PREMATURE THELARCHE IN PUERTO-RICO - A SEARCH FOR ENVIRONMENTAL-FACTORS
PREMATURE THELARCHE IN PUERTO-RICO - A SEARCH FOR ENVIRONMENTAL-FACTORS
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DOI：
10.1001/archpedi.1986.02140260065028
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发表时间：
1986-12-01
影响因子：
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通讯作者：
MILLS, JL
中科院分区：
文献类型：
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作者：
FRENITITULAER, LW;CORDERO, JF;MILLS, JL
波多黎各的儿科内分泌学家报告说，1978年至1981年间，乳房早熟的患者数量增加了三倍。一项配对病例对照研究被用来评估潜在的环境暴露与具有雌激素活性的物质以及家族因素的关系。对1978~1982年间确诊的120对病例进行分析。在2岁或2岁以上的受试者中，没有发现显著的相关性。在2岁前发病的受试者中，发现母亲有卵巢囊肿史、食用大豆配方奶粉和食用各种肉类产品与其显著正相关。在统计上，玉米产品的消费量与此呈显著的负相关。这些统计关联可能不足以解释报告的增加，因为在超过50%的病例受试者中，没有暴露于任何统计关联的风险因素。接触其他可能具有雌激素作用的物质，如制药厂的废物和杀虫剂，也被排除为可能的原因。这些发现表明，更好的诊断和报告，或者可以想象的全新的、未被怀疑的因素的存在，可能是报告的增加的原因。
Pediatric endocrinologists in Puerto Rico reported a threefold increase in the number of patients with premature thelarche seen between 1978 and 1981. A matched-pairs case-control study was conducted to evaluate associations with potential environmental exposures to substances with estrogenic activity, as well as with familial factors. Analysis was performed on 120 pairs, the case subjects of which were selected from those diagnosed between 1978 and 1982. In subjects 2 years of age or older at the onset of thelarche, no significant associations were found. In subjects with onset before 2 years of age, significant positive associations were found with a maternal history of ovarian cysts, consumption of soy-based formula, and consumption of various meat products. A statistically significant negative association was found with consumption of corn products. These statistical associations are probably not sufficient to explain the reported increase because in over 50% of the case subjects there was no exposure to any of the risk factors for which statistical associations were found. Exposure to other substances with possible estrogenic effect, such as waste products from pharmaceutical factories and pesticides, was also excluded as a possible cause. These findings suggest that better diagnosis and reporting, or conceivably the presence of entirely new, unsuspected factors, could account for the reported increase.