摘要
目的探讨氟暴露对女性内分泌激素的影响。方法于2011年4月，依据2010年4月对河南省饮水氟的预调查检测结果，在某县采用单纯随机抽样法选择7个村庄，分别为高氟区、改水区和对照区；采用整群随机抽样方法选择调查地区本地生长或至少居住5年以上的18—48岁女性进行横断面调查，依居住地区分为高氟组（116名）、改水组（132名）和对照组（227名）进行问卷调查和健康体检，并采集晨尿和空腹静脉血。采用氟离子选择电极法测定尿氟水平；酶联免疫吸附法测定血清促性腺激素释放激素（GnRH）水平；化学发光法测定血清促黄体生成素（LH）、促卵泡生成素（FSH）、雌二醇（E，）及睾酮（T）含量。结果改水组、高氟组、对照组调查对象的年龄分别为（39．44±7．34）、（38．84±8．03）、（37．45±7．70）岁，差异无统计学意义（F=3．02，P=0．05）。改水组、高氟组、对照组的尿氟水平分别为（1．34±1．07）、（2．59±1．57）、（0．92±0．46）mg／ml（F=105．38，P〈0．01）；卵泡期血清GnRH，LH，FSH，E2，T水平的差异均无统计学意义（P〉0．05）；排卵期血清E2值中位分别为67．73、58．09、84．96pg／ml，高氟组低于对照组（H=4．00，P〈0．05）；血清T含量分别为0．55、0．45、0．55ng/ml，高氟组低于改水组（H=6．47，P〈0．05），与对照组比较，差异无统计学意义（H=2．41，P〉0．05）。改水组、高氟组、对照组黄体期血清GnRH水平分别为24．09、20．16、23．50ng／ml，高氟组低于改水组（H=14．14，P〈0．05）和对照组（H=12．53，P〈0．05）；血清E2分别为81．47、64．60、74．55pg／ml，高氟组低于改水组（H=5．69，P〈0．05）。对不同组别女性激素水平异常率进行比较，改水组、高氟组、对照组E2异常率分别为22．73（30／102）、37．93（44／72）、20．26（46／181），高氟组高于改水组（x^2=6．82，P〈0．05）和对照组（x^2=12．38，P〈0．05）。结论氟暴露对女性排卵期和黄体期激素水平影响较大。
Objective To explore the influence of water fluoride exposure on reproductive hormones in female. Methods Cross-sectional study was conducted in seven villages of a county in Henan province by using simple random sampling including high fluoride area, defluoridation project area and control area on April,2011 based on the preliminary study results of fluoride concentration in drinking water. Women who were born and growth or lived in the village at least 5 years and aged 18 -48 years old were recruited using cluster sampling. They were divided into high fluoride group （HFG, 116 subjects ）, defluoridation project group （DFPG, 132 subjects） and control group （CG,227 subjects） in accordance with the above areas. All subjects accepted questionnaire and physical checkup. Fasting blood and morning urine samples were collected. The concentration of fluoride in urine was determined by fluoride ion selective electrode method. The serum level of GnRH was detected using enzyme linked immunosorbent assay （ ELISA）. The serum level of luteinizing hormone （ LH ）, follicle-stimulating hormone （ FSH ）, testosterone （T） , estradiol （E2 ） were determined by chemiluminesence immunoassay （CLIA）. Results The average age was （39.44±7.34）, （38.84 ± 8.03）, （37.45 ± 7.70） years old in female from DFPG, HFG and CG respectively, there were no significant differences among the three groups （ F = 3.02, P = 0. 05 ）. The urine fluoride levels were （ 1.34 ± 1.07）, （2. 59 ± 1.57）, （0. 92 ±0.46） mg/ml in female from DFPG,HFG and CG respectively, there was a significant difference among three groups （ F = 105.38, P 〈 0. 01 ） . No significant differences were observed of serum GnRH, LH, T, FSH and E2 among three groups in follicular phase（ P 〉 0. 05 ）. The serum levels of E2 in Ovulatory period were 67.73,58. 09,84. 96 pg/ml in female from DFPG, HFG and CG respectively. It was lower in HFG than that in CG （ H = 4. 00, P 〈 O. 05 ）. The serum levels of T in Ovulatory period were O. 55,0. 45,0. 55 ng/ml in female from DFPG, HFG and CG respectively. It was lower in HFG than that in DFPG （ H = 6. 47, P 〈 0. 05 ） , but no significant difference was observed between HFG and CG （ H = 2.41, P 〉 0. 05 ）. The serum levels of GnRH in Luteal phase were 24. 09,20. 16,23.50 ng/ml in female from DFPG,HFG and CG respectively. It was lower in HFG than that in DFPG （H= 14. 14,P 〈0. 05） and CG （H= 12.53,P 〈0. 05）. The serum level ofE2 in luteal phase were 81.47,64. 60,74. 55 pg/ml in female from DFPG,HFG and CG respectively. It was lower in HFG than that in DFPG （ H = 5.69, P 〈 0. 05 ）. As for LH, FSH and T, no significant differences were observed among the three groups （P 〉 0. 05 respectively）. The abnormal rates of E2 level were 22. 73 （30/102）, 37.93 （44/ 72） ,20. 26 （46/181） in female from DFPG,HFG and CG respectively. The E2 abnormal rate in female from HFGwas higher that from DFPG （X^2 =6.82,P〈0.05） and CG （X^2 =12.38,P〈0.05）.Conclusion Fluoride exposure may influence reproductive hormones in female, especially in ovulatory and luteal phase of menstrual cycle.
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2013年第2期142-146,共5页
Chinese Journal of Preventive Medicine
基金
基金项目：国家自然科学基金（81072247）
