氟暴露对成年女性性激素结合蛋白及雌二醇水平的影响

Effect of fluoride exposure on sex hormone binding globulin and estradiol in adult female

目的探讨饮水氟暴露对成年女性性激素结合蛋白（SHBG）及雌二醇水平的影响。方法采用现况调查，依据水氟检测结果，在河南省通许县抽取7个村作为调查点，其中2个为高氟村（高氟组）、2个为实施降氟改水工程村（改水组）和3个对照村（对照组）；整群抽取调查点本地生长或居住5年以上的18～48岁成年女性．采集饮用水、晨尿和空腹静脉血。应用氟离子选择电极法检测饮用水和尿中氟含量；酶联免疫吸附法（ELISA）检测血清SHBG含量；化学发光免疫分析法检测血清雌二醇含量。结果高氟组、改水组和对照组水氟含量分别为2．44、0．36、0．37mg／L，组间比较差异有统计学意义（F=12．289，P〈0．01），其中高氟组分别高于改水组与对照组（P均〈0．05）。高氟组、改水组和对照组尿氟含量分别为2．58、1.45、0．96mg／L，组间比较差异有统计学意义（F=130．418，P〈0．05），其中高氟组分别高于改水组与对照组（P均〈0．01），改水组高于对照组（P〈0．01）。高氟组、改水组和对照组血清SHBG浓度分别为41．63、50．68、57．19nmol／L，组间比较差异有统计学意义（F=3．806，P〈0．05），其中高氟组低于对照组（P〈0．01）。高氟组、改水组和对照组血清雌二醇浓度分别为54．29、75．57、75．00nmol／L，组间比较差异有统计学意义（F=5．481，P〈0．05），其中高氟组分别低于改水组与对照组（P均〈0．01）。高氟组血清雌二醇含量与年龄呈负相关（r=-0．224，P〈0．01）。结论长期氟暴露能够影响成年女性血清SHBG和雌二醇的水平。

Objective To explore the influence of water fluoride exposure on sex hormone binding globulin（SHBG） and estradiol（E2） in aduh female. Methods Cross-sectional study was conducted in seven villages of Tongxu county including two high fluoride groups （HFG）, two defluoridation project groups （DFPG） and three control groups （CG） based on the fluoride concentration in drinking water. Adult female who was born and groun in the villages or lived for more than 5 years and aged 18 - 48 years old were recruited using cluster sampling. Fasting venous blood, drinking water and morning urine samples were collected. The fluoride levels in drinking water and urine were detected by fluoride-ion selective electrode method. Serum SHBG level was determined using enzyme-linked immunosorbent assay （ELISA）. The chemical luminescence immune analysis method was used to detect serum E2 concentration. Results The fluoride levels in drinking water were 2.44, 0.36 and 0.37 mg/L in HFG, DFPG and CG, respectively. The fluoride levels in drinking water were significantly different among the three groups（F = 12.289, P 〈 0.01 ）. The fluoride level in drinking water in HFG was significantly higher than those in DFPG and CG（all P 〈 0.05）. The fluoride levels in urine were 2.58, 1.45 and 0.96 mg/L in HFG, DFPG and CG, respectively. The fluoride levels in urine were significandy different among the three groups（F = 130.418, P 〈 0.05）. The fluoride level in urine in HFG was significantly higher than those in DFPG and CG （all P 〈 0.01）. The fluoride level in urine in DFPG was significantly higher than that in CG（P 〈 0.01）. Serum SHBG levels were 41.63, 50.68 and 57.19 nmol/L in HFG, DFPG and CG, respectively. Serum SHBG levels were significantly different among the three groups（F = 3.806, P 〈 0.05）. Serum SHBG level in HFG was significantly lower than that in CG（P 〈 0.01）. Serum E2 levels were 54.29, 75.57 and 75.00 nmol/L in HFG, DFPG and CG, respectively. Serum E2 levels were significantly different among the three groups（F = 5.481, P 〈 0.05）. Serum E2 level in HFG was significantly lower than those in DFPG and CG（all P 〈 0.01）. Serum E2 level in HFG was negatively correlated with age（r = - 0.224, P 〈 0.01）, which was not found in DFPG and CG. Conclusions Long-time fluorine exposure may affect serum SHBG and E2 levels in adult female.