鄰苯二甲酸酯類暴露對內分泌荷爾蒙之影響：流行病學之回顧   全文下載

Phthalates Exposure and Endocrinal Effects: An Epidemiological Review

鄰苯二甲酸酯類為日常生活中無所不在之內分泌干擾物，可能對一般民眾之健康造成潛在之影響。本篇使用三個常用之科學性資料庫（PubMed 、Medline及 ScienceDirect），進行鄰苯二甲酸酯類對人體重要健康影響之流行病學文獻回顧，包括內分泌荷爾蒙、甲狀腺及類固醇荷爾蒙之調控，生殖影響、懷孕、性早熟、肥胖及不孕等。部分研究證據顯示鄰苯二甲酸酯類暴露量會對下列人體健康產生負面影響：性荷爾蒙（尤其是睪固酮及黃體刺激素）、甲狀腺素（主要是四碘甲狀腺素）、精液品質、新生兒肛門到生殖器距離、懷孕週數及神經發展（認知功能及智力發展）等。此外，雖然研究結果之一致性仍待確認，但有些研究證據則顯示鄰苯二甲酸酯類暴露量會增加某些不良健康狀況之發生：性早熟、流產、肥胖、子宮肌瘤等。由目前流行病學研究可知，鄰苯二甲酸酯類之暴露可能會對人體生殖、甲狀腺及生長發育造成影響。雖然仍需要進行大型長期世代追蹤研究以釐清相關研究之相關性，實有必要預防性降低孕婦及幼兒等易感性族群之鄰苯二甲酸酯類暴露量，以避免對下一代生殖及生長發育造成不良之健康影響。

Phthalates are ubiquitous endocrine disruptors which may cause potential health effects in general populations. We explored 3 scien-tific databases (PubMed, Medline, and ScienceDirect) to search epidemiological studies focused on phthalates exposure and the important health effects including endocrine, hormonal regulation of thyroid and steroid, reproductive effects, pregnancy, precocious puberty, obesity, and infertility in human. Some studies demonstrated negative association between phthalate levels and sex steroid hormones (testosterone, LH), thyroid hormones (thyroxine), sperm quality, anogenital distance, gestational age and neurodevelopment (cognitive function and intelligence quotient), although most of them have some limitations. A few studies showed positive association between phthalate levels and precocious puberty, pregnancy loss, obesity, leiomyoma, although results of some studies were not consistent. In summary, phthalates may affect reproductive and sex hormones, thyroid function and development. Although large-scale cohort studies are needed to clarify the association, it is necessary to reduce the phthalates exposure in pregnant women and young children to prevent unexpected consequences of reproductive and development effects in the offspring.