Study On Environmental Hormone Exposure Of Precocious Girls In Fuyang,Anhui Province

ObjectiveChildhood precocious puberty is a kind of endocrine disease with the early arrival of puberty.During human development,the hypothalamic-pituitary-gonad Alzxis,（HPGA）is the basis of human sexual development and reproductive function,and is affected by gonadotropin-releasing Hormone（Gn RH）secreted by hypothalamus.After the age of7-9,with the hypothalamus sensitivity to the negative feedback effect of sex hormones decreased,Gn RH secretion began to increase,making HPGA function active,and gradually entered the stage of sexual maturity.If HPGA function is activated earlier,girls will develop gonadal development and secondary sexual characteristics before age8 and boys will develop Central Precocious Puberty（CPP）by age 9.In addition,as a result of all kinds of exogenous sex hormones and hormone containing food cosmetics health care products caused by the peripherals precocious sex.In recent years,with the change of living environment and the influence of social factors,the incidence of precocious puberty in children has significantly increased,and the disease has developed into the second largest endocrine disease after childhood obesity.A number of studies have pointed out that Environmental hormones cause the early onset of puberty in children by interfering with the function of hormones and causing biological effects in human body.Environmental hormone series analysis can understand the amount of environmental hormone exposure in daily life,such as personal hygiene products,plastic food containers and cleaning agents.Assessing environmental toxins in the body is therefore the first step in helping patients recover.The main objectives of this study are as follows:1.To investigate the possible roles of four common categories of 15 environmental hormones in the pathogenesis of precocious puberty in girls;2.Through this study,it is expected to establish the application of high performance liquid chromatography tandem mass spectrometry detection method to evaluate the exposure of environmental hormones in children,accumulate basic data for the exposure of environmental hormones in children in Fuyang area,and provide reliable analysis data for the screening of children’s precocious puberty in the future.Methods1.Subjects:62 cases of precocious children were randomly selected from the growth and Development department of our hospital,including 30 cases of peripheral precocious puberty and 32 cases of central precocious puberty,as well as 25 healthy girls who were examined in the pediatrics department of our hospital at the same time as the normal group.Inclusion criteria:The diagnostic criteria of central precocious puberty were in accordance with the consensus on diagnosis and treatment of central precocious puberty（2015）,and peripheral precocious puberty was in accordance with the differential diagnosis and treatment of peripheral precocious puberty.Exclusion criteria:peripheral precocious puberty with clear etiology,including gonadal tumor,adrenal disease,and failure to complete the questionnaire.After grouping,there was no significant difference in age,height,weight and other general information among the three groups（P>0.05）are comparable.2.Professionals fill in the questionnaire with the help of children’s family members to inquire about the actual situation of possible exposure to environmental hormones in daily life.Researchers also improved the precocious group of girls serum hormone,luteinizing hormone,follicle stimulating hormone,estradiol,thyroid stimulating hormone and reproductive color ultrasound examination.Fifteen environmental hormones were detected in the urine of three groups of girls,including:（1）Phthalate esters:Monoethyl hexyl phthalate（MEHP）,mono-butyl phthalate（MBP）,Monomethyl phthalate（Monomethyl）Phthalate（MMP）,Monoethyl phthalate（MEP）;（2）Phenols:Bisphenol A（BPA）,Bisphenol B（BPB）,Nonyl phenol（4-NP）,Octyl pheno（4-OP）;（3）Estrogens:Diethylstilbestrol（DES）,17α-ethylenyl stilbediol（EE2）;（4）P-hydroxybenzoates:Methyl parahydroxybenzoats（MP）,Ethyl P-hydroxybenzoate（EP）,Propyl The exposure levels of p-hydroxybenzoate（PP）and Butyl P-hydroxybenzoate（BP）;All clinical data and laboratory and imaging findings were statistically analyzed to evaluate the possible role of environmental hormones in the etiology of precocious puberty.Results1.In Fuyang,Anhui province,there were no significant differences in living near industrial areas,adult skin care products,use of detergent,consumption of genetically modified products,fish,fried food,eggs,puffed food and pickled vegetables among girls in CPP、PPP and normal group（P>0.05）.However,when it came to the use of plastic cups,the behavior of girls in the PPP group was significantly higher than in the CPP group and the healthy control group.2.Serum hormone levels in CPP group and PPP group:the average LH,FSH and E2levels of girls in CPP group were significantly higher than those in PPP group.There were no statistically significant differences inβ-HCG,TSH and f T4 levels between CPP group and PPP group（P>0.05）.3.Exposure levels of environmental hormones in urine:Monoethyl hexyl phthalate（MEHP）and mono-butyl in the urine of girls in CPP and PPP groups The distribution of Mono-butyl phthalate（MBP）exposure was statistically different（P<0.05）,there was no significant difference between CPP and normal group in girls’urinary MEHP、MBP exposure（P>0.05）.However,the distribution of urinary MEHP、MBP exposure levels of girls in PPP and CPP groups was statistically different from that in the normal group（P<0.05）.4.Correlation analysis of basal FSH,LH,E₂,average uterine length and ovarian volume with exposure levels of MEHP and MBP in CPP and PPP groups:MEHP distribution in PPP group was positively correlated with E₂（P<0.05）.ConclusionFrequent use of plastic products may promote the onset of precocious puberty;Girls in Fuyang area of Anhui province are generally polluted by environmental hormones.Mono-ethylhexyl phthalate may play an important role in the pathogenesis of peripheral precocity and interfere with the secretion of sex hormones in vivo...