背景:已知邻苯二甲酸酯(PAEs)具有激素样特性,越来越多的儿童表达与指定性别不同的性别认同。然而,关于PAEs暴露与性别认同之间潜在联系的研究有限.
方法:从2017年10月至2020年10月,厦门共有571名儿童(278名男孩)完成了儿童血压和环境因素(CBPEF)队列的随访。中国。使用超高效液相色谱-串联质谱法在三次访问时测量尿PAE代谢物。儿童性别角色量表用于评估性别认同(男性气质,女性气质,雌雄同体和未分化),Tanner定义用于定义青春期时间。广义线性模型和对数二项回归用于评估PAEs暴露之间的关系,性别特征得分和性别认同。
结果:总体而言,超过90%的参与者中大多数PAEs的浓度高于检测限值.在第1次访视中,女性男童占10.1%,男性男童占11.3%;而在随访期间,这些数字分别上升至10.8%和12.3%,分别。青春期早期发病占男孩和女孩的24.8%和25.6%。长期接触邻苯二甲酸单-2-乙基己酯(MEHP)(β=1.20,95CI=0.13,2.28),邻苯二甲酸单-2-乙基-5-羟基己酯(MEHHP)(β=1.25,95CI=0.22,2.28)和邻苯二甲酸单-2-乙基-5-氧代己酯(MEOHP)(β=1.40,95CI=0.24,2.56)与进入青春期较早的男孩的女性特质评分差异增加有关,长期暴露于邻苯二甲酸二(2-乙基己基)酯(DEHP)也可能具有这种积极影响(β=1.38,95CI=0.36,2.41)。对于性别认同,在进入青春期较早的男孩中,低分子量邻苯二甲酸盐(LMWP)的持续暴露与未分化类型呈负相关(RR=0.18,95CI=0.05,0.75,P<0.05)。大多数PAE代谢物暴露显示其女性气质的风险比>1。
结论:长期接触PAEs会增加青春期早期男孩的女性特质评分。尽管机制仍有待确定,环境污染可能有微妙的,但对儿童性别认同的影响可衡量。减少这些化学品的接触对性别发展具有重要的公共意义。
BACKGROUND: Phthalate esters (PAEs) are known to have hormone-like properties, and there is a growing trend of children expressing a gender identity different from assigned sex. However, there has been limited research in the potential links between PAEs exposure and gender identity.
METHODS: A total of 571 children (278 boys) completed the follow-up from Oct 2017 to Oct 2020 in Childhood Blood Pressure and Environmental Factors (CBPEF) cohort in Xiamen,
China. Urinary PAE metabolites were measured at three time of visits using ultraperformance liquid chromatography-tandem mass spectrometry. The Children\'s Sex Role Inventory scale was used to assess gender identity (
masculinity, femininity, androgyny and undifferentiated), and Tanner definition was used to define puberty timing. Generalized linear models and log-binomial regression were used to assess the relationships between PAEs exposure, gender trait scores and gender identity.
RESULTS: Overall, the concentration of most PAEs in more than 90% of participants was above the limit of detection values. In visit 1, there were 10.1% boys with femininity and 11.3% girls with
masculinity; while these figures increased to 10.8% and 12.3% during follow-up, respectively. Early puberty onset accounted for 24.8% and 25.6% among boys and girls. Long-term exposure to mono-2-ethylhexyl phthalate (MEHP) (β = 1.20, 95%CI = 0.13, 2.28), mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP) (β = 1.25, 95%CI = 0.22, 2.28) and mono-2-ethyl-5-oxohexyl phthalate (MEOHP) (β = 1.40, 95%CI = 0.24, 2.56) was associated with the increased differences of femininity trait scores in boys who enter puberty earlier, prolonged exposure to di(2-ethylhexyl) phthalate (DEHP) might also have such a positive impact (β = 1.38, 95%CI = 0.36, 2.41). For gender identity, persistent exposure to low molecular weight phthalates (LMWP) was negatively associated with undifferentiated type among boys entering puberty earlier (RR = 0.18, 95%CI = 0.05, 0.75, P < 0.05), and most of the PAE metabolites exposures showed risk ratios > 1 for their femininity.
CONCLUSIONS: Long-term exposure to PAEs increase the femininity trait scores in boys with early onset of puberty. Although the mechanisms remain to be determined, environmental pollution might have subtle, yet measurable effects on childhood gender identity. Reducing these chemicals exposure has important public implications on gender development.