Exposure Assessment of Urinary Heavy Metals in the Patients with Endometriosis, Adenomyosis, and Leiomyoma in northen Taiwan.

• Main Authors: TAI, WAN-JOU, 戴宛柔
• Other Authors: HUANG, PO-CHIN
• Format: Others
• Language: zh-TW
• Published: 2018
• Online Access: http://ndltd.ncl.edu.tw/handle/2e8pru

碩士 === 國立聯合大學 === 環境與安全衛生工程學系碩士班 === 106 === The prevalence of female infertility is around 15% in Taiwan, among which the prevalences of endometriosis, adenomyosis and leiomyoma are 6-10%, 20-35% and 20-50%, respectively. Previous studies indicated that the heavy metal exposure was associated with estrogen-related diseases. Studies showed that heavy metals may bind to estrogen receptors thus increase the prevalence of estrogen dependent diseases. The heavy metal exposure would induce oxidative stress in the body, and then resulted in an increase in the concentration of oxidative damage markers, for example, 8-hydroxy-2-deoxyguanosine (8-OHdG) in patients with endometrial abnormalities. However, the relationship between heavy metal exposure and 8-OHdg-induced diseases is still unclear. The study aimed to investigate the exposure to lead, cadmium, cobalt, nickel, chromium and copper by measuring their urinary levels some of patients with endometriosis, adenomyosis and leiomyoma by measuring their urinary levels, and the association between the heavy metal exposures, 8-OHdG, and diseases. This study recruited 20-50 years reproductive- aged women at a Taipei Hospital Obstetrics and Gynecology Department’s outpatient clinic and infertility clinic between May to December 2016. 85 cases of EN, 76 cases of AD, 98 cases of LEI, and 82 cases of controls were recruited. Urine was collected from each participant and were determined the six heavy metals concentrations by inductively coupled plasma-mass spectrometry, and the 8-OHdG concentrations by liquid chromatography tandem mass spectrometer. All statistical analyses were performed using SPSS statistical software. The results showed that the median concentrations of urinary cobalt (Co), nickel (Ni) and copper (Cu) of patients with endometriosis were 1.00, 2.42, and 10.5 µg/g creatinine, respectively, and significantly higher than those in the control group. We categorized the data by tertile of concentrations based on control group and adjusted with potential confounders (age, physical activity, second-hand smoking, and creatinine) to estimate the risk owing to heavy metal exposures. Compared with the low exposure to Co﹝T3 (≥ 0.87 μg/L) V.S T1 (< 0.42 μg/L)﹞and Ni﹝T3 (≥ 2.41 μg/L) V.S T1 (< 1.05 μg/L)﹞, the odd ratios for the high exposure group were 3.0 and 5.7, respectively. In adenomyosis group, the median concentrations of urinary cadmium (Cd), cobalt (Co), nickel (Ni) and copper (Cu) were 1.07, 1.41, 3.66 and 10.3 µg/g creatinine, respectively, and significantly higher than those in the control group. After adjusting with potential confounders (age and creatinine) in models. Compared with the low exposure to Cd﹝T3 (≥ 1.03 μg/L) V.S T1 (< 0.53 μg/L)﹞, Co﹝T3 (≥ 0.87 μg/L) V.S T1 (< 0.42 μg/L)﹞, Ni﹝T3 (≥ 2.41 μg/L) V.S T1 (< 1.05 μg/L)﹞, and Cr﹝T3 (≥ 0.15 μg/L) V.S T1 (< 0.01 μg/L)﹞, the odd ratios for the high exposure group were 15.4, 5.0, 10.3, and 3.2, respectively. In leiomyoma group, the median concentrations of urinary lead (Pb), cadmium (Cd), cobalt (Co), nickel (Ni) and chromium (Cr) were 0.86, 0.93, 1.15, 2.57, and 0.17 µg/g creatinine, respectively, and significantly higher than those in the control group. After adjustung with potential confounders (age, age of menarche, and creatinine) in models. Compared with the low exposure to Cr﹝T3 (≥ 0.15 μg/L) V.S T1 (< 0.01 μg/L)﹞, the odd ratios for the high exposure group was 4.6. The median concentrations of urinary 8-OHdG of patients with EN, AD, LEI were 1.94, 3.24, and 3.21 µg/g creatinine, respectively. The observed levels in AD and LEI group were significantly higher than that in the control group (2.15 µg/g creatinine). The study explore to association between heavy metals, 8-OHdG, and disease. In the EN group, although nickel exposure increased 8-OHdG concentration, but 8-OHdG may not increase the risk of EN for mediator.In the AD group, nickel and cadmium exposure increased 8-OHdG concentration. 8-OHdG may increase the risk of AD for mediator.In the LEI group, although nickel and chromium exposure increased 8-OHdG concentration, but 8-OHdG may not increase the risk of LEI for intermediate variables. Conclusively, the 20-50 years reproductive- aged women exposure to cobalt and nickel increases the risk of endometriosis; on the other hand, the exposure to cadmium, cobalt, nickel and chromium, would increase the risk of adenomyosis, and nickel and cadmium exposure increases 8-OHdG levels. This increases the risk of adenomyosis; when chromium exposure increases, it increases the risk of leiomyosis.