Association of urinary phthalate metabolites and polycystic ovary syndrome in women undergoing in vitro fertilization

IF 2.8 4区医学 Q2 REPRODUCTIVE BIOLOGY

Reproductive toxicology Pub Date : 2025-09-01 DOI:10.1016/j.reprotox.2025.109041

Wenjie Zhou , Shuifang Lei , Hong Lv , Yangqian Jiang , Tianyu Sun , Yanjie Zhang , Hongxia Ma , Jie Wu , Yuan Lin

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引用次数: 0

Abstract

Background/objectives

Phthalates are a group of ubiquitous environmental endocrine disruptors that can be detected in human body and exert adverse effects on reproductive health. We aimed to explore the correlation of phthalate exposure with polycystic ovary syndrome (PCOS).

Methods

We included 420 females who underwent assisted reproductive technology (ART) treatments between 2015 and 2018 in Jiangsu, China, comprising 94 PCOS cases and 326 controls. Seventeen phthalate metabolites and three metabolites of phthalate substitutes were measured in the urine before the ART treatment. Multiple logistic and linear regression models were performed to assess the relationships of phthalate exposure with PCOS and sex hormone levels, including luteinizing hormone (LH), estradiol (E₂), follicle-stimulating hormone (FSH), and mediation analysis was conducted to assess the mediating effect of sex hormones. Potential covariates in the regression models include age, area of residence, household income, education, body mass index (BMI), tobacco use and alcohol intake.

Results

We found that the concentration of di (2-ethylhexyl) phthalate (ΣDEHP) (aOR = 1.40, 95 % CI: 1.02–1.92, P = 0.039) was associated with higher odds of PCOS. Additionally, increased levels of ΣDEHP (β = 0.08, 95 % CI: 0.01–0.15, P = 0.021) and its metabolites were correlated with elevated LH concentrations. In the mediation analysis, elevated LH mediated 34.56 % of the association between ΣDEHP and PCOS, respectively.

Conclusion

Exposure to environmental levels of DEHP was associated with increased odds of PCOS, partially mediated by elevated LH levels.

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体外受精妇女尿邻苯二甲酸酯代谢物与多囊卵巢综合征的关系。

背景/目的：邻苯二甲酸酯是一组普遍存在的环境内分泌干扰物，可在人体中检测到，并对生殖健康产生不利影响。我们的目的是探讨邻苯二甲酸盐暴露与多囊卵巢综合征（PCOS）的关系。方法：我们纳入了2015年至2018年在中国江苏省接受辅助生殖技术（ART）治疗的420名女性，其中包括94例PCOS病例和326例对照。在ART治疗前测定了17种邻苯二甲酸酯代谢物和3种邻苯二甲酸酯代谢物。采用多元logistic和线性回归模型评估邻苯二甲酸盐暴露与PCOS及黄体生成素（LH）、雌二醇（E2）、促卵泡激素（FSH）水平的关系，并进行中介分析评估性激素的中介作用。回归模型中的潜在协变量包括年龄、居住地区、家庭收入、教育程度、身体质量指数（BMI）、吸烟和饮酒。结果：我们发现邻苯二甲酸二（2-乙基己基）酯浓度（ΣDEHP）（aOR = 1.40, 95% CI: 1.02 ~ 1.92, P = 0.039）与PCOS的高发生率相关。此外，ΣDEHP （β = 0.08, 95% CI: 0.01 ~ 0.15, P = 0.021）及其代谢物水平的升高与LH浓度升高相关。在中介分析中，LH升高分别介导了ΣDEHP与PCOS之间34.56%的关联。结论：暴露于环境水平的DEHP与PCOS的几率增加有关，部分是由LH水平升高介导的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Reproductive toxicology 生物-毒理学

CiteScore

6.50

自引率

3.00%

发文量

131

审稿时长

45 days

期刊介绍： Drawing from a large number of disciplines, Reproductive Toxicology publishes timely, original research on the influence of chemical and physical agents on reproduction. Written by and for obstetricians, pediatricians, embryologists, teratologists, geneticists, toxicologists, andrologists, and others interested in detecting potential reproductive hazards, the journal is a forum for communication among researchers and practitioners. Articles focus on the application of in vitro, animal and clinical research to the practice of clinical medicine. All aspects of reproduction are within the scope of Reproductive Toxicology, including the formation and maturation of male and female gametes, sexual function, the events surrounding the fusion of gametes and the development of the fertilized ovum, nourishment and transport of the conceptus within the genital tract, implantation, embryogenesis, intrauterine growth, placentation and placental function, parturition, lactation and neonatal survival. Adverse reproductive effects in males will be considered as significant as adverse effects occurring in females. To provide a balanced presentation of approaches, equal emphasis will be given to clinical and animal or in vitro work. Typical end points that will be studied by contributors include infertility, sexual dysfunction, spontaneous abortion, malformations, abnormal histogenesis, stillbirth, intrauterine growth retardation, prematurity, behavioral abnormalities, and perinatal mortality.