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Vu Huynh QT, Ban HT, Vuong NL, Khanh NP. The relationship between bisphenol A and phthalates with precocious puberty in Vietnamese children. J Pediatr Endocrinol Metab 2024; 37:644-651. [PMID: 38829694 DOI: 10.1515/jpem-2024-0144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/17/2024] [Indexed: 06/05/2024]
Abstract
OBJECTIVES This study is aimed to explore the correlation between bisphenol A (BPA) and phthalates, including diethylhexylphthalate (DEHP) and dibutylphthalate (DBP), and precocious puberty (PP). METHODS A case-control study was conducted in Ho Chi Minh City, Vietnam, from November 2021 to April 2022, involving 250 children, with 124 of them diagnosed with PP and 126 serving as controls. We assessed the levels of urinary BPA, DEHP, and DBP in all participants and examined their association with the risk of PP. RESULTS BPA was detected in 11.3 % of PP cases but was not found in any individuals in the control group (p<0.001). Diethylhexylphthalate metabolite (MEHP) was not detected in any of the samples. Positive urinary results for dibutylphthalate metabolite (MBP) were observed in 8.1 % of PP cases and 2.4 % in the control group, with an odds ratio of 3.6 (95 % confidence interval: 0.97-13.4, p=0.03). CONCLUSIONS The PP group exhibited a higher prevalence of positive urinary BPA and DBP levels compared to the control group.
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Affiliation(s)
- Quynh Thi Vu Huynh
- Department of Pediatrics, 249295 University of Medicine and Pharmacy at Ho Chi Minh City , Ho Chi Minh City, Vietnam
- Nephrology and Endocrinology Department, Children's Hospital 2, Ho Chi Minh City, Vietnam
| | - Ho Tran Ban
- Department of Pediatric Surgery, 249295 University of Medicine and Pharmacy at Ho Chi Minh City , Ho Chi Minh City, Vietnam
- General Surgery Department, Children's Hospital 2, Ho Chi Minh City, Vietnam
| | - Nguyen Lam Vuong
- Department of Medical Statistics and Informatics, Faculty of Public Health, 249295 University of Medicine and Pharmacy at Ho Chi Minh City , Ho Chi Minh City, Vietnam
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Bigambo FM, Wang D, Sun J, Ding X, Li X, Gao B, Wu D, Gu W, Zhang M, Wang X. Association between Urinary BPA Substitutes and Precocious Puberty among Girls: A Single-Exposure and Mixed Exposure Approach from a Chinese Case-Control Study. TOXICS 2023; 11:905. [PMID: 37999557 PMCID: PMC10675366 DOI: 10.3390/toxics11110905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/27/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023]
Abstract
There is an argument that BPA substitutes may have the same or more deleterious health effects as BPA due to their structural similarity. This study explored the association between urinary BPA substitutes and precocious puberty among girls by including 120 girls with precocious puberty (cases) aged 2-10 years enrolled at Nanjing Children's Hospital Department of Endocrinology in China between April 2021 to September 2021 and 145 healthy girls (controls) recruited from a primary school. Logistic regression was used to evaluate the effect of single exposures, and Bayesian kernel machine regression (BKMR) and quantile-based g-computation were used for the mixed effect. In the multivariate logistic regression, BPS (bisphenol S), TBBPA (tetrabromobisphenol A), and BPFL (bisphenol-FL) were significantly associated with increased risk of precocious puberty (odds ratio (OR) = 1.75, 95% confidence interval (CI): 1.13, 2.76, p = 0.014), (OR = 1.46, CI: 1.06, 2.05; p = 0.023), and (OR = 1.47, CI: 1.01, 2.18; p = 0.047), respectively. The BMKR and quantile-based g-computation models revealed consistent associations for single exposures and there was insufficient evidence for the associations of the mixed exposure of bisphenols with precocious puberty. In conclusion, BPA substitutes such as BPS, TBBPA, and BPFL may be associated with an increased risk of precocious puberty in girls.
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Affiliation(s)
- Francis Manyori Bigambo
- Department of Endocrinology, Children’s Hospital of Nanjing Medical University, Nanjing 210008, China; (F.M.B.); (D.W.); (W.G.)
| | - Dandan Wang
- Department of Endocrinology, Children’s Hospital of Nanjing Medical University, Nanjing 210008, China; (F.M.B.); (D.W.); (W.G.)
| | - Jian Sun
- Department of Emergency, Pediatric Intensive Care Unit, Children’s Hospital of Nanjing Medical University, Nanjing 210008, China;
| | - Xinliang Ding
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (X.D.); (X.L.); (B.G.); (D.W.)
- Wuxi Center for Disease Control and Prevention, The Affiliated Wuxi Center for Disease Control and Prevention, Nanjing Medical University, Wuxi 214023, China
- Research Base for Environment and Health in Wuxi, Chinese Center for Disease Control and Prevention, Wuxi 214023, China
| | - Xiuzhu Li
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (X.D.); (X.L.); (B.G.); (D.W.)
- Wuxi Center for Disease Control and Prevention, The Affiliated Wuxi Center for Disease Control and Prevention, Nanjing Medical University, Wuxi 214023, China
- Research Base for Environment and Health in Wuxi, Chinese Center for Disease Control and Prevention, Wuxi 214023, China
| | - Beibei Gao
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (X.D.); (X.L.); (B.G.); (D.W.)
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Di Wu
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (X.D.); (X.L.); (B.G.); (D.W.)
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Wei Gu
- Department of Endocrinology, Children’s Hospital of Nanjing Medical University, Nanjing 210008, China; (F.M.B.); (D.W.); (W.G.)
| | - Mingzhi Zhang
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (X.D.); (X.L.); (B.G.); (D.W.)
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Xu Wang
- Department of Endocrinology, Children’s Hospital of Nanjing Medical University, Nanjing 210008, China; (F.M.B.); (D.W.); (W.G.)
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Bassols J, de Zegher F, Diaz M, Carreras-Badosa G, Garcia-Beltran C, Puerto-Carranza E, Oliver-Vila C, Casano P, Franco CA, Malpique R, López-Bermejo A, Ibáñez L. Effects of half-dose spiomet treatment in girls with early puberty and accelerated bone maturation: a multicenter, randomized, placebo-controlled study protocol. Trials 2023; 24:56. [PMID: 36694227 PMCID: PMC9873221 DOI: 10.1186/s13063-022-07050-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/23/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND A "mismatch" sequence of less prenatal weight gain and more postnatal weight gain may lead to ectopic lipid accumulation, and trigger the development of early adrenarche/pubarche and the activation of the gonadotropic axis resulting in early puberty and ending up in full-blown adolescent polycystic ovary syndrome (PCOS). In the present study, we assess whether a low-dose combination of generics that collectively reduce ectopic fat through different pathways can slow down the accelerated maturation in "mismatch" girls with early puberty. METHODS Randomized, placebo-controlled, multicenter, phase 2a, study in 64 girls [age, 8.0-9.3 years; birthweight (BW) for gestational age in lower tertile (-1.96< Z-score <-0.44), body mass index (BMI) in upper tertile (+0.44< Z-score < +1.96) and early progressive puberty (Tanner B2 at 7.7-9.0 years)]. Pharmacological intervention will be with a half-dose version of SPIOMET (mini-spiomet), a combination that reverts the PCOS phenotype in "mismatch" adolescents; mini-spiomet will contain spironolactone (25 mg/day, to raise brown adipose tissue activity), pioglitazone (3.75 mg/day, to raise adiponectin and insulin sensitivity), and metformin (425 mg/day, to raise AMPK activity and GDF15). Recruitment: 1 year; double-blind treatment: 1 year; open follow-up: 1 year; analyses and reporting: 1 year. INTERVENTIONS randomization (1:1) for placebo vs mini-spiomet. PRIMARY OUTCOME annualized bone age advancement (0-1 year) by BoneXpert; secondary outcomes: insulin, IGF-I, high-molecular-weight adiponectin (HMW-adip), sex hormone binding globulin (SHBG), ultra-sensitive C-reactive protein (usCRP), androgens, luteinizing hormone (LH), follicle-stimulating hormone (FSH), oestradiol, growth-and-differentiation factor 15 (GDF15), C-X-C motif chemokine ligand-14 (CXCL14), safety parameters, and quantification of hepato-visceral fat. DISCUSSION The present study, if successful, may provide a first proof of the concept that the rapid maturation of girls with an upward mismatch between pre- and post-natal weight gain can be slowed down with a fixed low-dose combination of old and safe generics jointly targeting a reduction of ectopic fat without necessarily lowering body weight. TRIAL REGISTRATION EudraCT 2021-006766-21. Registered on May 30, 2022.
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Affiliation(s)
- Judit Bassols
- Maternal-Fetal Metabolic Research Group, Girona Biomedical Research Institute (IDIBGI), Girona, Spain
| | - Francis de Zegher
- Leuven Research & Development, University of Leuven, Leuven, Belgium
| | - Marta Diaz
- Endocrinology Department, Pediatric Research Institute Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Carreras-Badosa
- Pediatric Endocrinology Research Group, Girona Biomedical Research Institute (IDIBGI), Girona, Spain
| | - Cristina Garcia-Beltran
- Endocrinology Department, Pediatric Research Institute Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Cora Oliver-Vila
- Pediatric Endocrinology Research Group, Girona Biomedical Research Institute (IDIBGI), Girona, Spain
| | - Paula Casano
- Endocrinology Department, Pediatric Research Institute Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
| | - Céline Alicia Franco
- Endocrinology Department, Pediatric Research Institute Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Rita Malpique
- Endocrinology Department, Pediatric Research Institute Sant Joan de Déu, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
| | - Abel López-Bermejo
- Pediatric Endocrinology Research Group, Girona Biomedical Research Institute (IDIBGI), Girona, Spain.
- Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain.
- Department of Medical Sciences, University of Girona, Girona, Spain.
| | - Lourdes Ibáñez
- Endocrinology Department, Pediatric Research Institute Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain.
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Mohsen R, El-Zohairy E, Hassan MM, Fathy M, Magdy M, Atef S, Issak M, Taha SHN. The Possible Association between Phthalates and Bisphenol A Exposure and Idiopathic Precocious Puberty in Egyptian Girls. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Bisphenol A (BPA) and phthalates are utilized in large spectrum of plastics, as polyvinyl chloride as well as personal products, medical equipment, and epoxy resins. Phthalate and bisphenol A are the most common endocrine disrupting chemicals that interrupt the endocrine system and cause developmental, reproductive, neurological, and immune disturbances in humans. However, the relation between phthalates and bisphenol A and precocious puberty (PP) in human is still controversial.
AIM: Consequently, the present study aimed to detect and investigate the association between exposure to bisphenol A and monobutyl phthalate (MBP) and precocious puberty in Egyptian girls.
METHODS: Urine samples were collected from 100 young females. The subjects were divided into two major groups, precocious puberty group consisted of 60 young females diagnosed by an endocrine pediatric specialist and controls consisted of 40 normal young females matched in age and demographic characters. In urine, MBP and bisphenol A (BPA) were measured with high-performance liquid chromatography.
RESULTS: The mean concentration of MBP level was 22.758 ± 6.216 for the PP group and 15.283 ± 6.262 for controls with statistical difference between the studied groups (p < 0.001). Furthermore, the mean concentration of BPA was 405.02 ± 223.54 for the PP group and 97.95 ± 55 for controls with significant difference between groups (p < 0.001).
CONCLUSION: The present study found that idiopathic precocious puberty in young females was associated with high phthalate metabolites and bisphenol A levels in urine.
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Endocrine-Disrupting Chemicals and Early Puberty in Girls. CHILDREN-BASEL 2021; 8:children8060492. [PMID: 34200537 PMCID: PMC8226958 DOI: 10.3390/children8060492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 12/27/2022]
Abstract
In recent decades, pubertal onset in girls has been considered to occur at an earlier age than previously. Exposure to endocrine-disrupting chemicals (EDCs) has been associated with alterations in pubertal timing, with several reports suggesting that EDCs may have a role in the secular trend in pubertal maturation, at least in girls. However, relevant studies give inconsistent results. On the other hand, the majority of girls with idiopathic precocious or early puberty present the growth pattern of constitutional advancement of growth (CAG), i.e., growth acceleration soon after birth. Herein, we show that the growth pattern of CAG is unrelated to exposure to endocrine-disrupting chemicals and is the major determinant of precocious or early puberty. Presented data suggest that EDCs, at most, have a minor effect on the timing of pubertal onset in girls.
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de Zegher F, Ibáňez L. On the rising incidence of early breast development: puberty as an adaptive escape from ectopic adiposity in mismatch girls. Eur J Endocrinol 2021; 185:L1-L2. [PMID: 33950862 PMCID: PMC8183632 DOI: 10.1530/eje-21-0287] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/05/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Francis de Zegher
- University of Leuven, University of Leuven, Leuven, Belgium
- Correspondence should be addressed to F de Zegher Email
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