饮用水消毒副产物暴露与男性精液质量关系的研究

发布时间：2018-04-21 19:08

本文选题：生物标志物 + 消毒副产物　；参考：《华中科技大学》2014年博士论文

【摘要】：第一部分管网水THMs暴露与男性精液质量之间的关系研究目的：采用管网水中监测的四种三卤甲烷(trihalomethanes, THMs)浓度结合个体日常用水情况作为外暴露标志物,初步探讨管网水THMs暴露与男性精液质量之间的关系。方法：采用前瞻性队列研究设计,以来武汉市某综合医院生殖医学中心寻求精液分析并且居住于某大型水厂区域内的324名育龄期男性为研究对象,通过监测研究对象精液样本收集前三个月管网水中四种THMs[三氯甲烷(chloroform, TCM)、二氯一溴甲烷(bromodichloromethane, BDCM)、一氯二溴甲烷(dibromochloromethane, DBCM)和三溴甲烷(bromoform,TBM)]浓度的时间和空间分布,并结合日常生活用水活动信息和THMs不同暴露途径吸收系数评估个体的THMs外暴露水平,采用多变量线性回归分析经口和经洗澡途径暴露管网水中THMs与精液质量之间的关系。结果：多变量线性回归分析结果显示经口摄入的TTHMs、TCM和Br-THMs与降低的精子密度(P for trend分别为0.01、0.03和0.05)和精子总数(P for trend分别为0.02、0.05和0.09)之间存在显著或建议性的剂量-反应关系。此外,研究发现与第一分位数经洗澡摄入的TCM相比较,第三分位数经洗澡摄入的TCM与精子直线性存在显著的负相关(β＝2.28%,95%CI：-4.44,-0.11)。结论：本部分研究结果表明人群经口途径暴露饮用水THMs可能与降低的精子密度和精子总数有关。第二部分基础水平的血液THMs与男性精液质量和睾酮之间的关系研究目的：采用基础水平的血液THMs作为内暴露生物标志物,进一步探讨饮用水THMs暴露与男性精液质量和睾酮之间的关系。方法：采用横断面研究设计,以来武汉市某综合医院生殖医学中心寻求精液分析的401名育龄期男性为研究对象,采用固相微萃取-气相色谱法检测早晨采集的血样中四种THMs浓度评估个体基础水平的THMs内暴露水平,采用多变量线性回归分析基础水平的血液THMs与精液质量和睾酮之间的关系。结果：多变量线性回归分析结果显示与第一分位数血液BDCM相比较,第二分位数血液BDCM与精子总数之间存在显著的负相关(β=-0.13million,95%CI:-0.22,-0.03)；与第一分位数血液DBCM相比较,第二分位数血液DBCM与精子直线性之间也存在显著的负相关(β=-4.74%,95%CI:-807,-1.42);同时发现血液TCM和TTHMs与降低的精子密度之间存在建议性的剂量-反应关系(both P for trend=0.07)。此外,研究结果还显示血液DBCM与降低的血清总睾酮之间存在建议性的剂量-反应关系(P for trend=0.07)。结论：本部分研究结果进一步表明人群暴露饮用水THMs可能与降低的精子总数和精子密度有关,同时也可能与降低的睾酮有关。第三部分尿液中TCAA水平与男性精液质量之间的关系研究目的：采用尿液中三氯乙酸(trichloroacetic acid, TCAA)水平作为内暴露生物标志物,探讨饮用水消毒副产物(disinfection by-products, DBPs)暴露与男性精液质量之间的关系。方法：本部分我们开展了一项大规模横断面研究,以来武汉市某综合医院生殖医学中心寻求精液分析的2009名育龄期男性为研究对象,采用气相色谱法检测尿液中TCAA浓度评估个体经饮用水暴露DBPs的水平,采用多变量logistic回归和多变量线性回归分析尿TCAA水平与精液质量之间的关系。结果：多变量logistic回归分析结果显示与第一份位数尿TCAA水平相比,第二和第四分位数尿TCAA水平使低于精子密度正常参考值风险增加(OR=1.79,95%CI:1.19,2.69和OR=1.51,95%CI:0.98,2.31);第二和第三分位数尿TCAA水平使低于精子活力正常参考值风险增加(OR=1.46,95%CI:1.12,1.90和OR=1.30,95%CI:1.00,1.70)；第二分位数尿TCAA水平使低于精子总数正常参考值风险增加(OR=1.62,95%CI：1.04,2.55)。多变量线性回归分析显示了相似的结果。结论：本部分研究结果表明人群经饮水途径暴露DBPs可能与降低的精子密度、精子总数和精子活力有关。
[Abstract]:Study on the relationship between the exposure of water THMs in the first part and the quality of semen

Objective : To investigate the relationship between water THMs exposure and semen quality of men by using trihalomethanes ( THMs ) concentrations monitored in pipe network water as external exposure markers .

Methods : A prospective cohort study was conducted to investigate the temporal and spatial distribution of four THMs in water in a large water plant , including the time and spatial distribution of four THMs , bromomethane ( BDCM ) , bromomethane ( DBCM ) , bromoform ( BDCM ) , monochlorodibromide ( DBCM ) and bromoform ( TBM ) in the area of a large water plant .

Results : The results of multivariate linear regression showed that TTHMs , TCM and Br - THMs ingested by oral intake and decreased sperm density ( P for trend were 0 . 01 , 0 . 03 and 0 . 05 ) and sperm count ( P for trend were 0 . 02 , 0 . 05 and 0 . 09 respectively ) and sperm count ( P for trend , 0 . 02 , 0 . 05 and 0 . 09 ) .

Conclusion : The results of this study indicate that THMs exposed to drinking water by oral route may be related to decreased sperm density and total sperm count .

Study on the relationship between the blood THMs of the second part and the semen quality and testosterone in men

Objective : To study the relationship between THMs exposure and semen quality and testosterone in drinking water .

Methods : A cross - sectional study was conducted to investigate the relationship between THMs and semen quality and testosterone in the blood samples collected in the morning by using solid - phase micro - extraction - gas chromatography to assess the exposure level of four THMs in blood samples collected in the morning .

Results : The results of multivariate linear regression analysis showed that there was a significant negative correlation between BDCM ( 尾 = - 0.13million , 95 % CI : - 0.22 , - 0.03 ) .
There was also a significant negative correlation between the second quartile blood DBCM and sperm linearity ( 尾 = - 4.74 % , 95 % CI : -807 , - 1.42 ) compared to the first quartile of blood DBCM , while there was a suggested dose - response relationship between TCM and TTHMs and decreased sperm density ( both P for trend = 0.07 ) . In addition , the study showed a suggested dose - response relationship between blood DBCM and decreased serum total testosterone ( P for trend = 0.07 ) .

Conclusion : The results of this study further suggest that the population exposed to drinking water THMs may be related to decreased sperm count and sperm density , and may also be associated with reduced testosterone .

Study on the relationship between TCAA level and semen quality in the third part of urine

Objective : To investigate the relationship between disinfection by - products ( DBPs ) exposure and semen quality in drinking water by using the level of trichloroacetic acid ( TCAA ) in urine as internal exposure biomarker .

Methods : A large - scale cross - sectional study was conducted in this part . In 2009 , we studied the relationship between urinary TCAA and semen quality by using multi - variable logistic regression and multivariate linear regression .

Results : The results of multivariate logistic regression analysis showed that compared with the first digit urine TCAA level , the second and fourth quartile urinary TCAA levels increased significantly below the normal reference value of sperm density ( OR = 1.79 , 95 % CI : 1.19 , 2.69 and OR = 1.51 , 95 % CI : 0.98 , 2.31 ) ; the second and third quartile urinary TCAA levels increased significantly below the normal reference value of sperm motility ( OR = 1.46 , 95 % CI : 1.12 , 1.90 and OR = 1.30 , 95 % CI : 1.00 , 1.70 ) ;
The second - digit urine TCAA level increased the risk of normal reference values below the total number of sperm ( OR = 1 . 62 , 95 % CI : 1.04 , 2.55 ) . Multivariate linear regression analysis showed similar results .

Conclusion : The results of this study suggest that exposure of DBPs to the population via drinking water pathway may be related to decreased sperm density , total sperm count and sperm motility .

【学位授予单位】：华中科技大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R339.21;R123.1

【参考文献】