Background

Despite many epidemiological studies having been conducted, the impact of postnatal exposure of endocrine disruptors (EDs) on testicular function remains a controversial issue.

Aim

To systematically review the literature and perform a quantitative synthesis to evaluate the effect of EDs on testicular function.

Materials and methods

A comprehensive search was conducted in the MEDLINE, Scopus, and CENTRAL databases. Eligible for the systematic review were observational (cross-sectional and cohort) studies with (i) adult men who had a high probability of postnatal exposure to EDs (“exposed”), (ii) adult men who had a low probability of postnatal exposure to EDs (“non-exposed”), and (iii) an outcome of interest [seminal parameters and reproductive hormone concentrations]. The continuous outcomes in each of the studies were synthesized by the random effects model and expressed as standardized mean difference (SMD) with 95% confidence interval (CI).

Results

Thirteen studies, including 959 exposed and 907 non-exposed men, fulfilled the inclusion criteria. Exposure to EDs was associated with decreased LH [SMD − 0.17, 95% CI − 0.33 to − 0.02, 10 studies (616 exposed, 563 non-exposed), I² 40%, p = 0.09], progressive motility [SMD − 0.45, 95% CI − 0.77 to − 0.13, three studies (133 cases, 153 controls), I² 38%, p = 0.20], and normal morphology [SMD − 0.50, 95% CI − 0.85 to − 0.14, eight studies (562 cases, 540 controls), I² 87%, p < 0.01] compared with non-exposure. No difference was observed between the other study groups.

Conclusions

Postnatal exposure to EDs is associated with decreased semen quality. Nevertheless, there is no evidence that a disruption of testicular function mediates the deterioration in semen quality.

中文翻译：

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产后内分泌干扰物暴露对睾丸功能的影响：系统评价和荟萃分析。

背景

尽管已进行了许多流行病学研究，但产后内分泌干扰物（ED）暴露对睾丸功能的影响仍然是一个有争议的问题。

目标

为了系统地回顾文献并进行定量合成以评估EDs对睾丸功能的影响。

材料和方法

在MEDLINE，Scopus和CENTRAL数据库中进行了全面搜索。符合条件的系统评价为观察性研究（横断面和队列研究），其中（i）产后暴露于EDs的可能性高的成年男性（“暴露”），（ii）产后暴露的可能性低的成年男性EDs（“未暴露”），和（iii）感兴趣的结果[半数参数和生殖激素浓度]。每项研究的连续结果均由随机效应模型合成，并表示为具有95％置信区间（CI）的标准化均值差（SMD）。

结果

十三项研究，包括959名暴露男性和907名未暴露男性，均符合纳入标准。暴露于EDs与LH降低相关[SMD-0.17，95％CI-0.33至-0.02，10项研究（616暴露，563未暴露），I ² 40％，p  = 0.09]，进行性运动[SMD-0.45 ，95％CI-0.77至-0.13，三项研究（133例，153名对照），I ² 38％，p  = 0.20]和正常形态[SMD-0.50，95％CI-0.85至-0.14，八项研究（ 562例，540例对照者，I ² 87％，p  <0.01]。其他研究组之间未观察到差异。

结论

产后暴露于EDs与精液质量下降有关。然而，没有证据表明睾丸功能的破坏会导致精液质量下降。