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[背景]子宫内膜异位症是一种雌激素依赖性疾病。具有激素特性的持久性环境化学物,例如有机氯杀虫剂(OCPs),可能会影响子宫内膜异位症的风险。[目的]探讨子宫内膜异位症的风险与环境OCPs暴露之间的相关性。[方法]数据来自妇女子宫内膜异位症风险(WREN)研究,这是一项以人群为基础的子宫内膜异位症的病例-对照研究,参加者为华盛顿州西部一个大型医疗保健系统中18~49岁的女性。测定1996—2001年间首次诊断、并经手术证实的子宫内膜异位症患者(n=248)以及以人群为基础的对照者(n=538)的血清OCP浓度。采用非条件logistic回归分析估计比值比(OR)和95%CI,以年龄、参考年份、血清脂质、受教育程度、种族/民族、吸烟和酒精摄入量进行校正。[结果]子宫内膜异位症的风险增加与血清β-六氯环己烷(HCH)(第三与最低四分位数范围相比:OR=1.7;95%CI:1.0~2.8;最高与最低四分位数范围相比:OR=1.3;95%CI:0.8~2.4)和灭蚁灵(最高与最低组相比:OR=1.5;95%CI:1.0~2.2)的浓度相关。当分析限定于卵巢子宫内膜异位症病例时,血清β-HCH浓度与子宫内膜异位症之间的相关性更强(第三与最低四分位数范围相比:OR=2.5;95%CI:1.5~5.2;最高与最低四分位数范围相比:OR=2.5;95%CI:1.1~5.3)。[结论]在这个以美国太平洋西北地区大型医疗保健系统的妇女为对象的对照-病例研究中,β-HCH和灭蚁灵的血清浓度均与子宫内膜异位症呈正相关。有机氯杀虫剂在环境中持久存在,这类杀虫剂过去曾经在美国广泛使用,目前或仍在其他国家使用,它们可能会影响育龄期妇女的健康。
[Background] Endometriosis is an estrogen-dependent disease. Persistent environmental chemicals with hormonal properties, such as organochlorine pesticides (OCPs), may affect the risk of endometriosis. [Objective] To explore the correlation between the risk of endometriosis and environmental OCPs exposure. METHODS: Data from the Women with Endometriosis Risk (WREN) Study, a case-control study of population-based endometriosis, was conducted by a large healthcare system in Western Washington State 18 to 49 years old women. Serum OCP concentrations were determined in patients with endometriosis (n = 248) who were first diagnosed and surgically confirmed during 1996-2001, and in population-based controls (n = 538). Non-conditional logistic regression analysis was used to estimate the odds ratio (OR) and 95% CI, adjusted for age, reference year, serum lipid, education, race / ethnicity, smoking and alcohol intake. [Results] The increased risk of endometriosis correlated with serum beta-HCH (third and lowest quartile: OR = 1.7; 95% CI: 1.0-2.8; highest OR = 1.3; 95% CI: 0.8 to 2.4) was associated with the concentration of mirex (highest versus lowest group: OR = 1.5; 95% CI: 1.0 to 2.2) compared with the lowest quartile range: OR = 1.3; When the analysis was limited to cases of ovarian endometriosis, the correlation between serum beta-HCH concentrations and endometriosis was stronger (third compared to the lowest quartile range: OR = 2.5; 95% CI: 1.5-5.2; highest versus lowest quartile range: OR = 2.5; 95% CI: 1.1-5.3). [Conclusions] In this case-control study of women in the large healthcare system in the Pacific Northwest of the United States, the serum concentrations of β-HCH and mirex were positively correlated with endometriosis. Organochlorine pesticides persist in the environment. These pesticides, which were used in the United States in the past and are currently used or used in other countries, may affect the health of women of childbearing age.