{"id":35,"title":"Follicular-fluid neonicotinoid exposure and endometriosis: associations with reproductive outcomes and metabolic remodeling","title_zh":"卵泡液中新烟碱类杀虫剂暴露与子宫内膜异位症：与辅助生殖结局及代谢重塑的关联","url":"https://pubmed.ncbi.nlm.nih.gov/42994776","doi":"10.1016/j.envres.2026.126125","pmid":"42994776","journal":"Environ Res","kind":"paper","lang":"en","published_at":"2026-11-06T00:00:00+00:00","fetched_at":"2026-11-08T03:43:52+00:00","authors":["Liu Z","Zhao X","Shi H","Liu J","Jiang W","Gan Q","Liang X","Yang X"],"primary_topic":"oocyte","topics":[{"slug":"oocyte","score":5.0,"hits":["follicular","oocytes"]},{"slug":"endometrium","score":4.0,"hits":["endometriosis"]},{"slug":"omics-methods","score":3.0,"hits":["metabolome","metabolomic","metabolomics"]},{"slug":"art-clinical","score":2.0,"hits":["assisted reproductive","infertile"]},{"slug":"early-embryo","score":1.0,"hits":["zygotes"]}],"topic_score":5.0,"preference_score":0.0,"preference_labels":[],"llm_score":73.0,"final_score":73.0,"score_dims":{"novelty":78,"rigor":65,"impact":68,"relevance":88,"translation":62},"recommend_reason":"首次在人体卵泡液微环境中系统刻画新烟碱类杀虫剂暴露谱，并将其与子宫内膜异位症和ART结局、脂质/核苷酸相关代谢特征联系起来，为环境暴露与生殖毒性研究提供了可复用的多组学分析框架；但横断面设计、单中心中等样本与探索性代谢组结果限制了结论强度，适合作为研究方向参考而非临床决策依据。","keywords":["新烟碱类杀虫剂","卵泡液","子宫内膜异位症","辅助生殖结局","代谢组学","环境暴露"],"selected":1,"story_id":41,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-art","source_name":"PubMed · 辅助生殖临床","source_tier":1,"mention_count":2,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"该研究在接受辅助生殖技术（ART）的174例不孕女性（63例子宫内膜异位症、111例对照）的卵泡液中定量检测了16种新烟碱类杀虫剂及其代谢物，并采用单污染物回归与混合暴露模型分析其与子宫内膜异位症及ART结局的关系；另对40例亚组行非靶向代谢组学。卵泡液中这类污染物普遍检出，N-去甲基啶虫脒（N-dm-ACE）检出率最高，其浓度每增加一倍，患子宫内膜异位症的比值比为1.79（95%CI 1.38-2.32），且在混合模型中稳定占优；部分代谢物与成熟卵母细胞数减少、双原核受精卵减少及妊娠率降低相关，在子宫内膜异位症患者中更明显。代谢组发现324个差异特征，其中54个经FDR校正后仍显著，47个特征同时与N-dm-ACE和子宫内膜异位症相关。研究为横断面关联，因果与时间顺序需纵向研究验证。","summary":"Neonicotinoid insecticides (NEOs) are emerging environmental contaminants, but their presence and reproductive relevance in the human follicular microenvironment remain poorly understood. We quantified 16 NEOs and metabolites in follicular fluid from 174 infertile women undergoing assisted reproductive technology (ART), including 63 women with endometriosis and 111 controls. Associations with endometriosis and ART outcomes were assessed using single-analyte regression and mixture models. Untargeted metabolomics was performed in a nested subset of 40 women. NEOs were widely detected in follicular fluid, with N-desmethyl-acetamiprid (N-dm-ACE) showing the highest detection frequency. Each twofold increase in N-dm-ACE concentration was associated with higher odds of prevalent endometriosis (adjusted OR = 1.79, 95% CI: 1.38-2.32), and N-dm-ACE was consistently prioritized in mixture analyses. Several NEOs were also associated with adverse ART outcomes, including fewer mature oocytes, fewer two-pronuclear zygotes, and lower pregnancy odds, with stronger patterns among women with endometriosis. Metabolomic profiling identified 324 features differing between women with and without endometriosis at nominal P < 0.05, of which 54 remained significant after false discovery rate correction. Integrated exposure-metabolome analysis identified 47 features showing nominal associations with both N-dm-ACE and endometriosis. These findings identify cross-sectional associations between follicular-fluid NEO concentrations and existing endometriosis, alongside exploratory metabolic signatures involving lipid- and nucleotide-related features. Further longitudinal studies are needed to clarify their temporal and biological relevance.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}