双丁基邻苯二甲酸酯暴露与男性中柳氮磺胺吡啶药物和血清甲状腺激素的关系。
Dibutyl-phthalate exposure from mesalamine medications and serum thyroid hormones in men.
机构信息
Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
出版信息
Int J Hyg Environ Health. 2019 Jan;222(1):101-110. doi: 10.1016/j.ijheh.2018.08.008. Epub 2018 Aug 28.
BACKGROUND
Dibutyl phthalate (DBP) is an endocrine disruptor and used in some medication coatings, such as mesalamine for treatment inflammatory bowel disease (IBD).
OBJECTIVES
To determine whether high-DBP from some mesalamine medications alters thyroid function.
METHODS
Seventy men with IBD, without thyroid disease or any radiation history participated in a crossover-crossback prospective study and provided up to 6 serum samples (2:baseline, 2:crossover, 2:crossback). Men on non-DBP mesalamine (background exposure) at baseline crossed-over to DBP-mesalamine (high exposure) then crossed-back to non-DBP mesalamine (BHB-arm) and vice versa for men on DBP-mesalamine at baseline (HBH-arm). Serum concentrations of total triiodothyronine (T3), total thyroxine (T4), free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH) and thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb).
RESULTS
After crossover in BHB-arm (26 men, 134 samples), T3 decreased 10% (95% confidence interval (CI): 14%,-5%), T3/T4 ratio decreased 8% (CI: 12%,-3%), TPOAb, and TgAb concentrations decreased, 11% (-20%, -2%) and 15% (-23%, -5%), respectively; after crossback, they increased. When men in the HBH-arm (44 men, 193 samples) crossed-over, T3 decreased 7% (CI: -11%, -2%) and T3/T4 ratio decreased 6% (CI: -9%, -2%). After crossback, only TgAb increased and FT4 decreased.
CONCLUSIONS
High-DBP novel exposure or removal from chronic high-DBP exposure could alter elements of the thyroid system, and most probably alters the peripheral T4 conversion to T3 and thyroid autoimmunity, consistent with thyroid disruption. After exposure removal, these trends were mostly reversed.
背景
邻苯二甲酸二丁酯（DBP）是一种内分泌干扰物，用于某些药物涂层，如用于治疗炎症性肠病（IBD）的美沙拉嗪。
目的
确定某些美沙拉嗪药物中的高浓度邻苯二甲酸二丁酯是否会改变甲状腺功能。
方法
70 名患有 IBD 且无甲状腺疾病或任何辐射史的男性参与了一项交叉回返前瞻性研究，并提供了多达 6 份血清样本（2：基线，2：交叉，2：回返）。基线时服用非邻苯二甲酸二丁酯美沙拉嗪（背景暴露）的男性交叉服用邻苯二甲酸二丁酯美沙拉嗪（高暴露），然后交叉回服非邻苯二甲酸二丁酯美沙拉嗪（BHB 臂），反之亦然，基线时服用邻苯二甲酸二丁酯美沙拉嗪的男性（HBH 臂）。检测血清总三碘甲状腺原氨酸（T3）、总甲状腺素（T4）、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）和甲状腺过氧化物酶抗体（TPOAb）、甲状腺球蛋白抗体（TgAb）的浓度。
结果
在 BHB 臂（26 名男性，134 个样本）交叉后，T3 降低 10%（95%置信区间（CI）：14%，-5%），T3/T4 比值降低 8%（CI：12%，-3%），TPOAb 和 TgAb 浓度分别降低 11%（-20%，-2%）和 15%（-23%，-5%）；交叉回返后，它们增加。当 HBH 臂（44 名男性，193 个样本）中的男性交叉时，T3 降低 7%（CI：-11%，-2%），T3/T4 比值降低 6%（CI：-9%，-2%）。交叉回返后，只有 TgAb 增加，FT4 降低。
结论
高浓度邻苯二甲酸二丁酯的新型暴露或从慢性高浓度邻苯二甲酸二丁酯暴露中去除，可能会改变甲状腺系统的某些元素，并且很可能改变外周 T4 向 T3 的转化和甲状腺自身免疫，这与甲状腺功能障碍一致。暴露去除后，这些趋势大多得到逆转。
Zotero 插件