血清持久性有机污染物与多囊卵巢综合征风险之间的关联：一项具有中介分析的病例对照研究
Associations between serum persistent organic pollutants and polycystic ovary syndrome risk: a case-control study with mediation analysis.
摘要(中文译文)
持久性有机污染物（POPs），包括有机氯农药（OCPs）和全氟及多氟烷基物质（PFAS），是潜在与多囊卵巢综合征（PCOS）相关的内分泌干扰化学物。然而，关于其联合效应及潜在机制的证据仍然有限。我们开展了一项病例对照研究，纳入2023至2025年在中国河北大学附属医院招募的146例PCOS女性患者和241例对照。采用气相色谱-串联质谱（GC-MS/MS）和超高效液相色谱-串联质谱（UPLC-MS/MS）测定血清中15种POPs（6种OCPs和9种PFAS）的浓度。采用多因素logistic回归、加权分位数和（WQS）回归、分位数g计算（qgcomp）和贝叶斯核机器回归（BKMR）评估其与PCOS的关联。中介分析检验性激素是否介导这些关联。在单污染物分析中，PFOS（OR = 2.63，95% CI：1.78-3.88）、p,p'-DDE（OR = 2.25，95% CI：1.54-3.28）、七氯（OR = 1.99，95% CI：1.26-3.14）和PFHxS（OR = 1.74，95% CI：1.15-2.62）与PCOS风险升高显著相关。混合物分析显示，整体POPs混合物与PCOS呈强正相关（WQS OR = 9.29，95% CI：3.38-25.50；qgcomp OR = 7.04，95% CI：2.79-17.80），其中PFOS和p,p'-DDE为主要贡献者。BKMR确认PFOS（PIP = 1.000）和p,p'-DDE（PIP = 0.998）为最重要的贡献者。中介分析表明，睾酮介导了49.3%的PFOS-PCOS关联，而孕酮介导了20.9%的PFOS-PCOS关联和24.8%的p,p'-DDE-PCOS关联。在中国女性中，POPs暴露，尤其是PFOS和p,p'-DDE，与PCOS风险升高相关。性激素，特别是睾酮和孕酮，部分介导了这些关联，提示激素紊乱可能是连接POPs暴露与PCOS的潜在机制。
Abstract
Persistent organic pollutants (POPs), including organochlorine pesticides (OCPs) and per- and polyfluoroalkyl substances (PFAS), are endocrine-disrupting chemicals potentially linked to polycystic ovary syndrome (PCOS). However, evidence on their combined effects and underlying mechanisms remains limited. We conducted a case-control study including 146 women with PCOS and 241 controls recruited from the Affiliated Hospital of Hebei University, China (2023-2025). Serum concentrations of 15 POPs (6 OCPs and 9 PFAS) were measured using GC-MS/MS and UPLC-MS/MS. Associations with PCOS were evaluated using multivariable logistic regression, weighted quantile sum (WQS) regression, quantile g-computation (qgcomp), and Bayesian kernel machine regression (BKMR). Mediation analysis examined whether sex hormones mediated these associations. In single-pollutant analyses, PFOS (OR = 2.63, 95% CI: 1.78-3.88), p,p'-DDE (OR = 2.25, 95% CI: 1.54-3.28), heptachlor (OR = 1.99, 95% CI: 1.26-3.14), and PFHxS (OR = 1.74, 95% CI: 1.15-2.62) were significantly associated with increased PCOS risk. Mixture analyses revealed strong positive associations between the overall POPs mixture and PCOS (WQS OR = 9.29, 95% CI: 3.38-25.50; qgcomp OR = 7.04, 95% CI: 2.79-17.80), with PFOS and p,p'-DDE identified as predominant contributors. BKMR confirmed PFOS (PIP = 1.000) and p,p'-DDE (PIP = 0.998) as the most important contributors. Mediation analysis indicated that testosterone mediated 49.3% of the PFOS-PCOS association, while progesterone mediated 20.9% of the PFOS-PCOS and 24.8% of the p,p'-DDE-PCOS associations. Exposure to POPs, particularly PFOS and p,p'-DDE, was associated with elevated PCOS risk among Chinese women. Sex hormones, especially testosterone and progesterone, partially mediated these associations, suggesting hormonal disruption as a potential mechanism linking POPs exposure to PCOS.
如何引用
AMA
Zekun Zhao. Associations between serum persistent organic pollutants and polycystic ovary syndrome risk: a case-control study with mediation analysis.. Frontiers in public health. 2026; doi:10.3389/fpubh.2026.1807105.
APA
Zekun Zhao (2026). Associations between serum persistent organic pollutants and polycystic ovary syndrome risk: a case-control study with mediation analysis.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1807105
GB/T 7714
Zekun Zhao. Associations between serum persistent organic pollutants and polycystic ovary syndrome risk: a case-control study with mediation analysis.[J]. Frontiers in public health, 2026 doi:10.3389/fpubh.2026.1807105.
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