Urogenital abnormalities in men exposed to diethylstilbestrol in utero: a cohort study
Urogenital abnormalities in men exposed to diethylstilbestrol in utero: a cohort study
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DOI：
10.1186/1476-069x-8-37
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发表时间：
2009-08-18
影响因子：
6
通讯作者：
Hoover, Robert N.
中科院分区：
文献类型：
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作者：
Palmer, Julie R.;Herbst, Arthur L.;Hoover, Robert N.
背景资料：己烯雌酚（DES）是一种合成雌激素，在20世纪40年代70年代被广泛用于孕妇，已被证明会导致女儿的生殖问题。对产前暴露的男性的研究得出了相互矛盾的结果。S.队列DES暴露的儿子，我们检查了产前DES暴露的男性泌尿生殖系统异常的发生的关系。通过审查产前记录确定暴露状态。邮寄问卷调查（1994年，1997年，2001年）询问有关泌尿生殖道的具体异常。风险比（RR）估计考克斯回归与恒定的时间在风险和控制yearofbirth.Results：产前DES暴露与精索静脉曲张，阴茎结构异常，尿道狭窄，良性前列腺肥大，或炎症/感染的前列腺，尿道，或附睾。然而，隐睾、附睾囊肿和睾丸炎症/感染的RR分别为1.9（95%置信区间1.13.4）、2.5（1.54.3）和2.4（1.54.4）。在妊娠第11周之前开始接触DES的患者中，观察到更强的相关性：RR为2.9（1.65.2）隐睾症，3.5附睾囊肿为2.06.0，（1.75.4）睾丸炎症/感染。这些结果表明，产前暴露于DES会增加男性泌尿生殖系统异常的风险，并且在妊娠早期暴露的相关性最强。这些发现支持了这样的假设，即内分泌干扰化学物质可能是近年来隐睾症发病率增加的原因。
Background: Diethylstilbestrol ( DES), a synthetic estrogen widely prescribed to pregnant women during the 1940s70s, has been shown to cause reproductive problems in the daughters. Studies of prenatally-exposed males have yielded conflicting results.Methods: In data from a collaborative follow-up of three U. S. cohorts of DES-exposed sons, we examined the relation of prenatal DES exposure to occurrence of male urogenital abnormalities. Exposure status was determined through review of prenatal records. Mailed questionnaires (1994, 1997, 2001) asked about specified abnormalities of the urogenital tract. Risk ratios (RR) were estimated by Cox regression with constant time at risk and control for year of birth.Results: Prenatal DES exposure was not associated with varicocele, structural abnormalities of the penis, urethral stenosis, benign prostatic hypertrophy, or inflammation/infection of the prostate, urethra, or epididymus. However, RRs were 1.9 (95% confidence interval 1.13.4) for cryptorchidism, 2.5 (1.54.3) for epididymal cyst, and 2.4 (1.54.4) for testicular inflammation/infection. Stronger associations were observed for DES exposure that began before the 11(th) week of pregnancy: RRs were 2.9 (1.65.2) for cryptorchidism, 3.5 (2.06.0) for epididymal cyst, and 3.0 (1.75.4) for inflammation/infection of testes.Conclusion: These results indicate that prenatal exposure to DES increases risk of male urogenital abnormalities and that the association is strongest for exposure that occurs early in gestation. The findings support the hypothesis that endocrine disrupting chemicals may be a cause of the increased prevalence of cryptorchidism that has been seen in recent years.