1
|
Di S, Ning M, Yunfei L, Jiajia D, Panliang Z, Shan C, Ziyue C, Jun M, Yi S. Association between BMI and age at menarche or spermarche among both sexes: Findings from six successive national surveys in China. J Glob Health 2024; 14:04099. [PMID: 38726560 PMCID: PMC11082623 DOI: 10.7189/jogh.14.04099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024] Open
Abstract
Background To explore trends of the association between body mass index (BMI) and age at menarche or spermarche and its urban-rural disparities from 1995 to 2019. Methods A total of 912 753 children and adolescents - including 519 940 9-18 years old girls and 392 813 11-18 years old boys - were involved in six successive cross-sectional surveys conducted across 30 provinces in China from 1995 to 2019. Data on menarche and spermarche was collected using the status quo method, where same-gender physicians conducted face-to-face interviews to determine if children and adolescents had experienced their first menstrual cycle or ejaculation (yes/no). The median age at menarche or spermarche was estimated by probit analysis. Anthropometric measurements measured the height and weight of the study subjects. Children and adolescents were classified into thinness, normal range of weight, overweight, and obesity. t test was used to compare the differences in BMI between premenarchal and postmenarchal girls or prespermarcheal and postspermarcheal boys. Logistic regression was used to explore the associations between BMI/nutritional status and menarche or spermarche stratified by urban or rural residency status. Results From 1995 to 2019, BMI in all age groups growth over time, and the values of BMI among children and adolescents under 15 who had menarche or spermarche were more significant than those without menarche or spermarche. In 2019, for girls, thinness was associated with delayed menarche (odds ratio (OR) = 0.26; 95% confidence interval (CI) = 0.24-0.28), while overweight (OR = 1.99; 95% CI = 1.85-2.14) and obesity (OR = 2.20; 95% CI = 1.92-2.53) was associated with advanced menarche. For boys, thinness was associated with delayed spermarche (OR = 0.71; 95% CI = 0.65-0.78), overweight was associated with advanced spermarche (OR = 1.08; 95% CI = 1.01-1.15) while obesity had no association with spermarche. The OR between BMI and menarche in 1995 was 1.35 (95% CI = 1.33-1.37), which decreased to 1.19 (95% CI = 1.18-1.20) by 2019. The OR between BMI and spermarche in 1995 was 1.10 (95% CI = 1.09-1.11), which decreased to 1.02 (95% CI = 1.02-1.03) by 2019. The trends by urban-rural stratification were consistent with the total sample. Conclusions We have established a dose-response relationship between BMI and menarche in girls, whereas the association appears to be nonlinear in boys, and the associations were diminishing. Similar findings were observed in both urban and rural areas. Considering the dual adverse effects of obesity and early puberty on health, the results of this study suggest that sexual health education should be strengthened, especially among obese girls. Further research on the influencing factors and biological mechanisms of early puberty will be beneficial.
Collapse
Affiliation(s)
- Shi Di
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Ma Ning
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Liu Yunfei
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Dang Jiajia
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Zhong Panliang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Cai Shan
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Chen Ziyue
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Ma Jun
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Song Yi
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| |
Collapse
|
2
|
Peralta M, Lizcano F. Endocrine Disruptors and Metabolic Changes: Impact on Puberty Control. Endocr Pract 2024; 30:384-397. [PMID: 38185329 DOI: 10.1016/j.eprac.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/27/2023] [Accepted: 01/03/2024] [Indexed: 01/09/2024]
Abstract
OBJECTIVE This study aims to explore the significant impact of environmental chemicals on disease development, focusing on their role in developing metabolic and endocrine diseases. The objective is to understand how these chemicals contribute to the increasing prevalence of precocious puberty, considering various factors, including epigenetic changes, lifestyle, and emotional disturbances. METHODS The study employs a comprehensive review of descriptive observational studies in both human and animal models to identify a degree of causality between exposure to environmental chemicals and disease development, specifically focusing on endocrine disruption. Due to ethical constraints, direct causation studies in human subjects are not feasible; therefore, the research relies on accumulated observational data. RESULTS Puberty is a crucial life period with marked physiological and psychological changes. The age at which sexual characteristics develop is changing in many regions. The findings indicate a correlation between exposure to endocrine-disrupting chemicals and the early onset of puberty. These chemicals have been shown to interfere with normal hormonal processes, particularly during critical developmental stages such as adolescence. The research also highlights the interaction of these chemical exposures with other factors, including nutritional history, social and lifestyle changes, and emotional stress, which together contribute to the prevalence of precocious puberty. CONCLUSION Environmental chemicals significantly contribute to the development of certain metabolic and endocrine diseases, particularly in the rising incidence of precocious puberty. Although the evidence is mainly observational, it adequately justifies regulatory actions to reduce exposure risks. Furthermore, these findings highlight the urgent need for more research on the epigenetic effects of these chemicals and their wider impact on human health, especially during vital developmental periods.
Collapse
Affiliation(s)
- Marcela Peralta
- Center of Biomedical Investigation Universidad de La Sabana, CIBUS, Chía, Colombia
| | - Fernando Lizcano
- Center of Biomedical Investigation Universidad de La Sabana, CIBUS, Chía, Colombia; Department of Endocrinology, Diabetes and Nutrition, Fundación CardioInfantil-Instituto de Cardiología, Bogotá, Colombia.
| |
Collapse
|
3
|
Subah Z, Ryu JH. Impact of DDT on women's health in Bangladesh: escalating breast cancer risk and disturbing menstrual cycle. Front Public Health 2024; 12:1309499. [PMID: 38410669 PMCID: PMC10895053 DOI: 10.3389/fpubh.2024.1309499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/19/2024] [Indexed: 02/28/2024] Open
Affiliation(s)
- Zarin Subah
- College of Natural Resources and College of Agricultural and Life Sciences, University of Idaho Boise, Boise, ID, United States
| | | |
Collapse
|
4
|
Hassan S, Thacharodi A, Priya A, Meenatchi R, Hegde TA, R T, Nguyen HT, Pugazhendhi A. Endocrine disruptors: Unravelling the link between chemical exposure and Women's reproductive health. ENVIRONMENTAL RESEARCH 2024; 241:117385. [PMID: 37838203 DOI: 10.1016/j.envres.2023.117385] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/29/2023] [Accepted: 10/11/2023] [Indexed: 10/16/2023]
Abstract
An Endocrine Disrupting Chemical (EDC) is any compound that disrupts the function of the endocrine system in humans and is ubiquitous in the environment either as a result of natural events or through anthropogenic activities. Bisphenol A, phthalates, parabens, pesticides, triclosan, polychlorinated biphenyls, and heavy metals, which are frequently found in the pharmaceutical, cosmetic, and packaging sectors, are some of the major sources of EDC pollutants. EDCs have been identified to have a deteriorating effect on the female reproductive system, as evidenced by the increasing number of reproductive disorders such as endometriosis, uterine fibroids, polycystic ovary syndrome, premature ovarian failure, menstrual irregularity, menarche, and infertility. Studying EDCs in relation to women's health is essential for understanding the complex interactions between environmental factors and health outcomes. It enables the development of strategies to mitigate risks, protect reproductive and overall health, and inform public policy decisions to safeguard women's well-being. Healthcare professionals must know the possible dangers of EDC exposure and ask about environmental exposures while evaluating patients. This may result in more precise diagnosis and personalized treatment regimens. This review summarises the existing understanding of prevalent EDCs that impact women's health and involvement in female reproductive dysfunction and underscores the need for more research. Further insights on potential mechanisms of action of EDCs on female has been emphasized in the article. We also discuss the role of nutritional intervention in reducing the effect of EDCs on women's reproductive health. EDC pollution can be further reduced by adhering to strict regulations prohibiting the release of estrogenic substances into the environment.
Collapse
Affiliation(s)
- Saqib Hassan
- Department of Biotechnology, School of Bio and Chemical Engineering, Sathyabama Institute of Science and Technology, Chennai, Tamilnadu, 600119, India; Future Leaders Mentoring Fellow, American Society for Microbiology, Washington, 20036, USA
| | - Aswin Thacharodi
- Dr. Thacharodi's Laboratories, Department of Research and Development, Puducherry, 605005, India
| | - Anshu Priya
- SRF-ICMR, CSIR-Institute of Genomics and Integrative Biology (IGIB), South Campus, New Delhi, 110025, India
| | - R Meenatchi
- Department of Biotechnology, SRM Institute of Science and Technology, Faculty of Science and Humanities, Kattankulathur, Chengalpattu, Tamil Nadu, India
| | - Thanushree A Hegde
- Department of Civil Engineering, NMAM Institute of Technology, Nitte, Karnataka, 574110, India
| | - Thangamani R
- Department of Civil Engineering, NMAM Institute of Technology, Nitte, Karnataka, 574110, India
| | - H T Nguyen
- Institute of Research and Development, Duy Tan University, Da Nang, Viet Nam; School of Engineering & Technology, Duy Tan University, Da Nang, Viet Nam
| | - Arivalagan Pugazhendhi
- Institute of Research and Development, Duy Tan University, Da Nang, Viet Nam; School of Engineering & Technology, Duy Tan University, Da Nang, Viet Nam.
| |
Collapse
|
5
|
Lan H, Hu Z, Gan H, Wu L, Xie S, Jiang Y, Ye D, Ye X. Association between exposure to persistent organic pollutants and pubertal timing in boys and girls: A systematic review and meta-analysis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 265:115540. [PMID: 37801753 DOI: 10.1016/j.ecoenv.2023.115540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/08/2023]
Abstract
In recent years, the phenomenon of abnormal pubertal timing in children has become increasingly common worldwide. Persistent organic pollutants (POPs) may be one of the risk factors contributing to this phenomenon, but the relationship between them is unclear based on current evidence. The purpose of this study was to determine the association of POPs exposure with pubertal timing in girls and boys by conducting a systematic review and meta-analysis. We searched PubMed and Embase databases for studies before June 1, 2023. Meta-analysis was performed by pooling relative risk (RR) or odds ratio (OR) or prevalence ratio (PR) or hazard ratio (HR) estimates with 95 % confidence intervals (CIs). Subgroup analysis, publication bias assessment and sensitivity analysis were also carried out. A total of 21 studies were included, involving 2479 boys and 8718 girls. The results of meta-analysis showed that exposure to POPs was significantly associated with delayed pubertal timing in girls (RR: 0.85; 95 % CI: 0.79-0.91; p < 0.001). There was no statistically significant association between exposure to POPs and pubertal timing in boys (RR: 1.18; 95 % CI: 0.99-1.40; p = 0.070). Subgroup analysis showed that there may be gender differences in the effects of exposure to POPs on pubertal timing. Our results suggested that exposure to POPs could delay pubertal timing in girls. However, based on current evidence, no significant association was found between POPs exposure and pubertal timing in boys.
Collapse
Affiliation(s)
- Huili Lan
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Zhiqin Hu
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Hongya Gan
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Lixiang Wu
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Shushu Xie
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Yan Jiang
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Ding Ye
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Xiaoqing Ye
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, China.
| |
Collapse
|
6
|
Syed S, Qasim S, Ejaz M, Sammar, Khan N, Ali H, Zaker H, Hatzidaki E, Mamoulakis C, Tsatsakis A, Shah STA, Amir S. Effects of Dichlorodiphenyltrichloroethane on the Female Reproductive Tract Leading to Infertility and Cancer: Systematic Search and Review. TOXICS 2023; 11:725. [PMID: 37755736 PMCID: PMC10536953 DOI: 10.3390/toxics11090725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/15/2023] [Accepted: 08/17/2023] [Indexed: 09/28/2023]
Abstract
Persistent Organic Pollutants (POPs) such as dichlorodimethyltrichloroethane (DDT) are present and ubiquitous in the environment due to their resilient nature. DDT is a prevalent endocrine disruptor still found in detectable amounts in organisms and the environment even after its use was banned in the 1970s. Medline and Google Scholar were systematically searched to detect all relevant animal and human studies published in the last 20 years (January 2003 to February 2023) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. In total, 38 studies were included for qualitative synthesis. This systematic search and review indicated that exposure to DDT is associated with female reproductive health issues, such as reduced fecundability; increased risk of preterm/premature deliveries; increased periods of gestation; alterations in the synthesis of crucial reproductive hormones (Progesterone and Oxytocin) through ion imbalances and changes in prostaglandin synthesis, myometrial and stromal hypertrophy, and edema; and variations in uterine contractions through increased uterine wet weight. There was also limited evidence indicating DDT as a carcinogen sufficient to instigate reproductive cancers. However, this review only takes into account the in vitro studies that have established a possible pathway to understand how DDT impacts female infertility and leads to reproductive cancers. Links between the pathways described in various studies have been developed in this review to produce a summarized picture of how one event might lead to another. Additionally, epidemiological studies that specifically targeted the exposure to DDT of females belonging to various ethnicities have been reviewed to develop an overall picture of prevailing female reproductive health concerns in different nations.
Collapse
Affiliation(s)
- Shermeen Syed
- Functional Genomics and Proteomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Park Road Chak Shehzad, Islamabad 44000, Pakistan; (S.S.); (S.Q.); (M.E.); (S.); (N.K.); (S.T.A.S.)
| | - Shandana Qasim
- Functional Genomics and Proteomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Park Road Chak Shehzad, Islamabad 44000, Pakistan; (S.S.); (S.Q.); (M.E.); (S.); (N.K.); (S.T.A.S.)
| | - Maheen Ejaz
- Functional Genomics and Proteomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Park Road Chak Shehzad, Islamabad 44000, Pakistan; (S.S.); (S.Q.); (M.E.); (S.); (N.K.); (S.T.A.S.)
| | - Sammar
- Functional Genomics and Proteomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Park Road Chak Shehzad, Islamabad 44000, Pakistan; (S.S.); (S.Q.); (M.E.); (S.); (N.K.); (S.T.A.S.)
| | - Nimra Khan
- Functional Genomics and Proteomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Park Road Chak Shehzad, Islamabad 44000, Pakistan; (S.S.); (S.Q.); (M.E.); (S.); (N.K.); (S.T.A.S.)
| | - Haider Ali
- Cerebral Venous Disorder Lab, University of California, San Francisco, CA 94143, USA;
| | - Himasadat Zaker
- Histology and Microscopic Analysis Division, RASTA Specialized Research Institute (RSRI), West Azerbaijan Science and Technology Park (WASTP), Urmia 5756115322, Iran;
| | - Eleftheria Hatzidaki
- Department of Neonatology, University General Hospital of Heraklion, Medical School, University of Crete, 71003 Heraklion, Crete, Greece;
| | - Charalampos Mamoulakis
- Department of Urology, University General Hospital of Heraklion, Medical School, University of Crete, 71003 Heraklion, Crete, Greece;
| | - Aristidis Tsatsakis
- Toxicology Lab, Department of Medicine, University of Crete, 71003 Heraklion, Crete, Greece;
- Department of Human Ecology and Environmental Hygiene, IM Sechenov First Moscow State Medical University, Moscow 119991, Russia
| | - Syed Tahir Abbas Shah
- Functional Genomics and Proteomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Park Road Chak Shehzad, Islamabad 44000, Pakistan; (S.S.); (S.Q.); (M.E.); (S.); (N.K.); (S.T.A.S.)
| | - Saira Amir
- Functional Genomics and Proteomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Park Road Chak Shehzad, Islamabad 44000, Pakistan; (S.S.); (S.Q.); (M.E.); (S.); (N.K.); (S.T.A.S.)
| |
Collapse
|
7
|
Anastasiadis X, Matsas A, Panoskaltsis T, Bakas P, Papadimitriou DT, Christopoulos P. Impact of Chemicals on the Age of Menarche: A Literature Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1234. [PMID: 37508731 PMCID: PMC10378553 DOI: 10.3390/children10071234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/01/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023]
Abstract
A growing body of evidence suggests that chemicals interfere with the age of onset of menarche. We conducted a review in order to demonstrate the relationship between several categories of chemicals and menarche. We searched for English language papers using the Medline/PubMed database until April 2023. The chemical factors found to affect menarche were prenatal and antenatal smoke, phthalates, phenols, organochlorines, perfluoroalkyls and polyfluoroalkyls, metals, air pollutants and polybrominated diphenyl ethers. Low or high exposure to each chemical compound could affect the age of menarche, leading to early or delayed menarche. Furthermore, the results show that intrauterine exposure may have a different impact from antenatal exposure. There is evidence that endocrine-disrupting chemicals affect the age of menarche, but more research needs to be conducted.
Collapse
Affiliation(s)
- Xristos Anastasiadis
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Alkis Matsas
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Theodoros Panoskaltsis
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Panagiotis Bakas
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Dimitrios T Papadimitriou
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Panagiotis Christopoulos
- Second Department of Obstetrics and Gynecology, "Aretaieion" Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| |
Collapse
|
8
|
Malin Igra A, Rahman A, Johansson AL, Pervin J, Svefors P, Arifeen SE, Vahter M, Persson LÅ, Kippler M. Early Life Environmental Exposure to Cadmium, Lead, and Arsenic and Age at Menarche: A Longitudinal Mother-Child Cohort Study in Bangladesh. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:27003. [PMID: 36729392 PMCID: PMC9894154 DOI: 10.1289/ehp11121] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 12/07/2022] [Accepted: 01/03/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Several metals act as endocrine disruptors, but there are few large longitudinal studies about associations with puberty onset. OBJECTIVES We evaluated whether early life cadmium, lead, and arsenic exposure was associated with timing of menarche. METHODS In a mother-child cohort in rural Bangladesh (n=935), the exposure was assessed by concentrations in maternal erythrocytes in early pregnancy and in girls' urine at 5 and 10 years of age using inductively coupled plasma mass spectrometry. The girls were interviewed twice, at average ages 13.3 [standard deviation (SD)=0.43] and 13.8 (SD=0.43) y, and the date of menarche, if present, was recorded. Associations were assessed using Kaplan-Meier analysis and multivariable-adjusted Cox regression. RESULTS In total, 77% of the girls (n=717) had reached menarche by the second follow-up. The median age of menarche among all girls was 13.0 y (25th-75th percentiles: 12.4-13.7 y). At 10 years of age, median urinary cadmium was 0.25μg/L (5th-95th percentiles: 0.087-0.72μg/L), lead 1.6μg/L (0.70-4.2μg/L), and arsenic 54μg/L (19-395μg/L). Given the same age, girls in the highest quartile of urinary cadmium at 5 and 10 years of age had a lower rate of menarche than girls in the lowest quartile, with an adjusted hazard ratio of (HR) 0.80 (95% CI: 0.62, 1.01) at 5 years of age, and 0.77 (95% CI: 0.60, 0.98) at 10 years of age. This implies that girls in the highest cadmium exposure quartile during childhood had a higher age at menarche. Comparing girls in the highest to the lowest quartile of urinary lead at 10 years of age, the former had a higher rate of menarche [adjusted HR = 1.23 (95% CI: 0.97, 1.56)], implying lower age at menarche, whereas there was no association with urinary lead at 5 years of age. Girls born to mothers in the highest quartile of erythrocyte arsenic during pregnancy were less likely to have attained menarche than girls born to mothers in the lowest quartile [adjusted HR= 0.79 (95% CI: 0.62, 0.99)]. No association was found with girls' urinary arsenic exposure. DISCUSSION Long-term childhood cadmium exposure was associated with later menarche, whereas the associations with child lead exposure were inconclusive. Maternal exposure to arsenic, but not cadmium or lead, was associated with later menarche. https://doi.org/10.1289/EHP11121.
Collapse
Affiliation(s)
| | - Anisur Rahman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Anna L.V. Johansson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jesmin Pervin
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Pernilla Svefors
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Shams El Arifeen
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Marie Vahter
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lars-Åke Persson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- London School of Hygiene and Tropical Medicine, London, UK
| | - Maria Kippler
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
9
|
Franssen D, Johansson HKL, Lopez-Rodriguez D, Lavergne A, Terwagne Q, Boberg J, Christiansen S, Svingen T, Parent AS. Perinatal exposure to the fungicide ketoconazole alters hypothalamic control of puberty in female rats. Front Endocrinol (Lausanne) 2023; 14:1140886. [PMID: 37077353 PMCID: PMC10108553 DOI: 10.3389/fendo.2023.1140886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/03/2023] [Indexed: 04/05/2023] Open
Abstract
INTRODUCTION Estrogenic endocrine disrupting chemicals (EDCs) such as diethylstilbestrol (DES) are known to alter the timing of puberty onset and reproductive function in females. Accumulating evidence suggests that steroid synthesis inhibitors such as ketoconazole (KTZ) or phthalates may also affect female reproductive health, however their mode of action is poorly understood. Because hypothalamic activity is very sensitive to sex steroids, we aimed at determining whether and how EDCs with different mode of action can alter the hypothalamic transcriptome and GnRH release in female rats. DESIGN Female rats were exposed to KTZ or DES during perinatal (DES 3-6-12μg/kg.d; KTZ 3-6-12mg/kg.d), pubertal or adult periods (DES 3-12-48μg/kg.d; KTZ 3-12-48mg/kg.d). RESULTS Ex vivo study of GnRH pulsatility revealed that perinatal exposure to the highest doses of KTZ and DES delayed maturation of GnRH secretion before puberty, whereas pubertal or adult exposure had no effect on GnRH pulsatility. Hypothalamic transcriptome, studied by RNAsequencing in the preoptic area and in the mediobasal hypothalamus, was found to be very sensitive to perinatal exposure to all doses of KTZ before puberty with effects persisting until adulthood. Bioinformatic analysis with Ingenuity Pathway Analysis predicted "Creb signaling in Neurons" and "IGF-1 signaling" among the most downregulated pathways by all doses of KTZ and DES before puberty, and "PPARg" as a common upstream regulator driving gene expression changes. Deeper screening ofRNAseq datasets indicated that a high number of genes regulating the activity of the extrinsic GnRH pulse generator were consistently affected by all the doses of DES and KTZ before puberty. Several, including MKRN3, DNMT3 or Cbx7, showed similar alterations in expression at adulthood. CONCLUSION nRH secretion and the hypothalamic transcriptome are highly sensitive to perinatal exposure to both DES and KTZ. The identified pathways should be exploredfurther to identify biomarkers for future testing strategies for EDC identification and when enhancing the current standard information requirements in regulation.
Collapse
Affiliation(s)
- Delphine Franssen
- Neuroendocrinology Unit, GIGA Neurosciences, University of Liège, Liège, Belgium
- *Correspondence: Delphine Franssen,
| | | | | | - Arnaud Lavergne
- GIGA-Bioinformatics, GIGA Institute, Université de Liège, Liège, Belgium
| | - Quentin Terwagne
- Neuroendocrinology Unit, GIGA Neurosciences, University of Liège, Liège, Belgium
| | - Julie Boberg
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Sofie Christiansen
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Terje Svingen
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Anne-Simone Parent
- Neuroendocrinology Unit, GIGA Neurosciences, University of Liège, Liège, Belgium
- Department of Pediatrics, University Hospital Liege, Liege, Belgium
| |
Collapse
|
10
|
Ding T, Yan W, Zhou T, Shen W, Wang T, Li M, Zhou S, Wu M, Dai J, Huang K, Zhang J, Chang J, Wang S. Endocrine disrupting chemicals impact on ovarian aging: Evidence from epidemiological and experimental evidence. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 305:119269. [PMID: 35405219 DOI: 10.1016/j.envpol.2022.119269] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 03/14/2022] [Accepted: 04/03/2022] [Indexed: 06/14/2023]
Abstract
Endocrine-disrupting chemicals (EDCs) are ubiquitous in daily life, but their harmful effects on the human body have not been fully explored. Recent studies have shown that EDCs exposure could lead to infertility, menstrual disorder and menopause, resulting in subsequent effects on female health. Therefore, it is of great significance to clarify and summarize the impacts of EDCs on ovarian aging for explaining the etiology of ovarian aging and maintaining female reproductive health. Here in this review, we focused on the impacts of ten typical environmental contaminants on the progression of ovarian aging during adult exposure, including epidemiological data in humans and experimental models in rodents, with their clinical phenotypes and underlying mechanisms. We found that both persistent (polychlorinated biphenyls, perfluoroalkyl and polyfluoroalkyl substances) and non-persistent (phthalates) EDCs exposure could increase an overall risk of ovarian aging, leading to the diminish of ovarian reserve, decline of fertility or fecundity, irregularity of the menstrual cycle and an earlier age at menopause, and/or premature ovarian insufficiency/failure in epidemiological studies. Among these, the loss of follicles can also be validated in experimental studies of some EDCs, such as BPA, phthalates, parabens and PCBs. The underlying mechanisms may involve the impaired ovarian follicular development by altering receptor-mediated pro-apoptotic pathways, inducing signal transduction and cell cycle arrest and epigenetic modification. However, there were inconsistent results in the impacts on fertility/fecundity, menstrual/estrous cycle and hormone changes response to different EDCs, and differences between human and animal studies. Our review summarizes the current state of knowledge on ovarian disrupters, highlights their risks to ovarian aging and identifies knowledge gaps in humans and animals. We therefore propose that females adopt healthy lifestyle changes to minimize their exposure to both persistent and non-persistent chemicals, that have the potential damage to their reproductive function.
Collapse
Affiliation(s)
- Ting Ding
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wei Yan
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ting Zhou
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wei Shen
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Tian Wang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Milu Li
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Su Zhou
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Meng Wu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jun Dai
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Kecheng Huang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jinjin Zhang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jiang Chang
- Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, Wuhan, 430030, China; School of Public Health, Tongji Medical College, Huazhong University of Sciences and Technology, Wuhan, 430030, China
| | - Shixuan Wang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| |
Collapse
|
11
|
Yaglova NV, Obernikhin SS, Nazimova SV, Timokhina EP, Tsomartova DA, Yaglov VV. Development and Function of the Adrenal Zona Reticularis in Rats Prenatally and Postnatally Exposed to the Endocrine Disruptor DDT. BIOL BULL+ 2022. [DOI: 10.1134/s1062359022030177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
12
|
West CN, Schell LM, Gallo MV. Sex differences in the association of measures of sexual maturation to common toxicants: Lead, dichloro-diphenyl-trichloroethane (DDT), dichloro-diphenyl-dichloroethylene (DDE), and polychlorinated biphenyls (PCBs). Ann Hum Biol 2022; 48:485-502. [PMID: 35105206 DOI: 10.1080/03014460.2021.1998623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Many studies of human toxicant exposure examine the hypothesis that human sexual maturation can be affected through endocrine disruption. Within this body of literature there is significant variation in the findings. Variation may be related to the differential effects by toxicants between males and females as well as variation in sample size, toxicant levels, and the timing of exposure. We review sexual maturation outcomes between males and females when exposed to lead, dichlorodiphenyldichloroethylene (DDE), dichloro-diphenyl-trichloroethane (DDT), and polychlorinated biphenyls (PCBs) using a systematic process to gather peer-reviewed studies published from January 1994 through December 2019 on the NCBI website's PubMed search engine. The review includes 34 studies, some comprised of multiple analyses, to compare effects on sexual maturation by sex. The analysis shows that both boys and girls have delayed sexual maturation in relation to lead exposure. There are differences in the direction of effects associated with DDE/DDT and PCB exposure in boys and girls. PCBs exist as congeners of many structural forms, and that variation is considered in this review. Dioxin-like and non-dioxin-like PCBs exposure directionality differed between boys and girls as well. Future investigations into the basis of sex variation in DDE/DDT and PCB relationships to sexual maturation are warranted.
Collapse
Affiliation(s)
- Casey N West
- Department of Anthropology, University at Albany, Albany, NY, USA
| | - Lawrence M Schell
- Department of Anthropology, University at Albany, Albany, NY, USA.,Center for the Elimination of Minority Health Disparities, University at Albany, Albany, NY, USA.,Department of Epidemiology and Biostatistics, University at Albany, Albany, NY, USA
| | - Mia V Gallo
- Department of Anthropology, University at Albany, Albany, NY, USA.,Center for the Elimination of Minority Health Disparities, University at Albany, Albany, NY, USA
| |
Collapse
|
13
|
Uldbjerg CS, Koch T, Lim YH, Gregersen LS, Olesen CS, Andersson AM, Frederiksen H, Coull BA, Hauser R, Juul A, Bräuner EV. OUP accepted manuscript. Hum Reprod Update 2022; 28:687-716. [PMID: 35466359 PMCID: PMC9434240 DOI: 10.1093/humupd/dmac013] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 01/25/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Globally, the ages at pubertal onset for girls and boys have been decreasing during recent decades, partly attributed to excess body fat accumulation. However, a growing body of literature has recognized that endocrine disrupting chemicals (EDCs) may play an important role in this global trend, but the association has not yet been fully established. OBJECTIVE AND RATIONALE EDCs can interfere with normal hormone function and metabolism and play a role in pubertal onset. We aimed to systematically identify and evaluate the current evidence on the timing of pubertal onset in girls and boys following prenatal or postnatal exposures to xenobiotic EDCs. SEARCH METHODS Following PRISMA guidelines, we performed a systematic literature search of original peer-reviewed publications in the PubMed database through a block search approach using a combination of index MeSH and free text search terms. Publications were considered if they covered biomarkers of prenatal or postnatal exposures to xenobiotic EDCs (European Commission's list of category 1 EDCs) measured in maternal or child biospecimen and pubertal onset defined by the progression of the following milestones (and assessed in terms of the following measures): menarche (age), thelarche (Tanner staging) and pubarche (Tanner staging), in girls, and genital stage (Tanner staging), testicular volume (ml) and pubarche (Tanner staging), in boys. OUTCOMES The literature search resulted in 703 references, of which we identified 52 publications fulfilling the eligibility criteria for the qualitative trend synthesis and 23 publications for the meta-analysis. The qualitative trend synthesis provided data on 103 combinations of associations between prenatal or postnatal exposure to EDC compounds groups and puberty outcomes and the meta-analysis enabled 18 summary risk estimates of meta-associations. WIDER IMPLICATIONS Statistically significant associations in the qualitative trend synthesis suggested that postnatal exposure to phthalates may be associated with earlier thelarche and later pubarche. However, we did not find consistent evidence in the meta-analysis for associations between timing of pubertal onset in girls and boys and exposures to any of the studied xenobiotic EDCs. We were not able to identify specific pre- or postnatal windows of exposure as particularly critical and susceptible for effects of EDCs. Current evidence is subject to several methodological challenges and inconsistencies and evidence on specific exposure-outcome associations remains too scarce to firmly confirm EDC exposure as a risk factor for changes in age of pubertal onset in the general child population. To create a more uniform foundation for future comparison of evidence and to strengthen pooled studies, we recommend the use of more standardized approaches in the choice of statistical analyses, with exposure transformations, and in the definitions and assessments of puberty outcomes. The impact of mixtures of EDC exposures on the association also remains unestablished and would be valuable to elucidate for prenatal and postnatal windows of exposure. Future large, longitudinal epidemiological studies are needed to clarify the overall association.
Collapse
Affiliation(s)
| | | | - Y -H Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - L S Gregersen
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - C S Olesen
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - A -M Andersson
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - H Frederiksen
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - B A Coull
- Department of Biostatistics, T.H. Chan School of Public Health, Harvard University, Cambridge, MA, USA
| | - R Hauser
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Cambridge, MA, USA
| | - A Juul
- Correspondence address. Department of Growth and Reproduction, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Tel: +45-3545-5085; E-mail: (A.J.); Tel: +45-4242-8550; E-mail: (E.V.B.)
| | - E V Bräuner
- Correspondence address. Department of Growth and Reproduction, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Tel: +45-3545-5085; E-mail: (A.J.); Tel: +45-4242-8550; E-mail: (E.V.B.)
| |
Collapse
|
14
|
Sakali AK, Bargiota A, Fatouros IG, Jamurtas A, Macut D, Mastorakos G, Papagianni M. Effects on Puberty of Nutrition-Mediated Endocrine Disruptors Employed in Agriculture. Nutrients 2021; 13:nu13114184. [PMID: 34836437 PMCID: PMC8622967 DOI: 10.3390/nu13114184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 11/16/2022] Open
Abstract
Pesticide residues are largely found in daily consumed food because of their extensive use in farming and their long half-life, which prolongs their presence in the environment. Many of these pesticides act as endocrine-disrupting chemicals after pre- or postnatal exposure, significantly affecting, among other things, the time of puberty onset, progression, and completion. In humans, precocious or delayed puberty, and early or delayed sexual maturation, may entail several negative long-term health implications. In this review, we summarize the current evidence on the impact of endocrine-disrupting pesticides upon the timing of the landmarks of female and male puberty in both animals (vaginal opening, first estrus, and balanopreputial separation) and humans (thelarche, menarche, gonadarche). Moreover, we explore the possible mechanisms of action of the reviewed endocrine-disrupting pesticides on the human reproductive system. Access to safe, healthy, and nutritious food is fundamental for the maintenance of health and wellbeing. Eliminating the presence of hazardous chemicals in largely consumed food products may increase their nutritional value and be proven beneficial for overall health. Consequently, understanding the effects of human exposure to hazardous endocrine-disrupting pesticides, and legislating against their circulation, are of major importance for the protection of health in vulnerable populations, such as children and adolescents.
Collapse
Affiliation(s)
- Anastasia Konstantina Sakali
- Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (A.K.S.); (A.B.)
| | - Alexandra Bargiota
- Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece; (A.K.S.); (A.B.)
| | - Ioannis G. Fatouros
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece; (I.G.F.); (A.J.)
| | - Athanasios Jamurtas
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece; (I.G.F.); (A.J.)
| | - Djuro Macut
- Clinic of Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - George Mastorakos
- Unit of Endocrinology, Diabetes Mellitus and Metabolism, Aretaieion University Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Maria Papagianni
- Department of Nutrition and Dietetics, University of Thessaly, 42132 Trikala, Greece
- Unit of Endocrinology, 3rd Department of Pediatrics, Hippokration Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
- Correspondence:
| |
Collapse
|
15
|
Abstract
PURPOSE This study identifies the menstrual cycle irregularities of Latinx child and adolescent farmworkers. METHODS Child and adolescent farmworkers aged 13 to 20 years completed questionnaires about menstrual cycle patterns in 2019, and wore silicone passive collection wristbands for pesticide detection in 2018. Menstrual cycle irregularities were determined from the American College of Obstetricians and Gynecologists committee opinion. RESULTS Half of participants experienced any menstrual cycle irregularity; the most frequent irregularities were cycle length (38.6%) and having gone 90 days or more without a menstrual period (20.4%). Pesticides were detected in 92.9% of the wristbands; most participants were exposed to an endocrine disrupting chemical (EDC) pesticide. CONCLUSION Half of Latinx children and adolescents hired farmworkers experience irregular menstrual cycles, and most are exposed to EDCs. Inclusion of occupational and menstrual histories in child and adolescent medical visits is critical.
Collapse
|
16
|
Fucic A, Duca RC, Galea KS, Maric T, Garcia K, Bloom MS, Andersen HR, Vena JE. Reproductive Health Risks Associated with Occupational and Environmental Exposure to Pesticides. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126576. [PMID: 34207279 PMCID: PMC8296378 DOI: 10.3390/ijerph18126576] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/07/2021] [Accepted: 06/14/2021] [Indexed: 02/07/2023]
Abstract
A marked reduction in fertility and an increase in adverse reproductive outcomes during the last few decades have been associated with occupational and environmental chemical exposures. Exposure to different types of pesticides may increase the risks of chronic diseases, such as diabetes, cancer, and neurodegenerative disease, but also of reduced fertility and birth defects. Both occupational and environmental exposures to pesticides are important, as many are endocrine disruptors, which means that even very low-dose exposure levels may have measurable biological effects. The aim of this review was to summarize the knowledge collected between 2000 and 2020, to highlight new findings, and to further interpret the mechanisms that may associate pesticides with infertility, abnormal sexual maturation, and pregnancy complications associated with occupational, environmental and transplacental exposures. A summary of current pesticide production and usage legislation is also included in order to elucidate the potential impact on exposure profile differences between countries, which may inform prevention measures. Recommendations for the medical surveillance of occupationally exposed populations, which should be facilitated by the biomonitoring of reduced fertility, is also discussed.
Collapse
Affiliation(s)
- Aleksandra Fucic
- Institute for Medical Research and Occupational Health, 10000 Zagreb, Croatia
- Correspondence: ; Tel.: +385-15682500; Fax: +3814673303
| | - Radu C. Duca
- Unit Environmental Hygiene and Human Biological Monitoring, Department of Health Protection, National Health Laboratory, L-3555 Dudelange, Luxembourg;
- Centre for Environment and Health, KU Leuven, 3001 Leuven, Belgium
| | - Karen S. Galea
- Institute of Occupational Medicine, Edinburgh EH14 4AP, UK;
| | - Tihana Maric
- Medical School, University of Zagreb, 10000 Zagreb, Croatia;
| | - Kelly Garcia
- Department of Global and Community Health, George Mason University, Fairfax, VA 22030, USA; (K.G.); (M.S.B.)
| | - Michael S. Bloom
- Department of Global and Community Health, George Mason University, Fairfax, VA 22030, USA; (K.G.); (M.S.B.)
| | - Helle R. Andersen
- Department of Public Health, University of Southern Denmark, DK-5000 Odense C, Denmark;
| | - John E. Vena
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA;
| |
Collapse
|
17
|
Green MP, Harvey AJ, Finger BJ, Tarulli GA. Endocrine disrupting chemicals: Impacts on human fertility and fecundity during the peri-conception period. ENVIRONMENTAL RESEARCH 2021; 194:110694. [PMID: 33385395 DOI: 10.1016/j.envres.2020.110694] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/24/2020] [Accepted: 12/25/2020] [Indexed: 05/08/2023]
Abstract
It is becoming increasingly difficult to avoid exposure to man-made endocrine disrupting chemicals (EDCs) and environmental toxicants. This escalating yet constant exposure is postulated to partially explain the concurrent decline in human fertility that has occurred over the last 50 years. Controversy however remains as to whether associations exist, with conflicting findings commonly reported for all major EDC classes. The primary aim of this extensive work was to identify and review strong peer-reviewed evidence regarding the effects of environmentally-relevant EDC concentrations on adult male and female fertility during the critical periconception period on reproductive hormone concentrations, gamete and embryo characteristics, as well as the time to pregnancy in the general population. Secondly, to ascertain whether individuals or couples diagnosed as sub-fertile exhibit higher EDC or toxicant concentrations. Lastly, to highlight where little or no data exists that prevents strong associations being identified. From the greater than 1480 known EDCs, substantial evidence supports a negative association between exposure to phthalates, PCBs, PBDEs, pyrethroids, organochloride pesticides and male fertility and fecundity. Only moderate evidence exists for a negative association between BPA, PCBs, organochloride pesticides and female fertility and fecundity. Overall fewer studies were reported in women than men, with knowledge gaps generally evident for both sexes for all the major EDC classes, as well as a paucity of female fertility studies following exposure to parabens, triclosans, dioxins, PFAS, organophosphates and pyrethroids. Generally, sub-fertile individuals or couples exhibit higher EDC concentrations, endorsing a positive association between EDC exposure and sub-fertility. This review also discusses confounding and limiting factors that hamper our understanding of EDC exposures on fertility and fecundity. Finally, it highlights future research areas, as well as government, industry and social awareness strategies required to mitigate the negative effects of EDC and environmental toxicant exposure on human fertility and fecundity.
Collapse
Affiliation(s)
- Mark P Green
- School of BioSciences, University of Melbourne, Melbourne, VIC, Australia.
| | - Alexandra J Harvey
- School of BioSciences, University of Melbourne, Melbourne, VIC, Australia
| | - Bethany J Finger
- School of BioSciences, University of Melbourne, Melbourne, VIC, Australia
| | - Gerard A Tarulli
- School of BioSciences, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
18
|
Lopez-Rodriguez D, Franssen D, Bakker J, Lomniczi A, Parent AS. Cellular and molecular features of EDC exposure: consequences for the GnRH network. Nat Rev Endocrinol 2021; 17:83-96. [PMID: 33288917 DOI: 10.1038/s41574-020-00436-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2020] [Indexed: 12/12/2022]
Abstract
The onset of puberty and the female ovulatory cycle are important developmental milestones of the reproductive system. These processes are controlled by a tightly organized network of neurotransmitters and neuropeptides, as well as genetic, epigenetic and hormonal factors, which ultimately drive the pulsatile secretion of gonadotropin-releasing hormone. They also strongly depend on organizational processes that take place during fetal and early postnatal life. Therefore, exposure to environmental pollutants such as endocrine-disrupting chemicals (EDCs) during critical periods of development can result in altered brain development, delayed or advanced puberty and long-term reproductive consequences, such as impaired fertility. The gonads and peripheral organs are targets of EDCs, and research from the past few years suggests that the organization of the neuroendocrine control of reproduction is also sensitive to environmental cues and disruption. Among other mechanisms, EDCs interfere with the action of steroidal and non-steroidal receptors, and alter enzymatic, metabolic and epigenetic pathways during development. In this Review, we discuss the cellular and molecular consequences of perinatal exposure (mostly in rodents) to representative EDCs with a focus on the neuroendocrine control of reproduction, pubertal timing and the female ovulatory cycle.
Collapse
Affiliation(s)
| | - Delphine Franssen
- Neuroendocrinology Unit, GIGA Neurosciences, University of Liège, Liège, Belgium
| | - Julie Bakker
- Neuroendocrinology Unit, GIGA Neurosciences, University of Liège, Liège, Belgium
| | - Alejandro Lomniczi
- Division of Neuroscience, Oregon National Primate Research Center (ONPRC), OHSU, OR, USA
| | - Anne-Simone Parent
- Neuroendocrinology Unit, GIGA Neurosciences, University of Liège, Liège, Belgium.
- Department of Pediatrics, University Hospital Liège, Liège, Belgium.
| |
Collapse
|
19
|
García-Villarino M, Riaño-Galán I, Rodríguez-Dehli AC, Freire C, Vizcaíno E, Grimalt JO, Tardón A, Fernández-Somoano A. Association between pre/perinatal exposure to POPs and children's anogenital distance at age 4 years: A study from the INMA-Asturias cohort. Int J Hyg Environ Health 2020; 229:113563. [PMID: 32559636 DOI: 10.1016/j.ijheh.2020.113563] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 05/08/2020] [Accepted: 05/18/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Prenatal exposure to endocrine-disrupting chemicals may impair genital development and alter reproductive tract anatomy. Anogenital distance (AGD) is a useful biomarker of exposure to chemicals that act as endocrine disruptors. We evaluated associations between prenatal and perinatal exposure to several persistent organic pollutants (POPs) and AGD in 4-year-old children. METHODS Data were drawn from the INMA-Asturias cohort. Pediatricians measured the anofourchetal distance in female children and anoscrotal distance in male children. The anogenital index (AGI) was defined as the AGD divided by the child's weight at age of examination. We measured the levels of two hexachlorocyclohexane isomers, hexachlorobenzene, dichlorodiphenyltrichloroethane (DDT) and its metabolites, six polychlorinated biphenyl (PCB) congeners, and six polybrominated diphenyl ether (PBDE) congeners in maternal serum at 12 gestational weeks (n = 155) and in cord blood serum (n = 229). Anthropometric and parental sociodemographic variables were collected via face-to-face interviews. Linear regression models were used to evaluate the relationship between exposure to POPs and AGI, adjusted for confounders and stratified by sex. RESULTS In male children, we found inverse associations between AGI and maternal concentrations of PCB-138 (ß = -0.041, 95% confidence interval [CI]: -0.074, -0.008, second tertile), PCB-153 (ß = -0.052, 95% CI: -0.085, -0.020, second tertile), PCB-180 ß = -0.065, 95% CI: -0.096, -0.035, second tertile; ß = -0.042, 95% CI: -0.073, -0.011, third tertile), PBDE-209 (ß = -0.031, 95% CI: -0.058, -0.006), cord serum concentrations of PCB-153 (ß = -0.029, 95% CI: -0.059, -0.000, second tertile; ß = -0.047, 95% CI: -0.085, -0.008, third tertile), and PCB-180 (ß = -0.041, 95% CI: -0.078, -0.005, third tertile). In female children, AGI was positively associated with maternal serum concentrations of PCB-101 (ß = 0.039, 95% CI: 0.002, 0.076, second tertile), and higher cord serum levels of 4,4'-DDT (ß = 0.032, 95% CI: 0.003, 0.061, third tertile) and 4,4'-DDE (ß = 0.040, 95% CI: 0.011, 0.069, third tertile). CONCLUSIONS Our findings provide evidence of associations between specific POPs and AGI in boys and girls aged 4 years, and suggest that pre/perinatal exposure to POPs has a feminizing effect in males and a masculinizing effect in females.
Collapse
Affiliation(s)
- Miguel García-Villarino
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029, Madrid, Spain; Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IUOPA), Department of Medicine, University of Oviedo, Julian Clavería Street s/n, 33006, Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n. 33001, Oviedo, Asturias, Spain.
| | - Isolina Riaño-Galán
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029, Madrid, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n. 33001, Oviedo, Asturias, Spain; Servicio de Pediatría, Endocrinología, HUCA, Roma Avenue s/n. 33001, Oviedo, Asturias, Spain
| | - Ana Cristina Rodríguez-Dehli
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n. 33001, Oviedo, Asturias, Spain; Servicio de Pediatría. Hospital San Agustín, Heros Street, 4, 33410, Avilés, Asturias, Spain
| | - Carmen Freire
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029, Madrid, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.Granada), Avenida de Madrid 15, 18010, Granada, Spain
| | - Esther Vizcaíno
- Department of environmental Chemistry, Institute of Environmental Assessment and Water Research (IDAEA-CSIC), Jordi Girona Street, 18-26, 08034, Barcelona, Cataluña, Spain
| | - Joan O Grimalt
- Department of environmental Chemistry, Institute of Environmental Assessment and Water Research (IDAEA-CSIC), Jordi Girona Street, 18-26, 08034, Barcelona, Cataluña, Spain
| | - Adonina Tardón
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029, Madrid, Spain; Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IUOPA), Department of Medicine, University of Oviedo, Julian Clavería Street s/n, 33006, Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n. 33001, Oviedo, Asturias, Spain
| | - Ana Fernández-Somoano
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029, Madrid, Spain; Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IUOPA), Department of Medicine, University of Oviedo, Julian Clavería Street s/n, 33006, Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n. 33001, Oviedo, Asturias, Spain
| |
Collapse
|
20
|
Cabry R, Merviel P, Madkour A, Lefranc E, Scheffler F, Desailloud R, Bach V, Benkhalifa M. The impact of endocrine disruptor chemicals on oocyte/embryo and clinical outcomes in IVF. Endocr Connect 2020; 9:R134-R142. [PMID: 32380469 PMCID: PMC7354731 DOI: 10.1530/ec-20-0135] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/07/2020] [Indexed: 12/17/2022]
Abstract
The negative impact of endocrine-disrupting pesticides on human fertility is now a key issue in reproductive health. There are much fewer literature data about the impact of pesticide exposure on women than on men and very few studies of women participating in an in vitro fertilization (IVF) programme. In the present review, we found that (1) various pesticides with an endocrine-disrupting action are associated with poor oocyte maturation and competency, embryonic defects and poor IVF outcomes, and (2) some pesticide compounds are linked to specific causes of female infertility, such as premature ovarian insufficiency, polycystic ovarian syndrome, and endometriosis. IVF participants living in agricultural regions should be informed about the fertility decline, low ongoing pregnancy rates, and elevated risk of miscarriage associated with exposure to high doses of pesticides.
Collapse
Affiliation(s)
| | | | - Aicha Madkour
- Mohammed V University of Rabat, Reproductive Medicine, Rabat, Morocco
| | | | | | | | | | - Moncef Benkhalifa
- Amiens University, Amiens, Haut-de-France, France
- Correspondence should be addressed to M Benkhalifa:
| |
Collapse
|
21
|
Reynolds P, Canchola AJ, Duffy CN, Hurley S, Neuhausen SL, Horn-Ross PL, Rull RP. Urinary cadmium and timing of menarche and pubertal development in girls. ENVIRONMENTAL RESEARCH 2020; 183:109224. [PMID: 32085996 PMCID: PMC8758186 DOI: 10.1016/j.envres.2020.109224] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 01/30/2020] [Accepted: 02/03/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Cadmium (Cd) is a developmental toxicant that is released into the environment during industrial processes. Previous animal studies suggest that Cd may impact the onset of puberty. OBJECTIVES To determine whether Cd exposure, measured as urinary Cd concentration, was associated with ages at menarche and pubertal development. METHODS A cohort of 211 girls, ages 10-13 years at baseline, was followed for up to two years. Girls completed an interview and self-assessment of Tanner stages of breast development and pubic hair growth. They were followed monthly until menarche. Urinary Cd concentrations were measured in overnight urine specimens. Multivariable Cox regression was used to evaluate the association between urinary Cd and age at menarche and cumulative logit regression was used to evaluate the associations between urinary Cd and breast development and pubic hair growth. RESULTS The baseline geometric mean creatinine-adjusted Cd concentration was 0.22 μg/g creatinine (geometric standard deviation = 1.6) and decreased with increasing age (p-trend = 0.04). Cd levels were higher among Asian than White girls or girls of other/mixed race/ethnicity (p = 0.04). In multivariable analyses, girls with urinary Cd ≥ 0.4 μg/L were less likely to have attained menarche than girls with urinary Cd < 0.2 μg/L (hazard ratio = 0.42; 95% confidence interval, 0.23-0.78). Urinary Cd was negatively associated with pubic hair growth (p-trend = 0.01) but not with breast development (p-trend = 0.72) at baseline. CONCLUSIONS These findings suggest that a higher Cd body burden may delay some aspects of pubertal development among girls.
Collapse
Affiliation(s)
- Peggy Reynolds
- Cancer Prevention Institute of California, Fremont, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
| | - Alison J Canchola
- Cancer Prevention Institute of California, Fremont, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Christine N Duffy
- Cancer Prevention Institute of California, Fremont, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Susan Hurley
- Cancer Prevention Institute of California, Fremont, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Susan L Neuhausen
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA, USA
| | | | - Rudolph P Rull
- Cancer Prevention Institute of California, Fremont, CA, USA; School of Community Health Sciences, University of Nevada, Reno, NV, USA
| |
Collapse
|
22
|
Eckert-Lind C, Busch AS, Petersen JH, Biro FM, Butler G, Bräuner EV, Juul A. Worldwide Secular Trends in Age at Pubertal Onset Assessed by Breast Development Among Girls: A Systematic Review and Meta-analysis. JAMA Pediatr 2020; 174:e195881. [PMID: 32040143 PMCID: PMC7042934 DOI: 10.1001/jamapediatrics.2019.5881] [Citation(s) in RCA: 171] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
IMPORTANCE The initial clinical sign of pubertal onset in girls is breast gland development (thelarche). Although numerous studies have used recalled age at menarche (first menstruation) to assess secular trends of pubertal timing, no systematic review has been conducted of secular trends of thelarche. OBJECTIVES To systematically evaluate published data on pubertal timing based on age at thelarche and evaluate the change in pubertal onset in healthy girls around the world. DATA SOURCES A systematic literature search was performed in PubMed and Embase of all original peer-reviewed articles published in English before June 20, 2019. STUDY SELECTION Included studies used clinical assessment of breast development in healthy girls and used adequate statistical methods, including the reporting of SEs or CIs. The quality of the articles was evaluated by assessing study design, potential sources of bias, main characteristics of the study population, and methods of statistical analysis. DATA EXTRACTION AND SYNTHESIS In accordance with PRISMA guidelines, all articles were assessed for eligibility independently by 2 authors. Weighted regression analysis was performed using a random-effects model. MAIN OUTCOMES AND MEASURES Studies examining age at thelarche (development of Tanner breast stage 2) in healthy girls. RESULTS The literature search resulted in a total of 3602 studies, of which 30 studies fulfilled the eligibility criteria. There was a secular trend in ages at thelarche according to race/ethnicity and geography. Overall, the age at thelarche decreased 0.24 years (95% CI, -0.44 to -0.04) (almost 3 months) per decade from 1977 to 2013 (P = .02). CONCLUSIONS AND RELEVANCE The age at thelarche has decreased a mean of almost 3 months per decade from 1977 to 2013. A younger age at pubertal onset may change current diagnostic decision-making. The medical community needs current and relevant data to redefine "precocious puberty," because the traditional definition may be outdated, at least in some regions of the world.
Collapse
Affiliation(s)
- Camilla Eckert-Lind
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Alexander S. Busch
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jørgen H. Petersen
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark,Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Frank M. Biro
- Division of Adolescent and Transition Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Gary Butler
- Institute of Child Health, University College London Hospital, London, United Kingdom
| | - Elvira V. Bräuner
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anders Juul
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
23
|
Attfield KR, Pinney SM, Sjödin A, Voss RW, Greenspan LC, Biro FM, Hiatt RA, Kushi LH, Windham GC. Longitudinal study of age of menarche in association with childhood concentrations of persistent organic pollutants. ENVIRONMENTAL RESEARCH 2019; 176:108551. [PMID: 31376650 DOI: 10.1016/j.envres.2019.108551] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 06/18/2019] [Accepted: 06/18/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Age at female puberty is associated with adult morbidities, including breast cancer and diabetes. Hormonally active chemicals are suspected of altering pubertal timing. We examined whether persistent organic pollutants (POPs) are associated with age at menarche in a longitudinal study. METHODS We analyzed data for females enrolled at age 6-8 years in the Breast Cancer and Environment Research Program from California and Ohio. Participants were followed annually 2004-2013 and provided serum (mean age 7.8 years) for measurement of polychlorinated biphenyl (PCB), organochlorine pesticide (OCP), and polybrominated diphenyl ether (PBDE) concentrations. Age of menarche was assigned based on parental and participant reported dates and ages of menarche. Adjusted hazard ratios (aHRs) for menarchal onset were calculated with Cox proportional regression. Body mass index (BMI), potentially on the causal pathway, was added to parallel analyses. RESULTS Age of menarche was later with higher summed PCB levels (median 11.9 years in quartile 1 [Q1] versus 12.7 in quartile 4 [Q4]) and OCP levels (12.1 years versus 12.4, respectively). When adjusting for all covariates except BMI, higher POP concentrations were associated with later age at menarche (Q4 versus Q1 aHRs: PBDEs 0.75 [95% CI 0.58, 0.97], PCBs 0.67 [95% CI 0.5, 0.89], and OCPs 0.66 [95% CI 0.50, 0.89]). Additional adjustment for BMI attenuated aHRs; PCB aHR approached the null. CONCLUSION Findings revealed later onset of menarche with higher concentrations of certain POPs, possibly through an association with BMI. Altered pubertal timing may have long lasting effects on reproductive health and disease risk, so continued attention is important for understanding the biological processes affected by hormonally active chemicals.
Collapse
Affiliation(s)
- Kathleen R Attfield
- California Department of Public Health, Richmond, CA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Susan M Pinney
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Andreas Sjödin
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Robert W Voss
- California Department of Public Health, Richmond, CA, USA
| | | | - Frank M Biro
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Robert A Hiatt
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | | | | |
Collapse
|
24
|
Nandi A, Behrman JR, Black MM, Kinra S, Laxminarayan R. Relationship between early-life nutrition and ages at menarche and first pregnancy, and childbirth rates of young adults: Evidence from APCAPS in India. MATERNAL AND CHILD NUTRITION 2019; 16:e12854. [PMID: 31141837 PMCID: PMC7038893 DOI: 10.1111/mcn.12854] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 05/02/2019] [Accepted: 05/21/2019] [Indexed: 01/28/2023]
Abstract
India's Integrated Child Development Services (ICDS) provides daily supplementary nutrition and other public health services to women and children. We estimated associations between exposure to early‐childhood ICDS nutrition and adult reproductive outcomes. During 1987–1990, a balanced protein–calorie supplement called “upma”—made from locally available corn–soya ingredients—was rolled out by subdistricts near Hyderabad and offered to pregnant women and children under age 6 years. In a controlled trial, 15 villages received the supplement and 14 did not. We used data from a 2010–2012 resurvey of adults born during the trial (n = 715 in intervention and n = 645 in control arms). We used propensity score matching methods to estimate the associations between birth in an intervention village and menarcheal age, age at first pregnancy, and fertility of adults. We found that women born in the intervention group during the trial, as compared with the control group, had menarche 0.45 (95% confidence interval [CI: 0.22, 0.68]; p < .001) years later and first pregnancy 0.53 (95% CI [0.04, 1.02]; p < .05) years later. Married women from the intervention group had menarche 0.36 (95% CI [0.09, 0.64]; p < .01) years later, first cohabitation with partner 0.8 (95% CI [0.27, 1.33]; p < .01) years later, and first pregnancy 0.53 (95% CI [0.04, 1.02]; p < .05) years later than married women in the control group. There was no significant difference between intervention and control group women regarding whether they had at least one childbirth or the total number of children born. The findings were similar when we employed inverse propensity score weighted regression models.
Collapse
Affiliation(s)
- Arindam Nandi
- Center for Disease Dynamics, Economics & Policy, Washington, DC, Washington, District of Columbia
| | - Jere R Behrman
- Departments of Economics and Sociology, Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Maureen M Black
- RTI International, Research Triangle Park, North Carolina.,Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Sanjay Kinra
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Ramanan Laxminarayan
- Center for Disease Dynamics, Economics & Policy, New Delhi, New Delhi, India.,Princeton Environmental Institute, Princeton University, Princeton, New Jersey
| |
Collapse
|
25
|
Lee JE, Jung HW, Lee YJ, Lee YA. Early-life exposure to endocrine-disrupting chemicals and pubertal development in girls. Ann Pediatr Endocrinol Metab 2019; 24:78-91. [PMID: 31261471 PMCID: PMC6603611 DOI: 10.6065/apem.2019.24.2.78] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 06/18/2019] [Indexed: 12/30/2022] Open
Abstract
Over the last decades, the onset of puberty in girls has occurred earlier, but the tempo of pubertal progression has been relatively slower, resulting in a younger age at puberty onset without a change in age at menarche. Sufficient energy availability and adiposity contribute to early pubertal development, and environmental factors, such as endocrine-disrupting chemicals (EDCs), may affect not only the control of energy balance, but also puberty and reproduction. EDCs are hormonally active substances that can perturb puberty by acting both peripherally on target organs, such as adipose tissue or adrenal glands, and/or centrally on the hypothalamic-pituitary-gonadal (HPG) axis. Depending on whether the exposure takes place earlier during fetal and neonatal life or later during early childhood, EDCs can lead to different outcomes through different mechanisms. Evidence of associations between exposures to EDCs and altered pubertal timing makes it reasonable to support their relationship. However, human epidemiologic data are limited or inconsistent and cannot provide sufficient evidence for a causal relationship between EDC exposure and changes in pubertal timing. Further investigation is warranted to determine the overall or different effects of EDCs exposure during prenatal or childhood windows on pubertal milestones and to reveal the underlying mechanisms, including epigenetic marks, whereby early-life exposure to EDCs affect the HPG-peripheral tissue axis.
Collapse
Affiliation(s)
- Jeong Eun Lee
- Department of Pediatrics, Inje University Busan Paik Hospital, Busan, Korea
| | - Hae Woon Jung
- Department of Pediatrics, Kyung Hee University Medical Center, Seoul, Korea
| | - Yun Jeong Lee
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, Korea
| | - Young Ah Lee
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, Korea,Address for correspondence: Young Ah Lee, MD, PhD Department of Pediatrics, Seoul National University Children’s Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel: +82-2-2072-2082 Fax: +82-2-2072-3917 E-mail:
| |
Collapse
|
26
|
Mahalingaiah S, Missmer SE, Cheng JJ, Chavarro J, Laden F, Hart JE. Perimenarchal air pollution exposure and menstrual disorders. Hum Reprod 2019; 33:512-519. [PMID: 29377993 DOI: 10.1093/humrep/dey005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 01/14/2018] [Indexed: 01/21/2023] Open
Abstract
STUDY QUESTION What is the association between perimenarchal exposure to total suspended particulate (TSP) in air, menstrual irregularity phenotypes and time to menstrual cycle regularity? SUMMARY ANSWER Exposures to TSP during high school are associated with slightly increased odds of menstrual irregularity and longer time to regularity in high school and early adulthood. WHAT IS KNOWN ALREADY The menstrual cycle is responsive to hormonal regulation. Particulate matter air pollution has demonstrated hormonal activity. However, it is not known if air pollution is associated with menstrual cycle regularity. STUDY DESIGN, SIZE, DURATION Cross sectional study of 34 832 of the original 116 430 women (29.91%) enrolled in 1989 from the Nurses' Health Study II (NHSII). The follow-up rate for this analytic sample was 97.76% at the 1991 survey. PARTICIPANTS/MATERIALS, SETTING, METHODS Annual averages of TSP were available for each year of high school attendance. We created three case definitions including high school menstrual irregularity and androgen excess. The time to menstrual cycle regularity was reported by participants as <1 year, 1-2 years, 3-4 years, 5 years or longer, or never on the baseline questionnaire. Odds ratios and 95% confidence intervals (CI) were calculated for 45 μg/m3 increases in TSP exposure, adjusted for risk factors for menstrual irregularity. MAIN RESULTS AND THE ROLE OF CHANCE In multivariable adjusted models, we observed that for every 45 μg/m3 increase in average high school TSP there was an increased odds (95%CI) of 1.08 (1.03-1.14), 1.08 (1.02-1.15) and 1.10 (0.98-1.25) for moderate, persistent, and persistent with androgen excess irregularity phenotypes, respectively. TSP was also associated with a longer time to cycle regularity, with stronger results among women with older ages at menarche and those living in the Northeast or the West. LIMITATIONS, REASONS FOR CAUTION The outcomes of menstrual regularity and time to cycle regularity were retrospectively assessed outcomes and may be susceptible to recall bias. There is also the potential for selection bias, as women had to live until 2011 to provide addresses. WIDER IMPLICATIONS OF THE FINDINGS Temporal exposure to air pollution in the adolescent and early adulthood window may be especially important, given its association with phenotypes of menstrual irregularity. The data from this study agrees with existing literature regarding air pollution and reproductive tract diseases. STUDY FUNDING/COMPETING INTEREST(S) Shruthi Mahalingaiah: Reproductive Scientist Development Program HD000849, and a research grant from the Boston University Department of Obstetrics and Gynecology, Stacey Missmer: R01HD57210 from the National Institute of Child Health and Human Development and the Massachusetts Institute of Technology Center for Environmental Health Sciences Translational Pilot Project Program, R01CA50385 from the National Cancer Institute, Jaime Hart and Francine Laden: 5R01ES017017 from the National Institute for Environmental Health Sciences, Jaime Hart: P30 ES00002 from the National Institute for Environmental Health Sciences at the National Institute of Health, The Nurses' Health Study II is supported by infrastructure grant UM1CA176726 from the National Cancer Institute, NIH, U.S. Department of Health and Human Services The authors have no conflicts of interest to declare.
Collapse
Affiliation(s)
- S Mahalingaiah
- Obstetrics and Gynecology, Boston University Medical Campus, 85 E Concord St. 6F, Boston, MA 02118, USA.,Department of Epidemiology, Boston University School of Public Health, 715 Albany St, Boston, MA 02118, USA.,Department of Physiology and Biophysics, Boston University School of Medicine, 700 Albany St, Boston, MA 02118, USA
| | - S E Missmer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.,Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Secchia Center, 15 Michigan St. NE, Michigan State University, Grand Rapids, MI, USA
| | - J J Cheng
- Obstetrics and Gynecology, Boston University Medical Campus, 85 E Concord St. 6F, Boston, MA 02118, USA
| | - J Chavarro
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
| | - F Laden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.,Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Landmark Center, 401 Park Drive, 3rd F West, Boston, MA 02115, USA.,Department of Environmental Health, Exposure, Epidemiology, and Risk Program, Harvard T.H. Chan School of Public Health, Landmark Center, 401 Park Drive, 3rd F West, Boston, MA 02115, USA
| | - J E Hart
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Landmark Center, 401 Park Drive, 3rd F West, Boston, MA 02115, USA.,Department of Environmental Health, Exposure, Epidemiology, and Risk Program, Harvard T.H. Chan School of Public Health, Landmark Center, 401 Park Drive, 3rd F West, Boston, MA 02115, USA
| |
Collapse
|
27
|
Street ME, Angelini S, Bernasconi S, Burgio E, Cassio A, Catellani C, Cirillo F, Deodati A, Fabbrizi E, Fanos V, Gargano G, Grossi E, Iughetti L, Lazzeroni P, Mantovani A, Migliore L, Palanza P, Panzica G, Papini AM, Parmigiani S, Predieri B, Sartori C, Tridenti G, Amarri S. Current Knowledge on Endocrine Disrupting Chemicals (EDCs) from Animal Biology to Humans, from Pregnancy to Adulthood: Highlights from a National Italian Meeting. Int J Mol Sci 2018; 19:E1647. [PMID: 29865233 PMCID: PMC6032228 DOI: 10.3390/ijms19061647] [Citation(s) in RCA: 138] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 05/23/2018] [Accepted: 05/31/2018] [Indexed: 02/07/2023] Open
Abstract
Wildlife has often presented and suggested the effects of endocrine disrupting chemicals (EDCs). Animal studies have given us an important opportunity to understand the mechanisms of action of many chemicals on the endocrine system and on neurodevelopment and behaviour, and to evaluate the effects of doses, time and duration of exposure. Although results are sometimes conflicting because of confounding factors, epidemiological studies in humans suggest effects of EDCs on prenatal growth, thyroid function, glucose metabolism and obesity, puberty, fertility, and on carcinogenesis mainly through epigenetic mechanisms. This manuscript reviews the reports of a multidisciplinary national meeting on this topic.
Collapse
Affiliation(s)
- Maria Elisabeth Street
- Department of Obstetrics, Gynaecology and Paediatrics, Azienda USL-IRCCS, Viale Risorgimento 80, 42123 Reggio Emilia, Italy.
| | - Sabrina Angelini
- Department of Pharmacy and Biotechnology, University of Bologna, Via Irnerio 48, 40126 Bologna, Italy.
| | - Sergio Bernasconi
- Former Department of Medicine, University of Parma, Via A. Catalani 10, 43123 Parma, Italy.
| | - Ernesto Burgio
- ECERI European Cancer and Environment Research Institute, Square de Meeus, 38-40, 1000 Bruxelles, Belgium.
| | - Alessandra Cassio
- Pediatric Endocrinology Programme, Pediatrics Unit, Department of Woman, Child Health and Urologic Diseases, AOU S. Orsola-Malpighi, Via Massarenti, 11, 40138 Bologna, Italy.
| | - Cecilia Catellani
- Department of Obstetrics, Gynaecology and Paediatrics, Azienda USL-IRCCS, Viale Risorgimento 80, 42123 Reggio Emilia, Italy.
| | - Francesca Cirillo
- Department of Obstetrics, Gynaecology and Paediatrics, Azienda USL-IRCCS, Viale Risorgimento 80, 42123 Reggio Emilia, Italy.
| | - Annalisa Deodati
- Department of Pediatrics (DPUO), Bambino Gesù Children's Hospital, Tor Vergata University, Piazza S. Onofrio 4, 00165 Rome, Italy.
| | - Enrica Fabbrizi
- Department of Pediatrics and Neonatology, Augusto Murri Hospital, Via Augusto Murri, 17, 63900 Fermo, Itlay.
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, Neonatal Pathology and Neonatal Section, AOU and University of Cagliari, via Ospedale, 54, 09124 Cagliari, Italy.
| | - Giancarlo Gargano
- Department of Obstetrics, Gynaecology and Paediatrics, Azienda USL-IRCCS, Viale Risorgimento 80, 42123 Reggio Emilia, Italy.
| | - Enzo Grossi
- Villa Santa Maria Institute, Neuropsychiatric Rehabilitation Center, Via IV Novembre 15, 22038 Tavernerio (Como), Italy.
| | - Lorenzo Iughetti
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatrics Unit, University of Modena and Reggio Emilia, via del Pozzo, 71, 41124 Modena, Italy.
| | - Pietro Lazzeroni
- Department of Obstetrics, Gynaecology and Paediatrics, Azienda USL-IRCCS, Viale Risorgimento 80, 42123 Reggio Emilia, Italy.
| | - Alberto Mantovani
- Department of Veterinary Public Health and Food Safety, Food and Veterinary Toxicology Unit ISS⁻National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Lucia Migliore
- Department of Traslational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma, 55, 56123 Pisa, Italy.
| | - Paola Palanza
- Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, 43126 Parma, Italy.
| | - Giancarlo Panzica
- Laboratory of Neuroendocrinology, Department of Neuroscience Rita Levi Montalcini, University of Turin, Via Cherasco 15, 10126 Turin, Italy.
- Neuroscience Institute Cavalieri-Ottolenghi (NICO), Regione Gonzole, 10, 10043 Orbassano (Turin), Italy.
| | - Anna Maria Papini
- Department of Chemistry 'Ugo Schiff', University of Florence, Via della Lastruccia, 3-13, 50019 Sesto Fiorentino, Florence, Italy.
| | - Stefano Parmigiani
- Unit of Evolutionary and Functional Biology-Department of Chemistry, Life Sciences and Environmental Sustainability (SCVSA)-University of Parma⁻11/a, 43124 Parma, Italy.
| | - Barbara Predieri
- Department of Medical and Surgical Sciences of the Mother, Children and Adults, Pediatrics Unit, University of Modena and Reggio Emilia, via del Pozzo, 71, 41124 Modena, Italy.
| | - Chiara Sartori
- Department of Obstetrics, Gynaecology and Paediatrics, Azienda USL-IRCCS, Viale Risorgimento 80, 42123 Reggio Emilia, Italy.
| | - Gabriele Tridenti
- Department of Obstetrics, Gynaecology and Paediatrics, Azienda USL-IRCCS, Viale Risorgimento 80, 42123 Reggio Emilia, Italy.
| | - Sergio Amarri
- Department of Obstetrics, Gynaecology and Paediatrics, Azienda USL-IRCCS, Viale Risorgimento 80, 42123 Reggio Emilia, Italy.
| |
Collapse
|
28
|
Affiliation(s)
- Robert A. Hiatt
- Department of Epidemiology and Biostatistics and Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California 94158, USA
| | | |
Collapse
|
29
|
The effect of follicullar fluid pesticides and polychlorinated biphenyls concentrations on intracytoplasmic sperm injection (ICSI) embryological and clinical outcome. Eur J Obstet Gynecol Reprod Biol 2017; 220:39-43. [PMID: 29154179 DOI: 10.1016/j.ejogrb.2017.11.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 10/19/2017] [Accepted: 11/01/2017] [Indexed: 01/30/2023]
Abstract
OBJECTIVES The present study evaluated the correlation between the concentrations of polychlorinated biphenyls (PCBs) and pesticides in the follicular fluid (FF) obtained during intracytoplasmic sperm injection (ICSI) with the ovarian response, endometrial thickness, and embryological and clinical outcomes. DESIGN Cross-sectional observational study. MATERIALS AND METHODS Women aged 20 to 38 years (300 infertile couples) presenting to a university-affiliated fertility center were approached to participate in the study. Only 150 couples that underwent ICSI for male factor infertility agreed to participate, and 94 of them had retrieved enough FF samples suitable for laboratory testing. The FF sample was obtained, centrifuged, and stored in liquid nitrogen. Two organochlorine pesticides (OCPs), Lindane and DDT;three organophosphates (OPs);chlorpyrifos;Diazinon; malathion; one Chloroacetanilide (Pretilachlor);two pyrethroids(Bioallethrin and β-cyfluthrin); and the concentrations of four PCBs, 28, 52, 138, 180, were estimated in the obtained FF samples by using gas chromatography/mass spectrometry. SPSS statistical analysis program (version 17) was used for analysis. Multiple regression analysis was used to correlate the PCBs and pesticides with ICSI outcomes. RESULTS There were significant negative correlations between FF concentrations of the eight examined pesticides and the four PCBs on the endometrial thickness. However, Pretilachlor, chlorpyrifos, β-cyfluthrin, and Diazinon were the only toxic agents that negatively correlated with the number of the oocytes retrieved. Fertilization and early embryo cleavage rates were negatively correlated with Pretilachlor and β-cyfluthrin. Moreover, high concentrations of Lindane,DDT, Diazinon,and chlorpyrifos were significantly associated lower implantation rate. PCB 28 and 180 concentration in the FF was associated with a lower number of retrieved oocytes and fertilization rate, respectively. The number of implanted embryos was negatively correlated with PCB 52 FF concentration. However, the clinical pregnancy rate did not reach the level of significance. CONCLUSION Higher concentrations of any studied PCBs and pesticides are associated with thinner endometrial thickness. The higher the level of Pretilachlor, β-cyfluthrin, PCB 28 and 180, the lower the retrieval, fertilization, and embryo cleavage rates. High PCB and pesticide concentrations in the FF adversely affected embryological ICSI outcomes. However, more data are needed to evaluate their effect on the clinical outcome.
Collapse
|
30
|
Park S, Chung C. Health behaviors related to endocrine-disrupting chemicals and the associated factors of adolescent Korean girls. Women Health 2017; 58:915-929. [PMID: 28805534 DOI: 10.1080/03630242.2017.1363124] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In this cross-sectional study, we examined the relationships among knowledge about endocrine-disrupting chemicals (EDCs), recognition of EDCs-related female reproductive illnesses, concern for the environment, perceived susceptibility to EDCs-related diseases, self- appraisal of exposure to EDCs, and health behaviors related to EDCs in adolescent Korean girls. A convenience sample of 218 girls was recruited during July and August 2015 from middle and high schools located in a city in Korea. The self-administered questionnaire incorporated four characteristics of the participants, five related factors, and a dependent variable of health behaviors. Four of the factors explained 20.4 percent of variance in health behaviors, and after controlling covariates, concern for the environment and self-appraisal of exposure to EDCs were still significant factors explaining 29.0 percent of the variance in health behaviors. However, for one factor, knowledge about EDCs, no independent contribution to health behaviors was observed. The findings indicated that education for young women should focus on enhancing their interests in the environment and awareness of environmental hazards. Further, clear and reliable guidelines to protect young women from the exposure to EDCs should be provided to adolescent girls.
Collapse
Affiliation(s)
- SoMi Park
- a Department of Nursing, Wonju College of Medicine, Institute for Well Aging, Institute of Lifestyle Medicine , Yonsei University, Wonju, Korea
| | - ChaeWeon Chung
- b College of Nursing, Research Institute of Nursing Science , Seoul National University, Seoul, Korea
| |
Collapse
|
31
|
Hardy A, Benford D, Halldorsson T, Jeger MJ, Knutsen HK, More S, Naegeli H, Noteborn H, Ockleford C, Ricci A, Rychen G, Schlatter JR, Silano V, Solecki R, Turck D, Bresson JL, Dusemund B, Gundert-Remy U, Kersting M, Lambré C, Penninks A, Tritscher A, Waalkens-Berendsen I, Woutersen R, Arcella D, Court Marques D, Dorne JL, Kass GE, Mortensen A. Guidance on the risk assessment of substances present in food intended for infants below 16 weeks of age. EFSA J 2017; 15:e04849. [PMID: 32625502 PMCID: PMC7010120 DOI: 10.2903/j.efsa.2017.4849] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Following a request from the European Commission to EFSA, the EFSA Scientific Committee (SC) prepared a guidance for the risk assessment of substances present in food intended for infants below 16 weeks of age. In its approach to develop this guidance, the EFSA SC took into account, among others, (i) an exposure assessment based on infant formula as the only source of nutrition; (ii) knowledge of organ development in human infants, including the development of the gut, metabolic and excretory capacities, the brain and brain barriers, the immune system, the endocrine and reproductive systems; (iii) the overall toxicological profile of the substance identified through the standard toxicological tests, including critical effects; (iv) the relevance for the human infant of the neonatal experimental animal models used. The EFSA SC notes that during the period from birth up to 16 weeks, infants are expected to be exclusively fed on breast milk and/or infant formula. The EFSA SC views this period as the time where health-based guidance values for the general population do not apply without further considerations. High infant formula consumption per body weight is derived from 95th percentile consumption. The first weeks of life is the time of the highest relative consumption on a body weight basis. Therefore, when performing an exposure assessment, the EFSA SC proposes to use the high consumption value of 260 mL/kg bw per day. A decision tree approach is proposed that enables a risk assessment of substances present in food intended for infants below 16 weeks of age. The additional information needed when testing substances present in food for infants below 16 weeks of age and the approach to be taken for the risk assessment are on a case-by-case basis, depending on whether the substance is added intentionally to food and is systemically available.
Collapse
|
32
|
Abstract
BACKGROUND To date, epidemiologic studies have not strongly supported an association between pesticide exposure and breast cancer. However, few previous studies had the ability to assess specific time periods of exposure. Studies that relied on adult serum levels of metabolites of organochlorine pesticides may not accurately reflect exposure during developmental periods. Furthermore, exposure assessment often occurred after diagnosis and key tumor characteristics, such as hormone receptor status, have rarely been available to evaluate tumor subtype-specific associations. We examined the association between pesticide exposure during childhood and adolescence and breast cancer risk in the prospective Sister Study cohort (N = 50,884 women) to assess this relation by tumor subtype. METHODS During an average 5-year follow-up, 2,134 incident invasive and in situ breast cancer diagnoses were identified. Residential and farm exposure to pesticides were self-reported at study enrollment during standardized interviews. Multivariable hazard ratios and 95% confidence intervals for breast cancer risk were calculated with Cox proportional hazards regression. RESULTS HRs were near null for the association between childhood/adolescent pesticide exposure and breast cancer risk overall or among ER+/PR+ invasive tumors. However, among women who were ages 0-18 before the ban of dichlordiphenyltrichloroethane in the US, exposure to fogger trucks or planes was associated with a hazard ratio = 1.3 for premenopausal breast cancer (95% confidence interval: 0.92, 1.7). CONCLUSION These findings do not support an overall association between childhood and adolescent pesticide exposure and breast cancer risk. However, modest increases in breast cancer risk were associated with acute events in a subgroup of young women.
Collapse
|
33
|
Munier M, Grouleff J, Gourdin L, Fauchard M, Chantreau V, Henrion D, Coutant R, Schiøtt B, Chabbert M, Rodien P. In Vitro Effects of the Endocrine Disruptor p,p'-DDT on Human Follitropin Receptor. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:991-9. [PMID: 26895433 PMCID: PMC4937862 DOI: 10.1289/ehp.1510006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 09/25/2015] [Accepted: 02/09/2016] [Indexed: 05/23/2023]
Abstract
BACKGROUND 1-chloro-4-[2,2,2-trichloro-1-(4-chlorophenyl)ethyl]benzene (p,p'-DDT) is a persistent environmental endocrine disruptor (ED). Several studies have shown an association between p,p'-DDT exposure and reproductive abnormalities. OBJECTIVES To investigate the putative effects of p,p'-DDT on the human follitropin receptor (FSHR) function. METHODS AND RESULTS We used Chinese hamster ovary (CHO) cells stably expressing human FSHR to investigate the impact of p,p'-DDT on FSHR activity and its interaction with the receptor. At a concentration of 5 μM p,p'-DDT increased the maximum response of the FSHR to follitropin by 32 ± 7.45%. However, 5 μM p,p'-DDT decreased the basal activity and did not influence the maximal response of the closely related LH/hCG receptor to human chorionic gonadotropin (hCG). The potentiating effect of p,p'-DDT was specific for the FSHR. Moreover, in cells that did not express FSHR, p,p'-DDT had no effect on cAMP response. Thus, the potentiating effect of p,p'-DDT was dependent on the FSHR. In addition, p,p'-DDT increased the sensitivity of FSHR to hCG and to a low molecular weight agonist of the FSHR, 3-((5methyl)-2-(4-benzyloxy-phenyl)-5-{[2-[3-ethoxy-4-methoxy-phenyl)-ethylcarbamoyl]-methyl}-4-oxo-thiazolidin-3-yl)-benzamide (16a). Basal activity in response to p,p'-DDT and potentiation of the FSHR response to FSH by p,p'-DDT varied among FSHR mutants with altered transmembrane domains (TMDs), consistent with an effect of p,p'-DDT via TMD binding. This finding was corroborated by the results of simultaneously docking p,p'-DDT and 16a into the FSHR transmembrane bundle. CONCLUSION p,p'-DDT acted as a positive allosteric modulator of the FSHR in our experimental model. These findings suggest that G protein-coupled receptors are additional targets of endocrine disruptors. CITATION Munier M, Grouleff J, Gourdin L, Fauchard M, Chantreau V, Henrion D, Coutant R, Schiøtt B, Chabbert M, Rodien P. 2016. In vitro effects of the endocrine disruptor p,p'-DDT on human follitropin receptor. Environ Health Perspect 124:991-999; http://dx.doi.org/10.1289/ehp.1510006.
Collapse
Affiliation(s)
- Mathilde Munier
- MITOVASC Institute, Angers, France
- UMR CNRS 6214, INSERM 1083, Laboratory of Integrated Neurovascular and Mitochondrial Biology, University of Angers, Angers, France
- Reference center for rare diseases of hormonal receptivity, Angers, France
| | - Julie Grouleff
- Department of Endocrinology, University Hospital, Angers, France
- Interdisciplinary Nanoscience Center,
| | - Louis Gourdin
- MITOVASC Institute, Angers, France
- UMR CNRS 6214, INSERM 1083, Laboratory of Integrated Neurovascular and Mitochondrial Biology, University of Angers, Angers, France
- Reference center for rare diseases of hormonal receptivity, Angers, France
| | - Mathilde Fauchard
- MITOVASC Institute, Angers, France
- UMR CNRS 6214, INSERM 1083, Laboratory of Integrated Neurovascular and Mitochondrial Biology, University of Angers, Angers, France
| | - Vanessa Chantreau
- MITOVASC Institute, Angers, France
- UMR CNRS 6214, INSERM 1083, Laboratory of Integrated Neurovascular and Mitochondrial Biology, University of Angers, Angers, France
| | - Daniel Henrion
- MITOVASC Institute, Angers, France
- UMR CNRS 6214, INSERM 1083, Laboratory of Integrated Neurovascular and Mitochondrial Biology, University of Angers, Angers, France
| | - Régis Coutant
- MITOVASC Institute, Angers, France
- UMR CNRS 6214, INSERM 1083, Laboratory of Integrated Neurovascular and Mitochondrial Biology, University of Angers, Angers, France
- Reference center for rare diseases of hormonal receptivity, Angers, France
- Department of Endocrinology, University Hospital, Angers, France
| | - Birgit Schiøtt
- Interdisciplinary Nanoscience Center,
- Center for Insoluble Protein Structures, and
- Department of Chemistry, Aarhus University, Aarhus, Denmark
| | - Marie Chabbert
- MITOVASC Institute, Angers, France
- UMR CNRS 6214, INSERM 1083, Laboratory of Integrated Neurovascular and Mitochondrial Biology, University of Angers, Angers, France
| | - Patrice Rodien
- MITOVASC Institute, Angers, France
- UMR CNRS 6214, INSERM 1083, Laboratory of Integrated Neurovascular and Mitochondrial Biology, University of Angers, Angers, France
- Reference center for rare diseases of hormonal receptivity, Angers, France
- Department of Pediatric Endocrinology, University Hospital, Angers, France
| |
Collapse
|
34
|
Organochlorine pesticides and female puberty in South Kazakhstan. Reprod Toxicol 2016; 65:67-75. [PMID: 27346842 DOI: 10.1016/j.reprotox.2016.06.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 06/09/2016] [Accepted: 06/22/2016] [Indexed: 11/22/2022]
Abstract
The purpose of the study was to assess the puberty of females living in cotton-growing regions of South Kazakhstan, where organochlorine pesticides are widely used. The physical growth and sexual development were assessed; organochlorine pesticides, gonadotropic and steroid hormones, as well as insulin-like growth factor 1 in the peripheral blood were determined. 524 females (adolescents aged 10-17) were examined. They were divided into 2 groups, depending on their place of residence. The clinical research included the assessment of physical and sexual development. All examined females lived in rural areas, i.e. they were comparable in terms of social, welfare, and climatographic factors. A high concentration of organochlorine pesticides (lindane-18.51±0.16mg/l, dieldrin-169.16±3.13mg/l, DDT-177.78±2.71mg/l, endrin-37.57±0.9mg/l) in the blood of females living in regions exposed to pesticides compared to their peers (4.05±0.41mg/l, 30.8±3.7mg/l, 109.7±2.58mg/l, 4.85±0.69mg/l respectively) was found (p<0.001). The physical and sexual development of such females was delayed. The research established a correlation between the concentration of pesticides and the endocrine status, as well as with the insulin-like growth factor 1. This shows the adverse effect of organochlorine pesticides on the development of the female reproductive system during puberty.
Collapse
|
35
|
Wainman BC, Kesner JS, Martin ID, Meadows JW, Krieg EF, Nieboer E, Tsuji LJ. Menstrual cycle perturbation by organohalogens and elements in the Cree of James Bay, Canada. CHEMOSPHERE 2016; 149:190-201. [PMID: 26855224 PMCID: PMC4827016 DOI: 10.1016/j.chemosphere.2015.12.056] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 11/23/2015] [Accepted: 12/15/2015] [Indexed: 05/29/2023]
Abstract
Persistent organohalogens (POHs) and metals have been linked to alterations in menstrual cycle function and fertility in humans. The Cree First Nations people living near James Bay in Ontario and Quebec, Canada, have elevated levels of POHs, mercury and lead compared to other Canadians. The present study examines the interrelationships between selected POHs and elements on menstrual cycle function in these Cree women. Menstrual cycle characteristics were derived from structured daily diaries and endocrine measurements from daily urine samples collected during one cycle for 42 women age 19-42. We measured 31 POHs in blood plasma and 18 elements in whole blood, for 31 of the participants. POHs and elements detected in ≥ 70% of the participants were transformed by principal component (PC) analysis to reduce the contaminant exposure data to fewer, uncorrelated PCA variables. Multiple regression analysis revealed that, after adjusting for confounders, PC-3 values showed significant negative association with cycle length, after adjusting for confounders (p = 0.002). PC-3 accounted for 9.2% of the variance and shows positive loadings for cadmium, selenium, and PBDE congeners 47 and 153, and a negative loading for copper. Sensitivity analysis of the model to quantify likely effect sizes showed a range of menstrual cycle length from 25.3 to 28.3 days using the lower and upper 95% confidence limits of mean measured contaminant concentrations to predict cycle length. Our observations support the hypothesis that the menstrual cycle function of these women may be altered by exposure to POHs and elements from their environment.
Collapse
Affiliation(s)
- Bruce C Wainman
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada L8S 4K1.
| | - James S Kesner
- Division of Applied Research and Technology, National Institute for Occupational Safety and Health, Cincinnati, OH, 45226, USA
| | - Ian D Martin
- Ian Martin Consultants, Elora, ON, Canada N0B 1S0
| | - Juliana W Meadows
- Division of Applied Research and Technology, National Institute for Occupational Safety and Health, Cincinnati, OH, 45226, USA
| | - Edward F Krieg
- Division of Applied Research and Technology, National Institute for Occupational Safety and Health, Cincinnati, OH, 45226, USA
| | - Evert Nieboer
- Biochemistry & Biomedical Sciences, McMaster University, Hamilton, ON, Canada L8S 4K1; Institute of Community Medicine, University of Tromsø, Norway
| | - Leonard J Tsuji
- Health Studies, The Department of Physical and Environmental Sciences, University of Toronto Scarborough, Toronto, ON, Canada M1C 1A4
| |
Collapse
|
36
|
Windham GC, Pinney SM, Voss RW, Sjödin A, Biro FM, Greenspan LC, Stewart S, Hiatt RA, Kushi LH. Brominated Flame Retardants and Other Persistent Organohalogenated Compounds in Relation to Timing of Puberty in a Longitudinal Study of Girls. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:1046-52. [PMID: 25956003 PMCID: PMC4590751 DOI: 10.1289/ehp.1408778] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 05/06/2015] [Indexed: 05/03/2023]
Abstract
BACKGROUND Exposure to hormonally active chemicals could plausibly affect pubertal timing, so we are investigating this in the Breast Cancer and the Environment Research Program. OBJECTIVES Our goal was to examine persistent organic pollutants (POPs) in relation to pubertal onset. METHODS Ethnically diverse cohorts of 6- to 8-year-old girls (n = 645) provided serum for measure of polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), and lipids. Tanner stages [breast (B) and pubic hair (PH)], and body mass index (BMI) were measured at up to seven annual clinic visits. Using accelerated failure time models, we calculated time ratios (TRs) for age at Tanner stages 2 or higher (2+) and POPs quartiles (Q1-4), adjusting for confounders (race/ethnicity, site, caregiver education, and income). We also calculated prevalence ratios (PRs) of Tanner stages 2+ at time of blood sampling. RESULTS Cross-sectionally, the prevalence of B2+ and PH2+ was inversely related to chemical serum concentrations; but after adjustment for confounders, only the associations with B2+, not PH2+, were statistically significant. Longitudinally, the age at pubertal transition was consistently older with greater chemical concentrations; for example: adjusted TR for B2+ and Q4 for ΣPBDE = 1.05; 95% CI: 1.02, 1.08, for ΣPCB = 1.05; 95% CI: 1.01, 1.08, and for ΣOCP = 1.10; 95% CI: 1.06, 1.14, indicating median ages of about 6 and 11 months older than least exposed, and with similar effect estimates for PH2+. Adjusting for BMI attenuated associations for PCBs and OCPs but not for PBDEs. CONCLUSIONS This first longitudinal study of puberty in girls with serum POPs measurements (to our knowledge) reveals a delay in onset with higher concentrations.
Collapse
Affiliation(s)
- Gayle C Windham
- California Department of Public Health, Richmond, California, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Parent AS, Franssen D, Fudvoye J, Gérard A, Bourguignon JP. Developmental variations in environmental influences including endocrine disruptors on pubertal timing and neuroendocrine control: Revision of human observations and mechanistic insight from rodents. Front Neuroendocrinol 2015; 38:12-36. [PMID: 25592640 DOI: 10.1016/j.yfrne.2014.12.004] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 12/13/2014] [Accepted: 12/15/2014] [Indexed: 12/21/2022]
Abstract
Puberty presents remarkable individual differences in timing reaching over 5 years in humans. We put emphasis on the two edges of the age distribution of pubertal signs in humans and point to an extended distribution towards earliness for initial pubertal stages and towards lateness for final pubertal stages. Such distortion of distribution is a recent phenomenon. This suggests changing environmental influences including the possible role of nutrition, stress and endocrine disruptors. Our ability to assess neuroendocrine effects and mechanisms is very limited in humans. Using the rodent as a model, we examine the impact of environmental factors on the individual variations in pubertal timing and the possible underlying mechanisms. The capacity of environmental factors to shape functioning of the neuroendocrine system is thought to be maximal during fetal and early postnatal life and possibly less important when approaching the time of onset of puberty.
Collapse
Affiliation(s)
- Anne-Simone Parent
- Developmental Neuroendocrinology Unit, GIGA Neurosciences, University of Liège, Sart-Tilman, B-4000 Liège, Belgium; Department of Pediatrics, CHU de Liège, Rue de Gaillarmont 600, B-4032 Chênée, Belgium
| | - Delphine Franssen
- Developmental Neuroendocrinology Unit, GIGA Neurosciences, University of Liège, Sart-Tilman, B-4000 Liège, Belgium
| | - Julie Fudvoye
- Developmental Neuroendocrinology Unit, GIGA Neurosciences, University of Liège, Sart-Tilman, B-4000 Liège, Belgium; Department of Pediatrics, CHU de Liège, Rue de Gaillarmont 600, B-4032 Chênée, Belgium
| | - Arlette Gérard
- Developmental Neuroendocrinology Unit, GIGA Neurosciences, University of Liège, Sart-Tilman, B-4000 Liège, Belgium; Department of Pediatrics, CHU de Liège, Rue de Gaillarmont 600, B-4032 Chênée, Belgium
| | - Jean-Pierre Bourguignon
- Developmental Neuroendocrinology Unit, GIGA Neurosciences, University of Liège, Sart-Tilman, B-4000 Liège, Belgium; Department of Pediatrics, CHU de Liège, Rue de Gaillarmont 600, B-4032 Chênée, Belgium.
| |
Collapse
|
38
|
Ouyang F, Longnecker MP, Venners SA, Johnson S, Korrick S, Zhang J, Xu X, Christian P, Wang MC, Wang X. Preconception serum 1,1,1-trichloro-2,2,bis(p-chlorophenyl)ethane and B-vitamin status: independent and joint effects on women's reproductive outcomes. Am J Clin Nutr 2014; 100:1470-8. [PMID: 25411282 PMCID: PMC4232015 DOI: 10.3945/ajcn.114.088377] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although preconception 1,1,1-trichloro-2,2,bis(p-chlorophenyl)ethane (DDT) exposure and B-vitamin deficiencies have each been shown to negatively affect human reproductive outcomes, little is known about their joint effect. OBJECTIVE We sought to examine whether B-vitamin sufficiency protects against adverse effects of DDT on clinical pregnancy (CP) and subclinical early pregnancy loss (EPL). DESIGN We measured preconception concentrations of plasma B vitamins (vitamin B-6, vitamin B-12, and folate) and serum total DDT [sum of p,p' and o,p' isomers of DDT and 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene] in 291 nulligravid women from Anhui, China, who were studied in 1996-1998. The women were followed prospectively from the time they stopped contraception until CP (gestational age ≥42 d) or 12 mo (whichever occurred first). EPL was identified by using daily urinary human chorionic gonadotropin. The women were categorized according to B-vitamin status (deficiency compared with sufficiency) and DDT concentration (high compared with low). RESULTS Of 291 study women, a total of 385 conceptions (31% of which ended in EPL) and 265 CPs occurred. Compared with women with adequate B-vitamins and low DDT, incidence rates of CP were reduced in women with B-vitamin deficiency and a high DDT concentration (P < 0.05 for all). Most notably, in women with sufficient vitamin B-12, DDT was not associated with the incidence of CP; in contrast, in women with vitamin B-12 deficiency, high DDT was associated with a lower incidence of CP (HR: 0.44; 95% CI: 0.23, 0.84); and the test for interaction was significant (P < 0.05). The odds of EPL decreased by 45% (95% CI: 21%, 62%) for each interquartile distance increase in folate in women with high DDT concentrations, and the test for interaction was significant (P = 0.006). CONCLUSIONS Our results provide suggestive evidence that vitamin B-12 and folate sufficiency may help protect against adverse reproductive effects of DDT exposure. Additional studies are needed to confirm our findings.
Collapse
Affiliation(s)
- Fengxiu Ouyang
- From the Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (FO); the Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Department of Health and Human Services, Research Triangle Park, NC (MPL); the Simon Fraser University, Faculty of Health Sciences, Burnaby, Canada (SAV); the Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD (SJ and XW); the Department of Environmental Health, Harvard School of Public Health, Boston, MA (SK); the Shanghai Jiaotong University School of Public Health, Shanghai, China (JZ); the National Clinical Research Center of Kidney Disease; State Key Laboratory of Organ Failure Research; Nanfang Hospital, Southern Medical University, Guangzhou, China (XX); and the Departments of International Health (PC) and Biostatistics (M-CW) and Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health (XW), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Matthew P Longnecker
- From the Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (FO); the Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Department of Health and Human Services, Research Triangle Park, NC (MPL); the Simon Fraser University, Faculty of Health Sciences, Burnaby, Canada (SAV); the Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD (SJ and XW); the Department of Environmental Health, Harvard School of Public Health, Boston, MA (SK); the Shanghai Jiaotong University School of Public Health, Shanghai, China (JZ); the National Clinical Research Center of Kidney Disease; State Key Laboratory of Organ Failure Research; Nanfang Hospital, Southern Medical University, Guangzhou, China (XX); and the Departments of International Health (PC) and Biostatistics (M-CW) and Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health (XW), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Scott A Venners
- From the Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (FO); the Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Department of Health and Human Services, Research Triangle Park, NC (MPL); the Simon Fraser University, Faculty of Health Sciences, Burnaby, Canada (SAV); the Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD (SJ and XW); the Department of Environmental Health, Harvard School of Public Health, Boston, MA (SK); the Shanghai Jiaotong University School of Public Health, Shanghai, China (JZ); the National Clinical Research Center of Kidney Disease; State Key Laboratory of Organ Failure Research; Nanfang Hospital, Southern Medical University, Guangzhou, China (XX); and the Departments of International Health (PC) and Biostatistics (M-CW) and Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health (XW), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Sara Johnson
- From the Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (FO); the Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Department of Health and Human Services, Research Triangle Park, NC (MPL); the Simon Fraser University, Faculty of Health Sciences, Burnaby, Canada (SAV); the Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD (SJ and XW); the Department of Environmental Health, Harvard School of Public Health, Boston, MA (SK); the Shanghai Jiaotong University School of Public Health, Shanghai, China (JZ); the National Clinical Research Center of Kidney Disease; State Key Laboratory of Organ Failure Research; Nanfang Hospital, Southern Medical University, Guangzhou, China (XX); and the Departments of International Health (PC) and Biostatistics (M-CW) and Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health (XW), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Susan Korrick
- From the Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (FO); the Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Department of Health and Human Services, Research Triangle Park, NC (MPL); the Simon Fraser University, Faculty of Health Sciences, Burnaby, Canada (SAV); the Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD (SJ and XW); the Department of Environmental Health, Harvard School of Public Health, Boston, MA (SK); the Shanghai Jiaotong University School of Public Health, Shanghai, China (JZ); the National Clinical Research Center of Kidney Disease; State Key Laboratory of Organ Failure Research; Nanfang Hospital, Southern Medical University, Guangzhou, China (XX); and the Departments of International Health (PC) and Biostatistics (M-CW) and Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health (XW), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Jun Zhang
- From the Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (FO); the Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Department of Health and Human Services, Research Triangle Park, NC (MPL); the Simon Fraser University, Faculty of Health Sciences, Burnaby, Canada (SAV); the Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD (SJ and XW); the Department of Environmental Health, Harvard School of Public Health, Boston, MA (SK); the Shanghai Jiaotong University School of Public Health, Shanghai, China (JZ); the National Clinical Research Center of Kidney Disease; State Key Laboratory of Organ Failure Research; Nanfang Hospital, Southern Medical University, Guangzhou, China (XX); and the Departments of International Health (PC) and Biostatistics (M-CW) and Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health (XW), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Xiping Xu
- From the Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (FO); the Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Department of Health and Human Services, Research Triangle Park, NC (MPL); the Simon Fraser University, Faculty of Health Sciences, Burnaby, Canada (SAV); the Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD (SJ and XW); the Department of Environmental Health, Harvard School of Public Health, Boston, MA (SK); the Shanghai Jiaotong University School of Public Health, Shanghai, China (JZ); the National Clinical Research Center of Kidney Disease; State Key Laboratory of Organ Failure Research; Nanfang Hospital, Southern Medical University, Guangzhou, China (XX); and the Departments of International Health (PC) and Biostatistics (M-CW) and Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health (XW), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Parul Christian
- From the Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (FO); the Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Department of Health and Human Services, Research Triangle Park, NC (MPL); the Simon Fraser University, Faculty of Health Sciences, Burnaby, Canada (SAV); the Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD (SJ and XW); the Department of Environmental Health, Harvard School of Public Health, Boston, MA (SK); the Shanghai Jiaotong University School of Public Health, Shanghai, China (JZ); the National Clinical Research Center of Kidney Disease; State Key Laboratory of Organ Failure Research; Nanfang Hospital, Southern Medical University, Guangzhou, China (XX); and the Departments of International Health (PC) and Biostatistics (M-CW) and Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health (XW), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Mei-Cheng Wang
- From the Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (FO); the Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Department of Health and Human Services, Research Triangle Park, NC (MPL); the Simon Fraser University, Faculty of Health Sciences, Burnaby, Canada (SAV); the Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD (SJ and XW); the Department of Environmental Health, Harvard School of Public Health, Boston, MA (SK); the Shanghai Jiaotong University School of Public Health, Shanghai, China (JZ); the National Clinical Research Center of Kidney Disease; State Key Laboratory of Organ Failure Research; Nanfang Hospital, Southern Medical University, Guangzhou, China (XX); and the Departments of International Health (PC) and Biostatistics (M-CW) and Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health (XW), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Xiaobin Wang
- From the Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (FO); the Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Department of Health and Human Services, Research Triangle Park, NC (MPL); the Simon Fraser University, Faculty of Health Sciences, Burnaby, Canada (SAV); the Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD (SJ and XW); the Department of Environmental Health, Harvard School of Public Health, Boston, MA (SK); the Shanghai Jiaotong University School of Public Health, Shanghai, China (JZ); the National Clinical Research Center of Kidney Disease; State Key Laboratory of Organ Failure Research; Nanfang Hospital, Southern Medical University, Guangzhou, China (XX); and the Departments of International Health (PC) and Biostatistics (M-CW) and Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health (XW), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| |
Collapse
|
39
|
Abstract
Nutrition is one of the most important factors affecting pubertal development. Puberty entails a progressive nonlinear process starting from prepubescent to full sexual maturity through the interaction and cooperation of biological, physical, and psychological changes. Consuming an adequate and balanced healthy diet during all phases of growth (infancy, childhood and puberty) appears necessary both for proper growth and normal pubertal development. Girls begin puberty at an earlier age compared to past decades. Excessive eating of many processed, high-fat foods, may be the cause of this phenomenon. Overweight or obese children are more likely to enter puberty early. Some evidence suggests that obesity can accelerate the onset of puberty in girls and may delay the onset of puberty in boys. Moreover, the progression of puberty is affected by nutrition. On the other hand, puberty triggers a growth spurt, which increases nutritional needs including macro and micronutrients. Increased caloric, protein, iron, calcium, zinc and folate needs have to be provided during this critical period of rapid growth. Severe primary or secondary malnutrition also can delay the onset and progression of puberty. The higher incidence of anorexia nervosa and bulimia in adolescents imposes a nutritional risk on pubertal development. Moreover, many environmental endocrine disruptors (EDs) have been identified that can significantly impair the normal course of puberty. This mini-review sums up some important findings in this important complex that link nutrition and pubertal development.
Collapse
Affiliation(s)
- Ashraf Soliman
- Department of Pediatrics, University of Alexandria Children's Hospital, Alexandria, Egypt
| | - Vincenzo De Sanctis
- Department of Pediatric and Adolescent Outpatients Clinic, Quisisana Hospital, Ferrara, Italy
| | - Rania Elalaily
- Department of Primary Health Care, AbuNakhla Hospital, Doha, Qatar
| |
Collapse
|
40
|
Neal-Kluever A, Aungst J, Gu Y, Hatwell K, Muldoon-Jacobs K, Liem A, Ogungbesan A, Shackelford M. Infant toxicology: State of the science and considerations in evaluation of safety. Food Chem Toxicol 2014; 70:68-83. [DOI: 10.1016/j.fct.2014.05.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 05/02/2014] [Accepted: 05/03/2014] [Indexed: 11/26/2022]
|
41
|
Yermachenko A, Dvornyk V. Nongenetic determinants of age at menarche: a systematic review. BIOMED RESEARCH INTERNATIONAL 2014; 2014:371583. [PMID: 25050345 PMCID: PMC4094877 DOI: 10.1155/2014/371583] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 05/12/2014] [Accepted: 06/06/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND The acceleration of pubertal development is an important medical and social problem, as it may result in increased morbidity and mortality in later life. This systematic review summarizes relevant data about nongenetic factors, which contribute to age at menarche (AAM), and suggests those which may be the most important. METHODS The available literature from 1980 till July 2013 was searched using PubMed and Google Scholar databases. Finally, 154 papers were selected for the analysis. RESULTS Environmental factors, which may affect AAM, vary in populations of different ethnicity. The prenatal, infancy, and early childhood periods are the most susceptible to these factors. Body weight, high animal protein intake, family stressors (e.g., single parenting), and physical activity seem to influence AAM in most populations. CONCLUSIONS The data about influence of nongenetic factors on AAM are still inconsistent. The factors affecting prenatal and early childhood growth seem to have a larger effect on further sexual maturation. Further studies are needed in order to validate the association between other environmental determinants and AAM in different ethnical groups.
Collapse
Affiliation(s)
- Anna Yermachenko
- School of Biological Sciences, The University of Hong Kong, Pokfulam Road, Pokfulam, Hong Kong
| | - Volodymyr Dvornyk
- School of Biological Sciences, The University of Hong Kong, Pokfulam Road, Pokfulam, Hong Kong
| |
Collapse
|
42
|
Abstract
Anthropologists have long known that human activity driven by culture changes the environment. This is apparent in the archaeological record and through the study of the modern environment. Perhaps the largest change since the paleolithic era is the organization of human populations in cities. New environments can reshape human biology through evolution as shown by the evolution of the hominid lineage. Evolution is not the only process capable of reshaping our biology. Some changes in our human biology are adaptive and evolutionary while others are pathological. What changes in human biology may be wrought by the modern urban environment? One significant new change in the environment is the introduction of pollutants largely through urbanization. Pollutants can affect human biology in myriad ways. Evidence shows that human growth, reproduction, and cognitive functioning can be altered by some pollutants, and altered in different ways depending on the pollutant. Thus, pollutants have significance for human biologists and anthropologists generally. Further, they illustrate the bio-cultural interaction characterizing human change. Humans adapt by changing the environment, a cultural process, and then change biologically to adjust to that new environment. This ongoing, interactive process is a fundamental characteristic of human change over the millennia.
Collapse
Affiliation(s)
- L M Schell
- Department of Anthropology, Department of Epidemiology and Biostatistics, University at Albany, State University of New York, Albany, New York, 12222, USA
| |
Collapse
|
43
|
Abstract
Endocrine disrupting chemicals (EDC) are ubiquitous and persistent compounds that have the capacity to interfere with normal endocrine homoeostasis. The female reproductive tract is exquisitely sensitive to the action of sex steroids, and oestrogens play a key role in normal reproductive function. Malignancies of the female reproductive tract are the fourth most common cancer in women, with endometrial cancer accounting for most cases. Established risk factors for development of endometrial cancer include high BMI and exposure to oestrogens or synthetic compounds such as tamoxifen. Studies on cell and animal models have provided evidence that many EDC can bind oestrogen receptors and highlighted early life exposure as a window of risk for adverse lifelong effects on the reproductive system. The most robust evidence for a link between early life exposure to EDC and adverse reproductive health has come from studies on women who were exposed in utero to diethylstilbestrol. Demonstration that EDC can alter expression of members of the HOX gene cluster highlights one pathway that might be vulnerable to their actions. In summary, evidence for a direct link between EDC exposure and cancers of the reproductive system is currently incomplete. It will be challenging to attribute causality to any single EDC when exposure and development of malignancy may be separated by many years and influenced by lifestyle factors such as diet (a source of phytoestrogens) and adiposity. This review considers some of the evidence collected to date.
Collapse
Affiliation(s)
- Douglas A Gibson
- Queen's Medical Research Institute, MRC Centre for Reproductive Health, The University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | | |
Collapse
|
44
|
Schell LM, Gallo MV, Deane GD, Nelder KR, DeCaprio AP, Jacobs A. Relationships of polychlorinated biphenyls and dichlorodiphenyldichloroethylene (p,p'-DDE) with testosterone levels in adolescent males. ENVIRONMENTAL HEALTH PERSPECTIVES 2014; 122:304-309. [PMID: 24398050 PMCID: PMC3948020 DOI: 10.1289/ehp.1205984] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 12/20/2013] [Indexed: 05/29/2023]
Abstract
BACKGROUND Concern persists over endocrine-disrupting effects of persistent organic pollutants (POPs) on human growth and sexual maturation. Potential effects of toxicant exposures on testosterone levels during puberty are not well characterized. OBJECTIVES In this study we evaluated the relationship between toxicants [polychlorinated biphenyls (PCBs), dichlorodiphenyldichloroethylene (p,p´-DDE), hexachlorobenzene (HCB), and lead] and testosterone levels among 127 Akwesasne Mohawk males 10 to < 17 years of age with documented toxicant exposures. METHODS Data were collected between February 1996 and January 2000. Fasting blood specimens were collected before breakfast by trained Akwesasne Mohawk staff. Multivariable regression models were used to estimates associations between toxicants and serum testosterone, adjusted for other toxicants, Tanner stage, and potential confounders. RESULTS The sum of 16 PCB congeners (Σ16PCBs) that were detected in ≥ 50% of the population was significantly and negatively associated with serum testosterone levels, such that a 10% change in exposure was associated with a 5.6% decrease in testosterone (95% CI: -10.8, -0.5%). Of the 16 congeners, the more persistent ones (Σ8PerPCBs) were related to testosterone, whereas the less persistent ones, possibly reflecting more recent exposure, were not. When PCB congeners were subgrouped, the association was significant for the sum of eight more persistent PCBs (5.7% decrease; 95% CI: -11, -0.4%), and stronger than the sum of six less persistent congeners (3.1% decrease; 95% CI: -7.2, 0.9%). p,p´-DDE was positively but not significantly associated with serum testosterone (5.2% increase with a 10% increase in exposure; 95% CI: -0.5, 10.9%). Neither lead nor HCB was significantly associated with testosterone levels. CONCLUSIONS Exposure to PCBs, particularly the more highly persistent congeners, may negatively influence testosterone levels among adolescent males. The positive relationship between p,p´-DDE and testosterone indicates that not all POPs act similarly. CITATION Schell LM, Gallo MV, Deane GD, Nelder KR, DeCaprio AP, Jacobs A; Akwesasne Task Force on the Environment. 2014. Relationships of polychlorinated biphenyls and dichlorodiphenyldichloroethylene (p,p´-DDE) with testosterone levels in adolescent males. Environ Health Perspect 122:304-309; http://dx.doi.org/10.1289/ehp.1205984.
Collapse
|
45
|
|
46
|
Ozen S, Goksen D, Darcan S. Agricultural Pesticides and Precocious Puberty. VITAMINS & HORMONES 2014; 94:27-40. [DOI: 10.1016/b978-0-12-800095-3.00002-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
|
47
|
Ingber SZ, Buser MC, Pohl HR, Abadin HG, Edward Murray H, Scinicariello F. DDT/DDE and breast cancer: A meta-analysis. Regul Toxicol Pharmacol 2013; 67:421-33. [DOI: 10.1016/j.yrtph.2013.08.021] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 08/29/2013] [Accepted: 08/30/2013] [Indexed: 11/28/2022]
|
48
|
Bourguignon JP, Franssen D, Gérard A, Janssen S, Pinson A, Naveau E, Parent AS. Early neuroendocrine disruption in hypothalamus and hippocampus: developmental effects including female sexual maturation and implications for endocrine disrupting chemical screening. J Neuroendocrinol 2013; 25:1079-87. [PMID: 24028442 DOI: 10.1111/jne.12107] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 08/03/2013] [Accepted: 09/05/2013] [Indexed: 01/25/2023]
Abstract
The timing of puberty has been mainly studied in females for several reasons, including the possible evaluation of a precise timer (i.e. menarcheal age) and concerns with respect to the high prevalence of precocity in females as opposed to males. Human evidence of altered female pubertal timing after exposure to endocrine disrupting chemicals (EDCs) is equivocal. Among the limiting factors, most studies evaluate exposure to single EDCs at the time of puberty and hardly assess the impact of lifelong exposure to mixtures of EDCs. Some rodent and ovine studies indicate a possible role of foetal and neonatal exposure to EDCs, in accordance with the concept of an early origin of health and disease. Such effects possibly involve neuroendocrine mechanisms because the hypothalamus is a site where homeostasis of reproduction, as well as control of energy balance, is programmed and regulated. In our previous studies, pulsatile gonadotrophin-releasing hormone (GnRH) secretion control via oestrogen, glutamate and aryl hydrocarbon receptors was shown to be involved in the mechanism of sexual precocity after early postnatal exposure to the insecticide dichlorodiphenyltrichloroethane. Very recently, we have shown that neonatal exposure to the potent synthetic oestrogen diethylstilbestrol (DES) is followed by early or delayed puberty depending on the dose, with consistent changes in developmental increase of GnRH pulse frequency. Moreover, DES results in reduced leptin stimulation of GnRH secretion in vitro, an effect that is additive with prenatal food restriction. Thus, using puberty as an endpoint of the effects of EDC, it appears necessary to consider pre- and perinatal exposure to low doses and to pay attention to the other conditions of prenatal life, such as energy availability, keeping in mind the possibility that puberty could not only be advanced, but also delayed through neuroendocrine mechanisms.
Collapse
Affiliation(s)
- J-P Bourguignon
- Developmental Neuroendocrinology Unit, GIGA Neurosciences, University of Liège, Liège, Belgium; Department of Pediatrics, CHU, Liège, Belgium
| | | | | | | | | | | | | |
Collapse
|
49
|
Lee Y, Styne D. Influences on the onset and tempo of puberty in human beings and implications for adolescent psychological development. Horm Behav 2013; 64:250-61. [PMID: 23998669 DOI: 10.1016/j.yhbeh.2013.03.014] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2012] [Revised: 03/24/2013] [Accepted: 03/25/2013] [Indexed: 12/27/2022]
Abstract
This article is part of a Special Issue "Puberty and Adolescence". Historical records reveal a secular trend toward earlier onset of puberty in both males and females, often attributed to improvements in nutrition and health status. The trend stabilized during the mid 20th century in many countries, but recent studies describe a recurrence of a decrease in age of pubertal onset. There appears to be an associated change in pubertal tempo in girls, such that girls who enter puberty earlier have a longer duration of puberty. Puberty is influenced by genetic factors but since these effects cannot change dramatically over the past century, environmental effects, including endocrine disrupting chemicals (EDCs), and perinatal conditions offer alternative etiologies. Observations that the secular trends in puberty in girls parallel the obesity epidemic provide another plausible explanation. Early puberty has implications for poor behavioral and psychosocial outcomes as well as health later in life. Irrespective of the underlying cause of the ongoing trend toward early puberty, experts in the field have debated whether these trends should lead clinicians to reconsider a lower age of normal puberty, or whether such a new definition will mask a pathologic etiology.
Collapse
Affiliation(s)
- Yvonne Lee
- University of California Davis Medical Center, 2516 Stockton Boulevard, Sacramento, CA 95817, USA.
| | | |
Collapse
|
50
|
Fisher MM, Eugster EA. What is in our environment that effects puberty? Reprod Toxicol 2013; 44:7-14. [PMID: 23602892 DOI: 10.1016/j.reprotox.2013.03.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 03/23/2013] [Accepted: 03/29/2013] [Indexed: 12/24/2022]
Abstract
Recent studies indicate that the onset of puberty is occurring at increasingly younger ages. Many etiologies have been hypothesized to be involved, but environmental exposures are among the most worrisome. Multiple organizations have endorsed the need to study and provide clinical awareness regarding the effect of a child's environment on pubertal timing. This review article summarizes the current understanding of the major environmental influences on pubertal timing, focusing on factors for which the most scientific evidence exists. The research reviewed addresses intrinsic factors unique to each individual, naturally occurring endocrine disruptors and chemical endocrine disruptors. In each category, evidence was found for and against the involvement of specific environmental factors on pubertal timing. Ultimately, an individual's environment is likely comprised of many aspects that collectively contribute to the timing of puberty. The need for research aimed at elucidating the effects of numerous specific yet disparate forms of exposures is emphasized.
Collapse
Affiliation(s)
- Marisa M Fisher
- Department of Pediatrics, Section of Pediatric Endocrinology, Riley Hospital for Children, Indiana University School of Medicine, 705 Riley Hospital Drive, Room 5960, Indianapolis, IN 46202, United States.
| | - Erica A Eugster
- Department of Pediatrics, Section of Pediatric Endocrinology, Riley Hospital for Children, Indiana University School of Medicine, 705 Riley Hospital Drive, Room 5960, Indianapolis, IN 46202, United States
| |
Collapse
|