Suyun Zhang1,2, Rongrong Tan1,2, Rui Pan3, Jianwei Xiong1,2, Ying Tian3, Jie Wu1,2, Ling Chen1,4. 1. State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China. 2. Department of Obstetrics and Gynecology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China. 3. Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China. 4. Department of Physiology, Nanjing Medical University, Nanjing, China.
Abstract
Context: Perfluoroalkyl and polyfluoroalkyl substances (PFASs), a group of ubiquitous environmental chemicals with properties of endocrine disruption, are often detectable in humans. Objective: The current study investigated the association between exposure to PFAS and primary ovarian insufficiency (POI). Design, Patients, Interventions, and Main Outcome Measures: Levels of plasma PFAS were measured in 120 Chinese women with overt POI and 120 healthy control subjects from 2013 to 2016. Associations between PFAS levels and odds of POI, as well as hormonal profiles, were evaluated using multiple logistic regression and multiple linear regression models. Results: Levels of perfluorooctanate (PFOA), perfluorooctane sulfonate (PFOS), and perfluorohexanesulfonate (PFHxS) were positively associated with the risks of POI (highest vs. lowest tertile, PFOA: OR, 3.80; 95% CI, 1.92-7.49; PFOS: OR, 2.81; 95% CI, 1.46-5.41; PFHxS: OR, 6.63; 95% CI, 3.22-13.65). In patients with POI, levels of PFOS and PFHxS exposure were positively associated with FSH (PFOS: adjusted β, 0.26; 95% CI, 0.15 to 0.38; PFHxS: adjusted β, 0.16; 95% CI, 0.04 to 0.28) and negatively associated with estradiol (PFOS: adjusted β, -0.30; 95% CI, -0.47 to -0.12; PFHxS: adjusted β, -0.19; 95% CI, -0.37 to -0.02). Exposure to PFOS and PFOA was associated with elevation of prolactin (PFOS: adjusted β, 0.17; 95% CI, 0.06 to 0.29; PFOA: adjusted β, 0.16; 95% CI, 0.01 to 0.30) or with a decrease of free triiodothyronine (PFOS: adjusted β, -0.88; 95% CI, -1.64 to -0.09; PFOA: adjusted β, -0.90; 95% CI, -1.88 to 0.09) and thyroxine (PFOS: adjusted β, -2.99; 95% CI, -4.52 to -1.46; PFOA: adjusted β, -3.42; 95% CI, -5.39 to -1.46). Conclusion: High exposure to PFOA, PFOS, and PFHxS is associated with increased risk of POI in humans.
Context:Perfluoroalkyl and polyfluoroalkyl substances (PFASs), a group of ubiquitous environmental chemicals with properties of endocrine disruption, are often detectable in humans. Objective: The current study investigated the association between exposure to PFAS and primary ovarian insufficiency (POI). Design, Patients, Interventions, and Main Outcome Measures: Levels of plasma PFAS were measured in 120 Chinese women with overt POI and 120 healthy control subjects from 2013 to 2016. Associations between PFAS levels and odds of POI, as well as hormonal profiles, were evaluated using multiple logistic regression and multiple linear regression models. Results: Levels of perfluorooctanate (PFOA), perfluorooctane sulfonate (PFOS), and perfluorohexanesulfonate (PFHxS) were positively associated with the risks of POI (highest vs. lowest tertile, PFOA: OR, 3.80; 95% CI, 1.92-7.49; PFOS: OR, 2.81; 95% CI, 1.46-5.41; PFHxS: OR, 6.63; 95% CI, 3.22-13.65). In patients with POI, levels of PFOS and PFHxS exposure were positively associated with FSH (PFOS: adjusted β, 0.26; 95% CI, 0.15 to 0.38; PFHxS: adjusted β, 0.16; 95% CI, 0.04 to 0.28) and negatively associated with estradiol (PFOS: adjusted β, -0.30; 95% CI, -0.47 to -0.12; PFHxS: adjusted β, -0.19; 95% CI, -0.37 to -0.02). Exposure to PFOS and PFOA was associated with elevation of prolactin (PFOS: adjusted β, 0.17; 95% CI, 0.06 to 0.29; PFOA: adjusted β, 0.16; 95% CI, 0.01 to 0.30) or with a decrease of free triiodothyronine (PFOS: adjusted β, -0.88; 95% CI, -1.64 to -0.09; PFOA: adjusted β, -0.90; 95% CI, -1.88 to 0.09) and thyroxine (PFOS: adjusted β, -2.99; 95% CI, -4.52 to -1.46; PFOA: adjusted β, -3.42; 95% CI, -5.39 to -1.46). Conclusion: High exposure to PFOA, PFOS, and PFHxS is associated with increased risk of POI in humans.
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