接受辅助生殖男性的大气气态污染物暴露与血清生殖激素谱的关联研究
Exposure to gaseous air pollutants and serum reproductive hormone profiles among men seeking assisted reproduction
摘要
研究基于中国安徽一个辅助生殖队列中的3284名男性,按激素检测前0–90、0–180、181–360及0–360天四个暴露窗口估算个体CO、NO2、SO2和O3暴露水平,检测血清FSH、LH、PRL、T、E2及激素比值,并用线性回归、五分位趋势分析、限制性立方样条和分层分析进行校正。结果显示,SO2暴露在四个窗口均与T、T/LH、T/E2降低相关;O3暴露则与这些雄激素相关指标升高相关;趋势分析支持存在暴露-反应关系;限制性立方样条提示SO2与T呈阈值型非线性关系,负相关主要见于低至中等浓度区间;CO和NO2的关联较弱且不稳定。结论认为大气SO2与O3暴露与求助于辅助生殖男性的生殖激素谱改变有关,仍需精液质量、生育结局和机制标志物研究加以验证。
原文摘要
Evidence on the relationship between gaseous air pollutants and male reproductive hormones remains limited. This study examined the associations of ambient CO, NO2, SO2, and O3 exposure with serum reproductive hormone profiles among men seeking assisted reproduction. We included 3284 men from an assisted reproduction cohort in Anhui, China. Individual exposures to CO, NO2, SO2, and O3 were estimated for 0-90, 0-180, 181-360, and 0-360 days before hormone measurement. Serum FSH, LH, PRL, T, E2, and hormone ratios were assessed. Linear regression, quintile-based trend analyses, restricted cubic spline models, and stratified analyses were performed with adjustment for demographic, lifestyle, reproductive, meteorological, and environmental covariates. SO2 exposure was associated with lower levels of T, T/LH, and T/E2 across all four exposure windows, whereas O3 exposure was associated with higher levels of these androgen-related indicators. Quintile-based trend analyses further supported exposure-response associations between SO2 and O3 exposure and male reproductive hormone levels. Restricted cubic spline and piecewise regression analyses suggested a threshold-like nonlinear relationship between SO2 exposure and T, with the inverse association mainly observed within the low-to-moderate exposure range. In contrast, the findings for CO and NO2 were less frequent and showed limited stability. Ambient SO2 and O3 exposures were associated with altered male reproductive hormone profiles among men seeking assisted reproduction. Further studies incorporating semen quality, fertility outcomes, and mechanistic biomarkers are warranted.
推荐理由:样本量较大(3284人)、暴露窗口分层与多种统计模型结合,为SO2/O3与男性生殖激素的暴露-反应关系和非线性阈值提供了较扎实的环境流行病学证据;但为单中心横断面设计、缺乏精液与妊娠结局,机制与临床转化有限,属值得一读。
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