全氟碳化物和內分泌功能之相關性研究:著重在生殖賀爾蒙及甲狀腺功能

Abstract

近年來，環境流行病學的研究顯示在胎兒和兒童時期暴露到環境汙染物，會干擾了特定時間的生長、內分泌系統和發育過程，不僅對胎兒和兒童會造成不良的健康和生長影響，也可能導致成人時期的病痛。全氟碳化物(Perfluoroalkyl substances, PFASs)，是近年來新興的環境汙染物，因結構類似人體荷爾蒙並干擾內分泌的人工合成化學物質被稱為內分泌干擾物(Endocrine-disrupting chemicals, EDCs)也稱為環境荷爾蒙，影響人體內分泌功能甚至會影響孩童的成長與日後發育。由於人體的內分泌功能是由各種激素調控，因此了解內分泌激素調節情形也有助於了解人體內分泌功能，且有研究指出胎兒及生殖系統正在發育的青少年對於環境汙染物特別是全氟碳化物較為敏感。因此本研究首先利用2006-2008建立的台灣青少年及年輕成人追蹤研究(YOung TAiwanese Cohort, YOTA)探討全氟碳化物與青少年生殖賀爾蒙之相關性，研究發現全氟碳化物會影響青少年族群的生殖賀爾蒙，並以12-17歲的女生較為嚴重。接著利用2004年建立的台灣出生世代(Taiwan Birth Panel study，TBPS)探討臍帶血中全氟碳化物和甲狀腺賀爾蒙之相關性，研究發現全氟碳化物主要影響促甲状腺激素(thyroid stimulating hormone, TSH)和四碘甲狀腺素(thyroxine, T4)的平衡。除了全氟碳化物外，其他的環境汙染物(例如: 二手煙、塑化劑和多氯聯苯等)也危害著兒童的健康，兒童環境健康不只是我們所關心的，更是全球所關注的重要議題，因亞洲兒同人數占全球的一半，加上亞洲的生活型態和嬰幼兒的養育環境與西方國家有很大的不同，因此先了解整體亞洲兒童環境健康的問題也將能了解全球一半的問題也能進行改善及後續進行深入探討，所以最後藉由2011年成立的亞洲出生世代(Birth Cohort Consortium of Asia, BiCCA)探討亞洲兒童環境健康，研究發現亞洲地區，汞和多氯聯苯的暴露影響兒童神經行為的研究是較確定的，但是二手煙、全氟碳化物和塑化劑等相關研究仍然需要更多的證據，未來希望也將能進行亞洲出生世代的研究整合，綜合探討為亞洲兒童的健康創造福祉。

Over the decades, epidemiologic research demonstrated the adverse health outcomes of the fetus and children from parental or childhood exposures to environmental pollution that disrupted time-specific growth, endocrine system, and developmental processes. Perfluoroalkyl substances (PFASs) are emerging environmental pollutions which are man-made chemicals and their structures are similar to human hormone and interference with human endocrine so called endocrine-disrupting chemicals (EDCs) or also environmental hormone. PFASs with endocrine-disrupting property impact seriously on children’s health through endocrine function. Human’s endocrine is regulated by a variety of hormones, so understanding the regulation of endocrine hormones may help to understand the human endocrine function. Moreover, studies pointed out that fetal and adolescent, crucial developmental periods of life course, are more vulnerable than other periods. To begin with, we used YOung TAiwanese Cohort (YOTA) which was established from 2006-2008 to explore the association between PFASs and reproductive hormone. We found that PFASs affected reproductive hormone in adolescence and young adults, especially for age of 12-17. Moreover, we investigated the association between PFASs and thyroid hormone in cord blood based on Taiwan Birth Panel study (TBPS) established in 2004. We found that PFASs impacted on infant’s thyroid stimulating hormone (TSH) and thyroxine (T4). In addition to the PFASs, variety of environmental pollution may influence on children’s health such as environmental tobacco smoke, phthalate, and polychlorinated biphenyl etc. Children’s environmental health is not just our concern in Taiwan but also an important issue in global. Asia contains half of the world's children, and the life style and child raising environment in Asia are quite different compared to western countries. Therefore, understanding the environmental health of Asian children could know the half problems in global, and we could make more improvement in Asia area for further exploration. The Birth Cohort Consortium of Asia (BiCCA), co-established in 2011, was used to investigate the children’s environmental health in Asia. We found that mercury and PCB appear more evidence on children’s neurodevelopment in Asia area. ETS, phthalate, and PFASs need more evidence related to children’s health outcomes in Asia area. For further, we would like to harmonize and explore more on children’s environmental health based on cohort study for children’s well-being and welfare.