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[背景]内分泌干扰物(EDCs)可能是泛自闭症障碍症候群的病因,但是要在内分泌干扰物的混合物中确定相关的化学物颇为困难。[目的]确定与自闭症行为相关的妊娠期EDC暴露。[方法]测定俄亥俄州辛辛那提市进行的健康结局与环境措施(Health Outcomes and Measures of the Environment,HOME)研究中175名孕妇的血液或尿液样本中8种邻苯二甲酸酯代谢物、双酚A、25种多氯联苯(PCBs)、6种有机氯杀虫剂、8种溴化阻燃剂、以及4种全氟烷基物质的浓度。在其儿童4岁和5岁时,由母亲完成社会反应量表(SRS)——这是一个针对自闭症行为的测量量表。采用两阶段分层分析,探讨调整混杂因素后,52种内分泌干扰物与SRS得分之间的相关性,以解释相互关联的EDCs的重复测量以及混杂影响。[结果]大部分EDCs与可忽略不计的SRS得分绝对差(≤1.5)呈现相关性。多溴联苯醚-28(PBDE-28)(β=2.5;95%CI:-0.6~5.6)或反式九氯(β=4.1;95%CI:0.8~7.3)的血清浓度每增加一个2-SD,则与更多的自闭症行为相关。相对未检测到者而言,在那些检测到有PCB-178(β=-3.0;95%CI:-6.3~0.2)、β-六氯环己烷(β=-3.3;95%CI:-6.1~-0.5)和PBDE-85(β=-3.2;95%CI:-5.9~-0.5)的妇女所生的儿童中,自闭症行为较少。全氟辛酸(PFOA)浓度增加也与自闭症行为较少相关(β=-2.0;95%CI:-4.4~0.4)。[结论]在这个队列研究中,某些EDCs与自闭症行为,但研究样本量有限,从而无法排除那些无相关性的化学物。PFOA、β-六氯环己烷、PCB-178、PBDE-28、PBDE-85和反式九氯作为与儿童自闭症行为相关的因素,值得进行更仔细研究。
[Background] Endocrine Disruptors (EDCs) may be the cause of ASD syndromes, but it is difficult to identify relevant chemicals in mixtures of endocrine disruptors. [Objective] To determine the gestational EDC exposure associated with autism behavior. [Method] Eight phthalate metabolites in blood or urine samples from 175 pregnant women in the Health Outcomes and Measures of the Environment (HOME) study were determined in the Cincinnati, OH, Phenol A, 25 PCBs, 6 organochlorine pesticides, 8 brominated flame retardants, and 4 perfluoroalkyl groups. At the age of 4 and 5 years of age, the mother completed a Social Response Scale (SRS) - a measurement of autistic behavior. A two-stage stratified analysis was used to investigate the correlation between 52 endocrine disruptors and SRS scores after adjustment for confounders to account for repeated measures of interrelated EDCs as well as confounding effects. [Results] The majority of EDCs were correlated with negligible SRS scores (≤1.5). Serum concentrations of PBDE-28 (β = 2.5; 95% CI: -0.6 to 5.6) or trans-nonachiorchloride (β = 4.1; 95% CI: 0.8 to 7.3) , Is associated with more autistic behavior. Relative to undetectable ones, those with PCB-178 (β = -3.0; 95% CI: -6.3 to 0.2), β-HCH Children born to women with PBDE-85 (β = -3.2; 95% CI: -5.9 to -0.5) had less autistic behavior. Increased concentrations of perfluorooctanoic acid (PFOA) also correlated with less autistic behavior (β = -2.0; 95% CI: -4.4 to 0.4). [Conclusions] In this cohort study, some EDCs behave in autism spectrum, but the sample size of the study is limited and thus can not rule out those unrelated chemicals. PFOA, beta-HCH, PCB-178, PBDE-28, PBDE-85 and trans-nonachlorophor, which are factors associated with autistic behavior in children, merit further study.