不孕與正常懷孕婦女體內金屬濃度與相關影響因子之探討

Blood metals concentration and relevant factors in infertility and fertility women.

廖凱威(Kai-Wei Liao)

指導教授 ： 簡伶朱

臺北醫學大學/公共衛生暨營養學院/公共衛生學研究所/碩士(2010年)

https://doi.org/10.6831/TMU.2010.00207

摘要

近年已知環境污染物可能造成人類的生殖危害，非必需微量元素的高低可能影響不孕的發生。本研究設計為橫斷性研究，以不孕和懷孕婦女血中金屬（鉛、鎘、汞、砷）濃度和髮汞濃度作為婦女金屬暴露之生物指標，分析不孕症與正常懷孕婦女血液非必需微量元素濃度及髮汞濃度，探討體內金屬濃度與女性不孕之相關性，進而分析造成女性不孕相關危險因子。研究期間為2008年8月至2010年3月，於台北某醫院進行收樣，個案為不孕婦女組384位，懷孕婦女組58位，收集血液和頭髮，並進行基本資料與問卷訪視，分析血液中鉛、鎘、汞、砷濃度，其中鉛、鎘、砷濃度使用感應耦合電漿質譜儀(Inductively Coupled Plasma Mass Spectrometry)分析，血汞與髮汞濃度使用汞分析儀(Mercury Analysis System)分析。結果發現不孕組髮汞幾何平均濃度為1.73±0.08 ppm，懷孕婦女則為1.56± 0.18 ppm。血汞幾何平均濃度為5.90±0.25 ppb，鉛為15.89±0.40 ppb，鎘為1.31±0.04 ppb，砷為12.99±0.27 ppb；懷孕婦女血汞的幾何平均濃度為7.28±0.47 ppb，鉛為11.90±0.63 ppb，鎘為1.35±0.04 ppb，砷為11.27±0.38 ppb。邏輯斯複迴歸模式中顯示喝酒習慣、運動習慣、血鉛濃度與血砷濃度與婦女發生不孕風險達統計上的顯著相關。有喝酒習慣的婦女比起沒有者，發生不孕風險為3.04倍(AOR=3.04, C.I=1.02-9.01)，沒有運動習慣的婦女比起有運動習慣者發生不孕風險為12.57倍(AOR=12.57, C.I=3.54-44.65)。當婦女血鉛濃度≧15.47 ppb比血鉛濃度＜15.47 ppb婦女發生不孕風險為2.19倍(AOR=2.19, C.I=1.02-4.69)，另外婦女血砷濃度≧12.86 ppb比血砷濃度＜12.86 ppb者，發生不孕的風險為4.48 倍(AOR=4.48, C.I=1.96-10.21)。本研究發現婦女的低血鉛濃度、低血砷濃度、沒有運動習慣和有喝酒習慣都是造成女性發生不孕的危險因子。

關鍵字

不孕症、懷孕婦女、髮汞、血鉛、血鎘、血汞、血砷

並列摘要

Objective This study investigated the relationship between metals exposure and relevant factors risk of infertility in women.

Design Cross-sectional study.

Sample Study participants consisted of 384 cases recruited at the center for reproductive medicine and infertility and 58 controls at the department of gynecology and obstetrics in Taipei, Taiwan.

Methods
A total of 384 participants were recruited from a hospital and provided written informed consent between August 2008 and March 2010. The participants were interviewed face-to-face by a trained interviewer who collected information about sociodemographic characteristics, occupation, pregnancy and reproductive history, fish intake, and other lifestyle characteristics. Mercury concentrations in blood and hair were determined with a mercury analyzer (HG-310; Hiranuma, Mito, Japan). Lead, cadmium, and arsenic concentrations in blood were measured by inductively coupled plasma mass spectrometry (ICP-MS; Thermo X-series II).

Results and Discussion
The geometric mean concentration in blood was mercury: 5.90±0.25 ppb, lead: 15.89±0.40 ppb, cadmium: 1.31±0.04 ppb, arsenic: 12.99±0.27 ppb respectively for the infertility women and mercury: 7.28±0.47 ppb, lead: 11.90±0.63 ppb, cadmium 1.35±0.04 ppb, arsenic: 11.27±0.38 ppb for the fertility women. The geometric mean hair mercury concentration was 1.73±0.08 and 1.56± 0.18 ppm for the infertility and fertility women. A multiple logistic regression model is shown that women with drinking habits were associated with a 3.04 fold risk for infertility (adjusted odds ratio = 3.04, 95%C.I = 1.02-9.01). Women without exercising habits were associated with
12.57 fold risk for infertility (adjusted odds ratio = 12.57, 95%C.I = 3.54-44.65). Compare to women with blood lead level ≧15.47 ppb could cause the 2.19 fold for infertility (adjusted odds ratio = 2.19, 95%C.I = 1.02-4.69). Women with blood arsenic level ≧12.86 ppb, women with blood arsenic level ＜12.86 ppb were associated with a 4.48 fold risk for infertility (adjusted odds ratio = 4.48, 95%CI = 1.96-10.21). These findings suggest an important role of very low blood lead level, blood arsenic level, without exercising habits and with drinking habits in the risk of infertility in women.

並列關鍵字

Infertility ； blood lead ； blood mercury ； blood cadmium ； blood arsenic ； hair mercury.

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