Correlation Analysis On Phthalates Exposure And Endometriosis

[Objective]①To investigate the information about the basic status, women’s health history, understandings and daily exposure to PAEs plasticizer of289female population (115endometriosis patients and174controls) through questionnaires;②To determine PAEs concentration in serum of310women (134cases and176controls) and to analyze the correlation between the PAEs levels in serum and related factors such as disease, sex hormone levels and daily exposure to PAEs;③To determine PAEs metabolites concentration in urine of291women (133cases and158controls) and to analyze the correlation between the PAEs metabolites levels in urine and related factors such as disease, sex hormone levels and daily exposure to PAEs;④To determine PAEs concentration in pathological tissue of130endometriosis patients and to analyze the correlation between the pathological tissue PAEs level and related factors such as sex hormone levels and daily exposure to PAEs.[Methods]①Collecting the information about the basic status, women’s health history, understandings and daily exposure to PAEs plasticizer of the research object through questionnaires;②Determining the PAEs in serum, in pathological tissue and the PAEs metabolites in urine by Gas Chromatograph (GC) and High Performance Liquid Chromatography (HPLC) with the pre-processor techniques of liquid phase extraction, solid phase extraction and neutral alumina column pre-purification;③Statistically analyzing the correlation between PAEs level of female population and related factors by SPSS13.0.[Results]①There was no statistical difference of age, BMI index, smoking, alcohol consumption, stress and rest situation between the case group and the control group (P>0.05); The case group had higher education level than the control group (P<0.01); The case group had a lager proportion of never childbearing, abortion history, taking contraceptives history, family history of gynecological diseases than the control group (P<0.05); There was no statistical difference of the daily exposure to PAEs between the case group and the control group (P>0.05); The female population either the control group or the case group knew little about the PAEs platicizer;②The positive ratio of serum DBP in the case group was98.5%, statistically higher than in the control group92.6%(P<0.05); The levels of serum DBP and DEHP in the case group were statistically higher than in the control group (0.304mg/L vs0.171mg/L,0.200mg/L vs0.163mg/L, P<0.01), after the correction of general linear models, the levels of serum DBP and DEHP were still statistically different between two groups (0.327mg/L vs0.167mg/L,0.192mg/L vs0.165mg/L, P<0.05); Serum DEP, DBP and DEHP concentration were statistically positive related (P<0.05); Statistical correlation was not found between serum PAEs concentration and sex hormone levels (P>0.05); Serum DEP level in the crowd of college or above was statistically higher than the crowd of high school or below (0.066mg/L vs0.051mg/L, P<0.05); Statistical correlation was not found between the levels of serum PAEs and related factors such as age, BMI, exposure factors to PAEs (P>0.05);③The levels of MMP, MEHP, MCMHP and∑DEHP in urine after creatinine correction in the case group were statistically higher than in the control group (53.70μg/gCr vs38.66μg/gCr,98.79μg/gCr vs9.02μg/gCr,27.86μg/gCr vs14.89μg/gCr,223.39μg/gCr vs95.48μg/gCr, P<0.05), the levels of MiBP, MnBP and MEOHP in the case group were statistically lower than in the control group (25.96μg/gCr vs42.50μg/gCr,24.74μg/gCr vs38.86μg/gCr,2.63μg/gCr vs4.63μg/gCr, P<0.05); After the correction of general linear models, the levels of MMP, MEHP, MCMHP and SDEHP in urine after creatinine correction in the case group were still statistically higher than in the control group (52.40μg/gCr vs38.51μg/gCr,110.72μg/gCr vs8.41μg/gCr,32.01μg/gCr vs13.59μg/gCr,250.64μg/gCr vs87.97μg/gCr, P<0.05), the statistical differences of MiBP, MnBP and MEOHP disappeared (30.42μg/gCr vs36.86μg/gCr,30.20μg/gCr vs32.98μg/gCr,3.48μg/gCr vs3.82μg/gCr, P>0.05); Statistical positive correlation was found between the levels of PAEs metabolites in urine (P>0.05); Statistical positive correlation was not found between most of the PAEs metabolites levels in urine and PAEs levels in serum; Statistical correlation was not found between PAEs metabolites levels in urine and sex hormone levels (P>0.05); After the correction of general linear models, the levels of MEP、MnBP、MiBP、MEHP、MEOHP、MEHHP、MECPP、∑DEHP in urine were statistically higher in the crowd of high school or below education than in the crowd of college or above education (31.25μg/gCr vs17.36μg/gCr,54.65μg/gCr vs26.98μ.g/gCr,55.65μg/gCr vs24.19μg/gCr,32.49μg/gCr vs22.00μg/gCr,8.17μg/gCr vs2.49μg/gCr,22.60μg/gCr vs11.61μg/gCr,30.39μg/gCr vs15.83μg/gCr,201.95μg/gCr vs113.41μg/gCr, P<0.05), the level of MEHHP in urine was statistically higher in the crowd of regular work and rest than in the crowd of irregular work and rest(19.30μg/gCr vs13.41μg/gCr, P<0.05), the level of MEOHP in urine was statistically higher in the crowd of having family history of gynecological diseases than in the crowd of no family history of gynecological diseases (8.41μg/gCr vs3.14μg/gCr, P<0.05), the level of MEHHP in urine was statistically higher in the crowd of having nail polish customary than in the crowd of rarely or never using nail polish (17.94μg/gCr vs12.52μg/gCr, P<0.05), the remaining exposure factors did not show statistical correlation (P>0.05) with the levels of PAEs metabolites in urine;④In the endometriosis pathological tissue of130cases, the positive ratios of DEP, DBP and DEHP were0,74.8%and99.3%respectively, the median of DBP and DEHP were0.72μg/g and2.57μg/g respectively; Levels of DBP and DEHP in pathological tissue were positively correlated (r=0.210, P=0.017); Levels of DBP in pathological tissue and in serum were negatively correlated (r=-0.275, P=0.002); Levels of PAEs in pathological tissue and levels of PAEs metabolites in urine were not statistically correlated (P>0.05); DBP level in pathological tissue was positively correlated with levels of E2and LH in serum (r=0.216, P=0.029; r=0.210, p=0.034); The correlation sthdy between the PAEs level in pathological tissue and related factors such as age BMI, daily exposure to PAEs had shown that only individual had a weak correlation, the majority was no statistical correlation.[Conclusion](pThe case group had higher education level than the control group; The case group had a lager proportion of never childbearing, abortion history, taking contraceptives history, family history of gynecological diseases than the control group; The female population either the control group or the case group knew little about the PAEs platicizer;②Levels of serum DBP and DEHP in the case group were statistically higher than in the control group;③Levels of urine MMP, MEHP, MCMHP and EDEHP in the case group were statistically higher than in the control group;④The positive ratios of DBP and DEHP in pathological tissue are fairly high;⑤PAEs exposure may be risk factors of endometriosis.