(b=-0.02,95%CI:-0.02~-0.01)、10.50 ng·L^(-1)(b=-0.02,95%CI:-0.03~-0.01)和10.50 ng·L^(-1)(b=-0.02,95%CI:-0.03~-0.01),且存在剂量-反应关系(均P_(趋势)<0.05)。性别分层后发现,在男性中,尿PNP每增加一个对数单位,血清TG-Ab水平增加1100.00 IU·L^(-1)(b=0.04,95%CI:0.00~0.08),血清FT3水平降低1020.00 pg·L^(-1)(b=-0.01,95%CI:-0.02~0.00),且存在剂量-反应关系(均P_(趋势)<0.05)。在女性中,尿PNP每增加一个对数单位,血清FT3下降1050.00 pg·L^(-1)(b=-0.02,95%CI:-0.03~-0.01),FT4下降10.50 ng·L^(-1)(b=-0.02,95%CI:-0.03~0.00),TT3下降10.70 ng·L^(-1)(b=-0.03,95%CI:-0.05~-0.01),TT4下降10.50μg·L^(-1)(b=-0.02,95%CI:-0.04~0.00[Background]Parathion and methyl parathion are typical organophosphorus insecticides and para-nitrophenol(PNP)is their main specific metabolite.Previous studies have shown that parathion and methyl parathion may play a role as endocrine disrupting chemicals,but the evidence is limited.[Objective]Our aim is to evaluate association between urinary PNP concentration and thyroid function among healthy adults and whether this association has gender differences.[Methods]The study was based on the 2007—2008 US National Health and Nutrition Examination Survey(NHANES).A total of 1071 subjects aging from 20 to 64 years with data on both urinary PNP and serum thyroid function indicators were finally enrolled.Thyroid function was evaluated by measuring serum thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4),total triiodothyronine(TT3),total thyroxine(TT4),thyroglobulin(TG),and thyroglobulin antibody(TG-Ab).A generalized linear model was used to analyze the relationship between urinary PNP and serum thyroid function indicators and the dose-response relationship.Gender differences were also explored.[Results]In the total population,the positive rate of PNP was 92.5%,and the median urinary PNP concentration adjusted for urinary creatinine was 0.62μg·g^(-1).The median creatinine-adjusted urinary PNP concentrations in the male and female populations were 0.60 and 0.66μg·g^(-1) respectively.The median activities or concentrations of serum thyroid function indicators TSH,FT3,FT4,TT3,and TT4 in the total population were 1500.00μIU·L^(-1),3200.00 pg·L^(-1),8.00 ng·L^(-1),1140.00 ng·L^(-1),and 76.00μg·L^(-1) respectively.In the total population,a logarithmic unit increase of urinary PNP was associated with 1050.00 pg·L^(-1) decrease in serum FT3 levels(b=-0.02,95%CI:-0.02--0.01),10.50 ng·L^(-1) decrease in FT4 levels(b=-0.02,95%CI:-0.03--0.01),and 10.50 ng·L^(-1) decrease in TT3 levels(b=-0.02,95%CI:-0.03--0.01),all in a dose-response manner(all P_(trend)<0.05).After sex stratification,for

关 键 词：对硫磷 甲基对硫磷 对硝基酚 甲状腺功能 

分 类 号：R12[医药卫生—环境卫生学]