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Qin XD, Zhou Y, Bloom MS, Qian Z(M, Geiger SD, Vaughn MG, Chu C, Li QQ, Yang BY, Hu LW, Yu Y, Zeng XW, Dong GH. Prenatal Exposure to PFAS, Associations with Preterm Birth and Modification by Maternal Estrogen Levels: The Maoming Birth Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:117006. [PMID: 37962440 PMCID: PMC10644897 DOI: 10.1289/ehp11377] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 10/16/2023] [Accepted: 10/16/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Estrogens play a critical role in parturition, and poly- and perfluoroalkyl substances (PFAS), which have estrogenic effects, have been associated with preterm birth. However, the impact of estrogens on the association between PFAS and preterm birth is unknown. OBJECTIVE The objective of this study is to investigate if estrogens modified the association between PFAS and preterm birth, using a nested case-control study design. METHODS A total of 371 preterm births and 508 controls were selected from a birth cohort study in China between 2016 and 2018. Perfluorobutanoic acid (PFBA), perfluorohexanesulfonic acid (PFHxS) and its branched isomer, perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS) and its branched isomer, and perfluorononanoic acid (PFNA) were quantified in maternal serum (mean gestational age of 32 wk). Estradiol and estriol were quantified in cord serum. Preterm birth was defined as live delivery at < 37 gestational weeks. Causal mediation analysis was used to estimate the mediation and interaction effects of estrogen on the association between PFAS and preterm birth. Latent profile analysis was used to identify important estrogen profiles. Multiple linear regression was used to estimate associations between PFAS and preterm birth and interactions between PFAS and estrogens on preterm birth. RESULTS Overall, higher odds ratios (ORs) of preterm birth were associated with each 1 ln-unit PFAS increase: PFBA [1.20, 95% confidence interval (CI): 1.14, 1.26], PFNA (1.30, 95% CI: 1.21, 1.39), PFOA (1.98, 95% CI: 1.54, 2.55), and PFOS (1.91, 95% CI: 1.76, 2.07) and its branched isomer (1.91, 95% CI: 1.90, 1.92). We detected statistically significant interactions between cord estradiol and PFAS on preterm birth, while no mediation effects of cord estrogen were observed. The ORs of PFOS (4.29, 95% CI: 1.31, 8.25), its branched isomer (6.71, 95% CI: 1.06, 11.91), and preterm birth were greater for participants with high cord estrogen levels than for participants with low cord estrogen levels. DISCUSSION Our findings suggest that estrogen modified the association between maternal PFAS exposure and preterm birth. Further studies on maternal PFAS exposure and preterm birth, taking interaction effects of cord estrogens into account, are warranted. https://doi.org/10.1289/EHP11377.
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Affiliation(s)
- Xiao-Di Qin
- Institute for Chemical Carcinogenesis, Guangzhou Medical University, Guangzhou, China
| | - Yang Zhou
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, China
| | - Michael S. Bloom
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Zhengmin (Min) Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, Missouri, USA
| | - Sarah Dee Geiger
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Michael G. Vaughn
- School of Social Work, College for Public Health & Social Justice, Saint Louis University, St. Louis, Missouri, USA
| | - Chu Chu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qing-Qing Li
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Bo-Yi Yang
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Li-Wen Hu
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yunjiang Yu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, China
| | - Xiao-Wen Zeng
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Messina M, Mejia SB, Cassidy A, Duncan A, Kurzer M, Nagato C, Ronis M, Rowland I, Sievenpiper J, Barnes S. Neither soyfoods nor isoflavones warrant classification as endocrine disruptors: a technical review of the observational and clinical data. Crit Rev Food Sci Nutr 2021; 62:5824-5885. [PMID: 33775173 DOI: 10.1080/10408398.2021.1895054] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Soybeans are a rich source of isoflavones, which are classified as phytoestrogens. Despite numerous proposed benefits, isoflavones are often classified as endocrine disruptors, based primarily on animal studies. However, there are ample human data regarding the health effects of isoflavones. We conducted a technical review, systematically searching Medline, EMBASE, and the Cochrane Library (from inception through January 2021). We included clinical studies, observational studies, and systematic reviews and meta-analyses (SRMA) that examined the relationship between soy and/or isoflavone intake and endocrine-related endpoints. 417 reports (229 observational studies, 157 clinical studies and 32 SRMAs) met our eligibility criteria. The available evidence indicates that isoflavone intake does not adversely affect thyroid function. Adverse effects are also not seen on breast or endometrial tissue or estrogen levels in women, or testosterone or estrogen levels, or sperm or semen parameters in men. Although menstrual cycle length may be slightly increased, ovulation is not prevented. Limited insight could be gained about possible impacts of in utero isoflavone exposure, but the existing data are reassuring. Adverse effects of isoflavone intake were not identified in children, but limited research has been conducted. After extensive review, the evidence does not support classifying isoflavones as endocrine disruptors.
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Affiliation(s)
- Mark Messina
- Department of Nutrition, Loma Linda University, Loma Linda, California, USA
| | - Sonia Blanco Mejia
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada
| | - Aedin Cassidy
- Nutrition and Preventive Medicine, Queen's University, Belfast, Northern Ireland, UK
| | - Alison Duncan
- College of Biological Sciences, University of Guelph, Guelph, Canada
| | - Mindy Kurzer
- Department of Food Science and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA
| | - Chisato Nagato
- Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Martin Ronis
- Health Sciences Center, Louisiana State University Health Sciences Center, Baton Rouge, New Orleans, USA
| | - Ian Rowland
- Human Nutrition, University of Reading, Reading, England, UK
| | | | - Stephen Barnes
- Department of Pharmacology and Toxicology, University of Alabama, Alabama, USA
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Banker M, Puttabyatappa M, O’Day P, Goodrich JM, Kelley AS, Domino SE, Smith YR, Dolinoy DC, Song PXK, Auchus RJ, Padmanabhan V. Association of Maternal-Neonatal Steroids With Early Pregnancy Endocrine Disrupting Chemicals and Pregnancy Outcomes. J Clin Endocrinol Metab 2021; 106:665-687. [PMID: 33280001 PMCID: PMC7947779 DOI: 10.1210/clinem/dgaa909] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Indexed: 12/12/2022]
Abstract
CONTEXT Steroids play an important role in fetal development and parturition. Gestational exposures to endocrine-disrupting chemicals (EDCs) affect steroidal milieu and pregnancy outcomes, raising the possibility of steroids serving as biomarkers. Most studies have not addressed the impact of EDC mixtures, which are reflective of real life scenarios. OBJECTIVE Assess the association of maternal and neonatal steroids with pregnancy outcomes and early pregnancy EDC levels. DESIGN Prospective analysis of mother-infant dyads. SETTING University hospital. PARTICIPANTS 121 mother-infant dyads. MAIN OUTCOME MEASURES The associations of maternal and neonatal steroidal hormones from 121 dyads with pregnancy outcomes, the associations of first trimester EDCs individually and as mixtures with maternal and neonatal steroids in a subset of 56 dyads and the influence of body mass index (BMI), age, and offspring sex in modulating the EDC associations with steroids were determined. RESULTS Steroid-specific positive or negative associations with pregnancy measures were evident; many maternal first trimester EDCs were negatively associated with estrogens and positively with androgen/estrogen ratios; EDC-steroid associations were influenced by maternal age, pre-pregnancy BMI, and fetal sex; and EDCs individually and as mixtures showed direct and inverse fetal sex-dependent associations with maternal and neonatal steroids. CONCLUSIONS This proof-of-concept study indicates association of steroids with pregnancy outcomes depending on maternal age, prepregnancy BMI, and fetal sex, with the effects of EDCs differing when considered individually or as mixtures. These findings suggest that steroidal hormonal measures have potential to serve as biomarkers of impact of EDC exposures and pregnancy outcome.
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Affiliation(s)
- Margaret Banker
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | | | - Patrick O’Day
- Departments of Pharmacology and Internal Medicine, Division of Metabolism, Endocrinology, & Diabetes, University of Michigan, Ann Arbor, MI, USA
| | - Jaclyn M Goodrich
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Angela S Kelley
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Steven E Domino
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Yolanda R Smith
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Dana C Dolinoy
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Peter X K Song
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Richard J Auchus
- Departments of Pharmacology and Internal Medicine, Division of Metabolism, Endocrinology, & Diabetes, University of Michigan, Ann Arbor, MI, USA
| | - Vasantha Padmanabhan
- Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI, USA
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Keelan JA, Hickey M, Hollier LP. Cord blood androgen measurements: the importance of assay validation. Hum Reprod 2017; 32:1360. [PMID: 28453632 DOI: 10.1093/humrep/dex075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jeffrey A Keelan
- School of Women's and Infants' Health, University of Western Australia, King Edward Memorial Hospital, Subiaco, Perth 6008, Australia
| | - Martha Hickey
- Department of Obstetrics and Gynaecology, The University of Melbourne, The Royal Women's Hospital, 20 Flemington Rd, Parkville, Melbourne, VIC 3052, Australia
| | - Lauren P Hollier
- Olga Tennison Autism Research Centre, Cooperative Research Centre for Living with Autism Spectrum Disorders (Autism CRC), School of Psychology and Public Health, La Trobe University, Bundoora, VIC 3086,Australia
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Huo X, Liu C. Reply I. Cord blood androgen measurement: the importance of assay validation. Hum Reprod 2017; 32:1361-1362. [PMID: 28453787 DOI: 10.1093/humrep/dex077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Xia Huo
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, 22 Xinling Road, Shantou, China
| | - Chunhua Liu
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, 22 Xinling Road, Shantou, China
- Department of Pediatrics, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
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Masuya Y, Okamoto Y, Inohara K, Matsumura Y, Fujioka T, Wada Y, Kosaka H. Sex-different abnormalities in the right second to fourth digit ratio in Japanese individuals with autism spectrum disorders. Mol Autism 2015; 6:34. [PMID: 26060570 PMCID: PMC4460687 DOI: 10.1186/s13229-015-0028-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 05/18/2015] [Indexed: 12/27/2022] Open
Abstract
Background The prevalence of autism spectrum disorders (ASDs) is higher in men than in women. The extreme male brain theory proposes that excessive prenatal testosterone activity could be a risk factor for ASDs. However, it is unclear whether prenatal sex hormone activity is a risk factor for women. The ratio of the length of the second to fourth digits (2D:4D) is considered to be a biomarker of the prenatal ratio of testosterone to estrogen. Therefore, this study compared the 2D:4D ratios of women with and without ASDs to determine if prenatal sex hormone activity could be a risk factor for ASDs in women. Methods The study included 35 Japanese men with ASDs, 17 Japanese women with ASDs, 59 typically developed (TD) Japanese men, and 57 TD Japanese women. We measured digit lengths and compared the 2D:4D ratios among the four groups. We also examined the relationship between the 2D:4D ratio and the autism-spectrum quotient score of each group. Results In our cohort, men with ASDs tended to have lower right-hand 2D:4D ratios relative to TD men. In contrast, the right 2D:4D ratios in women with ASDs were higher compared to those of TD women. No significant correlations were found between the 2D:4D ratios and the autism-spectrum quotient scores in any group. The higher right 2D:4D ratios in women could not be explained by age or full-scale intelligent quotients. This group difference was not found for the left 2D:4D or right–left 2D:4D ratios. Conclusions We found a reverse direction of abnormality in the right 2D:4D ratio for men and women with ASDs. It has been posited that high prenatal testosterone levels lead to a lower 2D:4D ratio. However, a recent animal study showed that testosterone injection to dam leads to a higher right 2D:4D ratio especially for female offspring, which might be mediated by abnormal adipose accumulation in the fingertip. Therefore, the present findings suggest that high prenatal testosterone could be a risk factor both for Japanese men and women with ASDs, elucidating one potential etiology of ASDs in women.
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Affiliation(s)
- Yasuhiro Masuya
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Fukui, 910-1193 Japan
| | - Yuko Okamoto
- Research Center for Child Mental Development, University of Fukui, Fukui, 910-1193 Japan ; Division of Developmental Higher Brain Functions, Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Fukui, 910-1193 Japan
| | - Keisuke Inohara
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Fukui, 910-1193 Japan ; Department of Informatics, Graduate School of Informatics and Engineering, The University of Electro-Communications, Chofu, 182-8585 Japan
| | - Yukiko Matsumura
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Fukui, 910-1193 Japan
| | - Toru Fujioka
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Fukui, 910-1193 Japan
| | - Yuji Wada
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Fukui, 910-1193 Japan ; Research Center for Child Mental Development, University of Fukui, Fukui, 910-1193 Japan ; Division of Developmental Higher Brain Functions, Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Fukui, 910-1193 Japan
| | - Hirotaka Kosaka
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Fukui, 910-1193 Japan ; Research Center for Child Mental Development, University of Fukui, Fukui, 910-1193 Japan ; Division of Developmental Higher Brain Functions, Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Fukui, 910-1193 Japan
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Hollier LP, Keelan JA, Hickey M, Maybery MT, Whitehouse AJO. Measurement of androgen and estrogen concentrations in cord blood: accuracy, biological interpretation, and applications to understanding human behavioral development. Front Endocrinol (Lausanne) 2014; 5:64. [PMID: 24829559 PMCID: PMC4014673 DOI: 10.3389/fendo.2014.00064] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 04/14/2014] [Indexed: 01/12/2023] Open
Abstract
Accurately measuring hormone exposure during prenatal life presents a methodological challenge and there is currently no "gold standard" approach. Ideally, circulating fetal hormone levels would be measured at repeated time points during pregnancy. However, it is not currently possible to obtain fetal blood samples without significant risk to the fetus, and therefore surrogate markers of fetal hormone levels must be utilized. Umbilical cord blood can be readily obtained at birth and largely reflects fetal circulation in late gestation. This review examines the accuracy and biological interpretation of the measurement of androgens and estrogens in cord blood. The use of cord blood hormones to understand and investigate human development is then discussed.
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Affiliation(s)
- Lauren P. Hollier
- Telethon Kids Institute, University of Western Australia, Subiaco, WA, Australia
- Neurocognitive Development Unit, School of Psychology, University of Western Australia, Crawley, WA, Australia
| | - Jeffrey A. Keelan
- School of Women’s and Infants’ Health, University of Western Australia, Crawley, WA, Australia
| | - Martha Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, VIC, Australia
| | - Murray T. Maybery
- Neurocognitive Development Unit, School of Psychology, University of Western Australia, Crawley, WA, Australia
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Hickey M, Hart R, Keelan JA. The relationship between umbilical cord estrogens and perinatal characteristics. Cancer Epidemiol Biomarkers Prev 2014; 23:946-52. [PMID: 24636976 DOI: 10.1158/1055-9965.epi-13-1321] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Prenatal estrogen exposure is thought to contribute to later life diseases such as breast cancer. However, few studies have directly measured prenatal estrogens and most have relied on proposed "markers" of estrogen exposure. We used a large population-based birth cohort to directly measure the relationship between prenatal estrogens and perinatal characteristics, including putative markers of estrogen exposure. METHODS Total estrone (E1), estradiol (E2), estriol (E3), and estetrol (E4) were assayed by liquid chromatography/tandem mass spectrometry from archived mixed arterial and venous serum from 860 umbilical cord blood samples. RESULTS Values for all estrogens were strongly intercorrelated. Cord estrogen concentrations did not differ between males and females. Levels of all estrogens were reduced in twins and concentrations increased with gestational age. Neither E1 nor E2 was correlated with birth weight, but E3 and E4 levels correlated weakly, whereas onset of labor was associated with higher estrogen concentrations. E1 and E2 concentrations were not associated with preeclampsia in the current pregnancy, but E3 and E4 concentrations were lower in pregnancies complicated by preeclampsia and antepartum hemorrhage. CONCLUSIONS Umbilical cord estrogen concentrations vary with gestational age, mode of delivery, pregnancy complications, and twinning, but not with infant sex. Putative markers of prenatal estrogen exposure, preeclampsia, and birth weight did not correlate with direct fetal measures of the most potent estrogen (E2) but were associated with weaker estrogens (E3 and E4). Twins had lower concentrations of all estrogens. IMPACT This is the largest and best characterized dataset of prenatal estrogen concentrations, measured using highly accurate mass spectrometry/spectroscopy. These observations represent the new "gold standard" for umbilical cord estrogens, and will inform the interpretation of other datasets and the early life origins of health and disease. Cancer Epidemiol Biomarkers Prev; 23(6); 946-52. ©2014 AACR.
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Affiliation(s)
- Martha Hickey
- Authors' Affiliations: Department of Obstetrics & Gynaecology, University of Melbourne, The Royal Women's Hospital, Melbourne, Victoria; and School of Women's and Infants' Health, King Edward Memorial Hospital, University of Western Australia, Perth, Australia
| | - Roger Hart
- Authors' Affiliations: Department of Obstetrics & Gynaecology, University of Melbourne, The Royal Women's Hospital, Melbourne, Victoria; and School of Women's and Infants' Health, King Edward Memorial Hospital, University of Western Australia, Perth, Australia
| | - Jeffrey A Keelan
- Authors' Affiliations: Department of Obstetrics & Gynaecology, University of Melbourne, The Royal Women's Hospital, Melbourne, Victoria; and School of Women's and Infants' Health, King Edward Memorial Hospital, University of Western Australia, Perth, Australia
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PAŠKOVÁ A, PAŘÍZEK A, HILL M, VELÍKOVÁ M, KUBÁTOVÁ J, DUŠKOVÁ M, ADAMCOVÁ K, KOUCKÝ M, ŠIMJAK P, ČERNÝ A, STÁRKA L. Steroid Metabolome in the Umbilical Cord: Is It Necessary To Differentiate Between Arterial and Venous Blood? Physiol Res 2014; 63:115-26. [DOI: 10.33549/physiolres.932624] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Steroids are important markers in pregnancy. Although estimating their levels separately in umbilical arterial (UA) and venous blood (UV) enable more precise insights into the functioning fetoplacental unit compared to using mixed umbilical blood (UM), selective aspiration of UA and UV is technically more demanding than collecting UM. We measured the levels of 67 unconjugated steroids and steroid polar conjugates in UA and UV using GC-MS in 80 women giving birth within weeks 28 to 42 of gestation. The samples were sorted into three groups: women entering labor within weeks 28-32 (group A, n=19), weeks 33-37 (group B, n=19), and weeks 38-42 (group C, n=42) of gestation, respectively. The preterm labors were due to pathologies unrelated to steroid status. Most unconjugated steroids exhibited pronounced arteriovenous differences (AVD). The AVD were less distinct in more stable steroid conjugates. Most steroids positively correlate with gestational age, but unconjugated 5β-reduced pregnanes show negative correlations, as do testosterone and androstenediol, substrates for the placental synthesis of estrogens. Tight correlations between steroids in UA and UV indicate that steroid measurements in UA, UV and UM can be accurately derived from each other, which is important for the diagnostics of steroid related diseases in newborns.
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Affiliation(s)
| | - A. PAŘÍZEK
- Department of Obstetrics and Gynecology of the First Faculty of Medicine, Charles University in Prague and General Teaching Hospital, Prague, Czech Republic
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Hill M, Pašková A, Kančeva R, Velíková M, Kubátová J, Kancheva L, Adamcová K, Mikešová M, Žižka Z, Koucký M, Šarapatková H, Kačer V, Matucha P, Meloun M, Pařízek A. Steroid profiling in pregnancy: a focus on the human fetus. J Steroid Biochem Mol Biol 2014; 139:201-22. [PMID: 23583279 DOI: 10.1016/j.jsbmb.2013.03.008] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 03/24/2013] [Accepted: 03/26/2013] [Indexed: 12/12/2022]
Abstract
In this review we focused on steroid metabolomics in human fetuses and newborns and its role in the physiology and pathophysiology of human pregnancy and subsequent stages of human life, and on the physiological relevance of steroids influencing the nervous systems with regards to their concentrations in the fetus. Steroid profiling provides valuable data for the diagnostics of diseases related to altered steroidogenesis in the fetal and maternal compartments and placenta. We outlined a potential use of steroid metabolomics for the prediction of reproductive disorders, misbalance of hypothalamic-pituitary-adrenal axis, and impaired insulin sensitivity in subsequent stages of human life. A possible role of steroids exhibiting a non-genomic effect in the development of gestational diabetes and in the neuroprotection via negative modulation of AMPA/kainate receptors was also indicated. Increasing progesterone synthesis and catabolism, declining production of tocolytic 5β-pregnane steroids, and rising activities of steroid sulfotransferases with the approaching term may be of importance in sustaining pregnancy. An increasing trend was demonstrated with advancing gestation toward the production of ketones (and 3β-hydroxyl groups in the case of 3α-hydroxy-steroids) was demonstrated in the fetus on the expense of 3α-hydroxy-, 17β-hydroxy-, and 20α-hydroxy-groups weakening in the sequence C17, C3, and C20. There was higher production of active progestogen but lower production of active estrogen and GABAergic steroids with the approaching term. Rising activities of placental CYP19A1 and oxidative isoforms of HSD17B, and of fetal CYP3A7 with advancing gestation may protect the fetus from hyperestrogenization. This article is part of a Special Issue entitled 'Pregnancy and Steroids'.
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Affiliation(s)
- Martin Hill
- Institute of Endocrinology, Národní třída 8, Prague CZ 116 94, Czech Republic.
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Elhddad AS, Lashen H. Fetal growth in relation to maternal and fetal IGF-axes: a systematic review and meta-analysis. Acta Obstet Gynecol Scand 2013; 92:997-1006. [DOI: 10.1111/aogs.12192] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Accepted: 06/03/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Agzail S.A. Elhddad
- Department of Obstetrics and Gynecology; Faculty of Medicine; Omar Al-Mukhtar University; Albeida Libya
| | - Hany Lashen
- Department of Human Metabolism; Academic Unit of Reproductive and Developmental Medicine; University of Sheffield; Sheffield UK
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12
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Keelan JA, Mattes E, Tan H, Dinan A, Newnham JP, Whitehouse AJO, Jacoby P, Hickey M. Androgen concentrations in umbilical cord blood and their association with maternal, fetal and obstetric factors. PLoS One 2012; 7:e42827. [PMID: 22916165 PMCID: PMC3423422 DOI: 10.1371/journal.pone.0042827] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 07/12/2012] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to measure umbilical blood androgen concentrations in a birth cohort using a highly specific liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay and assesses the effects of sex, labor, and gestational age on fetal androgen levels at birth. We performed a prospective cohort study of androgen concentrations in mixed arterial and venous umbilical cord serum from 803 unselected singleton pregnancies from a general obstetric population in Western Australia. Total testosterone (TT), Δ4-androstenedione, and dehydroepiandrosterone were extracted from archived cord serum samples and measured using LC-MS/MS. SHBG was measured by ELISA; free testosterone (FT) and bioavailable testosterone (BioT) values were also calculated. Median values for all three androgens were generally lower than previously published values. Levels of TT, FT, BioT, and SHBG were significantly higher in male verses female neonates (P<0.0001), while dehydroepiandrosterone levels were higher in females (P<0.0001). Labor was associated with a significant (∼15–26%) decrease in median cord blood TT and FT levels (both sexes combined), but a modest (∼16–31%) increase in SHBG, Δ4-androstenedione, and dehydroepiandrosterone concentrations. TT and FT were significantly negatively correlated with gestational age at delivery, while SHBG, Δ4-androstenedione, and dehydroepiandrosterone were positively correlated. Antenatal glucocorticoid administration also had a significant effect in the multiple regression models. This is the first study to report umbilical cord androgen levels in a large unselected population of neonates using LC-MS/MS. Our findings suggest that previous studies have over-estimated cord androgen levels, and that fetal, maternal, and obstetric factors influence cord androgen levels differentially. Caution should be exercised when interpreting previously-published data that have not taken all of these factors into account.
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Affiliation(s)
- Jeffrey A Keelan
- School of Women's and Infants' Health, King Edward Memorial Hospital, University of Western Australia, Perth, Western Australia, Australia.
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Agurs-Collins T, Rohrmann S, Sutcliffe C, Bienstock JL, Monsegue D, Akereyeni F, Bradwin G, Rifai N, Pollak MN, Platz EA. Racial variation in umbilical cord blood sex steroid hormones and the insulin-like growth factor axis in African-American and white female neonates. Cancer Causes Control 2012; 23:445-54. [PMID: 22252677 PMCID: PMC3333795 DOI: 10.1007/s10552-011-9893-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Accepted: 12/21/2011] [Indexed: 10/14/2022]
Abstract
PURPOSE To evaluate whether there is racial variation in venous umbilical cord blood concentrations of sex steroid hormones and the insulin-like growth factor (IGF) axis between female African-American and white neonates. METHODS Maternal and birth characteristics and venous umbilical cord blood samples were collected from 77 African-American and 41 white full-term uncomplicated births at two urban hospitals in 2004 and 2005. Cord blood was measured for testosterone, dehydroespiandrosterone-sulfate, estradiol, and sex steroid hormone-binding globulin (SHBG) by immunoassay. IGF-1, IGF-2, and IGF-binding protein-3 (IGFBP-3) were measured by ELISA. Crude and multivariable-adjusted geometric mean concentrations were computed for the hormones. RESULTS African-American neonates weighed less at birth (3,228 g vs. 3,424 g, p < 0.004) than whites. Birth weight was positively correlated with IGF-1, IGFBP-3, and the molar ratio of IGF-1 to IGFBP-3, but inversely correlated with the molar ratio of IGF-2 to IGFBP-3. Adjusted models showed higher testosterone (1.82 ng/ml vs. 1.47 ng/ml, p = 0.006) and the molar ratio of testosterone to SHBG (0.42 vs. 0.30, p = 0.03) in African-American compared to white female neonates. IGF-1, IGF-2, and IGFBP-3 were lower in African-American compared to white female neonates, but only the difference for IGF-2 remained significant (496.5 ng/ml vs. 539.2 ng/ml, p = 0.04). CONCLUSION We provide evidence of racial variation in cord blood testosterone and testosterone to SHBG in African-American compared to white female neonates, and higher IGF-2 in white compared to African-American female neonates. Findings suggest plausible explanations for a prenatal influence on subsequent breast cancer risk and mortality. Further work is needed to confirm these observations.
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Affiliation(s)
- Tanya Agurs-Collins
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.
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Faupel-Badger JM, Wang Y, Karumanchi SA, Stanczyk F, Pollak M, McElrath T, Hoover RN, Troisi R. Associations of pregnancy characteristics with maternal and cord steroid hormones, angiogenic factors, and insulin-like growth factor axis. Cancer Causes Control 2011; 22:1587-95. [PMID: 21947778 PMCID: PMC3321929 DOI: 10.1007/s10552-011-9835-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Accepted: 08/19/2011] [Indexed: 01/21/2023]
Abstract
BACKGROUND The objective of this study was to comprehensively profile biological factors in pregnancy that have been postulated to be important components of the in utero environment and may also have relevance to later susceptibility to cancer and other chronic diseases. METHODS Steroid sex hormones, IGFs, and angiogenic factors were measured in maternal and cord serum from term normotensive pregnancies. Spearman correlations and linear regression estimated relationships among the biological factors and clinical characteristics. RESULTS The analytes were generally not correlated between maternal and fetal circulations. However, significant correlations were demonstrated among several analytes within maternal or cord samples. A few analytes were associated with clinical characteristics (e.g., maternal IGF-1 and IGFBP-3 were inversely correlated with offspring birth weight, while maternal leptin and cord testosterone were positively correlated with this characteristic). Maternal androgens were higher in African-Americans than whites, and maternal PlGF and soluble fms-like tyrosine kinase-1 (sFlt-1) were higher in male than female offspring. CONCLUSIONS There were significant correlations among analytes, but the patterns differed depending on whether they were measured in the maternal or fetal circulation. The number and magnitude of correlations among analytes, however, should affect the design and interpretation of future studies.
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Affiliation(s)
- Jessica M Faupel-Badger
- Cancer Prevention Fellowship Program, Center for Cancer Training, National Cancer Institute, 6120 Executive Blvd. (EPS), Bethesda, MD 20892-7105, USA.
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Sprague BL, Trentham-Dietz A, Gangnon RE, Buist DSM, Burnside ES, Aiello Bowles EJ, Stanczyk FZ, Sisney GS, Skinner HG. The vitamin D pathway and mammographic breast density among postmenopausal women. Breast Cancer Res Treat 2011; 131:255-65. [PMID: 21847642 DOI: 10.1007/s10549-011-1726-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 08/04/2011] [Indexed: 01/20/2023]
Abstract
Laboratory studies have demonstrated that vitamin D has a number of chemopreventive properties, and that these properties may be mediated or modified by other molecules in the vitamin D pathway, such as parathyroid hormone (PTH) or calcium. However, there is little epidemiologic data exploring the effects of vitamin D on breast cancer risk in the context of these other molecules. We examined a panel of molecules in the vitamin D pathway in relation to mammographic breast density, a marker of breast cancer risk, in the Wisconsin Breast Density Study. A total of 238 postmenopausal women (ages 55-70, with no history of postmenopausal hormone use) were enrolled from mammography clinics in Madison, Wisconsin. Subjects provided blood samples that were analyzed for levels of 25-hydroxy vitamin D [25(OH)D], PTH, insulin-like growth factor-1 (IGF-1), IGF-binding protein 3 (IGFBP-3), retinol, and calcium. Percent breast density was measured using Cumulus software. In age-adjusted analyses there was a positive association between 25(OH)D and percent breast density (P = 0.05; mean percent density = 11.3% vs. 15.6% for 1st vs. 4th quartile of 25(OH)D). Breast density was inversely associated with PTH (P = 0.05; 16.0% vs. 11.4% for Q1 vs. Q4) and positively associated with the IGF-1:IGFBP-3 molar ratio (P = 0.02; 11.9% vs. 15.6% for Q1 vs. Q4). However, these associations were all null after further adjustment for body mass index (BMI; P > 0.25). The independent relation between 25(OH)D and breast density remained null among subgroups defined by BMI and serum levels of retinol, calcium, and estradiol. These results suggest no strong independent associations between the circulating molecules of the vitamin D pathway and mammographic breast density in postmenopausal women. While it remains possible that vitamin D could influence breast cancer risk, our results suggest that such an effect would be mediated through pathways other than breast density.
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Affiliation(s)
- Brian L Sprague
- Department of Surgery, University of Vermont, Burlington, VT 05401, USA.
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Lagiou P, Samoli E, Okulicz W, Xu B, Lagiou A, Lipworth L, Georgila C, Vatten L, Adami H, Trichopoulos D, Hsieh C. Maternal and cord blood hormone levels in the United States and China and the intrauterine origin of breast cancer. Ann Oncol 2011; 22:1102-1108. [DOI: 10.1093/annonc/mdq565] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ruder EH, Hartman TJ, Rovine MJ, Dorgan JF. Birth characteristics and age at menarche: results from the dietary intervention study in children (DISC). Cancer Causes Control 2010; 21:1379-86. [PMID: 20495859 DOI: 10.1007/s10552-010-9565-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2009] [Accepted: 04/02/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To examine whether birth weight, birth length, and gestational age are individually associated with age at menarche. METHODS Analyses were conducted using data from n = 278 female participants in the Dietary Intervention Study in Children (DISC). Age at menarche was prospectively collected as part of the original DISC investigation. DISC participants self-reported birth weight, birth length, and gestational age with assistance from their mothers and other records as part of the DISC06 Follow-up Study at ages 25-29. Linear regression was used to estimate the association of birth characteristics and age at menarche. RESULTS Birth weight was positively associated with age at menarche (p <or= 0.01) in multiple regression analyses after controlling for BMI-for-age percentile, race and DISC treatment group. No statistically significant relationships were detected between either length or gestational age and age at menarche. CONCLUSIONS Higher birth weight may be associated with a modest delay in age at menarche.
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Affiliation(s)
- Elizabeth H Ruder
- Cancer Prevention Fellowship Program, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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Abstract
Breast cancer incidence and birth weight are higher among Caucasian than Asian women, and birth size has been positively associated with breast cancer risk. Pregnancy hormone levels, however, have been generally lower in Caucasian than Asian women. We studied components of the insulin-like growth factor (IGF) system in cord blood from 92 singleton babies born in Boston, USA, and 110 born in Shanghai, China, in 1994–1995. Cord blood IGF-1 was significantly higher among Caucasian compared with Chinese babies (P<10−6). The opposite was noted for IGF-2 (P∼10−4). IGF-1 was significantly positively associated with birth weight and birth length in Boston, but not Shanghai. In contrast, stronger positive, though statistically non-significant, associations of IGF-2 with birth size were only evident in Shanghai. The associations of birth weight and birth length were positive and significant in taller women (for IGF-1 in Boston P∼0.003 and 0.03, respectively; for IGF-2 in Shanghai P∼0.05 and ∼0.04, respectively), among whom maternal anthropometry does not exercise strong constraints in foetal growth. The documentation of higher cord blood levels of IGF-1, a principal growth hormone that does not cross the placenta, among Caucasian than in Asian newborns is concordant with breast cancer incidence in these populations.
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