Selected Persistent Toxic Substances Associated With The Risk Of Primary Ovarian Insufficiency In Women

Persistent toxic substances?PTS?are important environmental issues that are associated with human health.PTS includes persistent organic pollutants?POPs?and toxic metalloids/metals.Most of POPs have been banned by various countries,but due to their stability and difficult to degrade,they are still ubiquitous in the environment.Toxic metalloids and metals such as arsenic?As?and cadmium?Cd?enter the environment with human activities such as metallurgy and mining.Metals cannot be thermally degraded and biodegraded,and remain in the environment.Effects of PTS on human health cannot be ignored.Epidemiological studies have found that PTS exposure is associated with female reproductive health such as decreased fecundability,early menopause,and adverse pregnancy outcomes.Animal studies have shown that exposure to PTS impaired ovarian function and induced a similar symptom of a common female disease,primary ovarian insufficiency?POI?.However,the limited evidence of association of PTS exposure with POI has been reported so far.Therefore,recognizing the correlation between typical PTS exposure and POI in women is of great practical significance for population prevention stratigies that control and manage these target environmental pollutants.?1?In this study,our case-control study was performed to explore the association between serum levels of selected POPs and risk for POI in a Chinese female population,including 157 cases and 217 healthy controls.Serum concentrations of polychlorinated biphenyls?PCBs?,organochlorine pesticides?OCPs?,polybrominated diphenyl ethers?PBDEs?and serum levels of reproductive hormones[follicle-stimulating hormone?FSH?,luteinizing hormone?LH?,anti-Mullerian hormone?AMH?and estradiol]were measured.The medians of dioxin-like PCBs?DL-PCBs?and p,p'-dichlorodiphenyltrichloroethane?p,p'-DDT?were significantly higher in case sera than in controls.Higher concentrations of DL-PCBs and p,p'-DDT were significantly associated with elevated risk of POI.A exposure-effect relationship was observed between the sum of DL-PCBs??₆ DL-PCBs?and the risk of POI?p for trend=0.003?,with odds ratios?OR?for the second and third tertiles,compared with the first,of 1.31-?95%CIs:0.67-2.57?and 3.15-fold?95%CIs:1.63-6.10?,respectively.Similar results were observed for the sum of p,p'-DDT and its metabolites??₂ p,p'-DDTs??third tertile:OR=2.71,95%CIs:1.43-5.14,p for trend=0.026?.In control women,FSH levels were negatively associated with PCBs exposure,while LH had a positive association with OCPs.In patients with POI,exposure to PCBs was correlated with higher levels of LH,whereas exposure to OCPs was associated with lower levels of AMH.The results of this study indicated that PCBs and DDTs exposure were potential risk factors for POI in women.?2?In this case-control study,a total of 169 POI cases and 209 healthy controls were recruited to determine the total urinary concentrations of arsenic?As?and cadmium?Cd?,serum levels of reproductive hormones?FSH,LH,AMH and E₂?.The median concentration of urinary As of POI cases was 21.5?g/L?28.0?g/g for creatinine adjustment?,which was significantly higher than the As concentration detected in the control group?median:13.8?g/L,19.3?g/g for creatinine adjustment?.Urinary As concentrations were significantly positively associated with the risk of POI in logisitic regression model?adjusted OR=2.66,95%CI:1.43-4.95 for the highest vs lowest tertile of arsenic;p for trend=0.004?.As for hormone levels,it was observed that urinary As concentrations were positively associated with FSH and LH levels,and negatively correlated with AMH and E₂ levels.The median concentration of Cd in the urine samples of the case group was 0.43?g/L?0.58?g/g for creatinine adjustment?,and it was significantly higher than that of controls?0.29?g/L,0.43?g/g for creatinine adjustment?.A significantly positive association was observed between urinary Cd and OR of POI using binary logistic regression models after the adjustment of confounders?OR=2.50,95%CIs:1.34-4.65for the third tertile,p for trend=0.001?.We also assessed the relationships between exposure of Cd and reproductive hormones that are important for ovarian functions.FSH and LH levels were positively associated with Cd,whereas AMH and E₂ levels were negatively correlated with this element.The above results suggested that exposure to As and Cd were also potential risk factors for POI.