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[目的]探讨上海市不同孕期孕妇的双酚A(BPA)暴露现状及其与甲状腺功能指标的关联。[方法]收集上海市7个区共210名孕妇(孕早、中、晚期各三分之一)的尿样,采用固相萃取-高效液相色谱串联质谱法(HPLC-MS/MS)测定尿液总BPA质量浓度,并检测血清中5个甲状腺功能指标的水平:游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)。了解不同孕期孕妇的BPA暴露水平,采用Pearson相关及多元线性回归分析尿BPA与血清甲状腺功能指标的关联。[结果]被检孕妇的尿液BPA检出率为95.7%,质量浓度范围为未检出~11.99μg/L,整体水平呈偏态分布,经尿比重校正后BPA质量浓度M(P_(25),P_(75))为0.53(0.36,0.83)μg/L,孕早、中、晚期BPA质量浓度差异无统计学意义。通过Pearson相关分析发现,孕早、晚期经尿比重校正的尿BPA质量浓度与血清TGAb水平呈正相关(r=0.396,P=0.002;r=0.440,P=0.000)。调整年龄、孕中BMI、孕周这些协变量后,两者仍呈正相关(b=0.369,95%CI:0.206~0.532,P=0.000)。尿BPA与其他甲状腺功能指标无相关性。[结论]上海市孕妇普遍存在BPA暴露,孕期BPA暴露可能影响血清TGAb水平。
[Objective] To investigate the status of bisphenol A (BPA) exposure and its correlation with thyroid function in different pregnant women in Shanghai. [Methods] Urine samples of 210 pregnant women (one third of early, middle and late pregnant women) in 7 districts of Shanghai were collected and analyzed by high performance liquid chromatography-tandem mass spectrometry (HPLC-MS / MS) Urinary total BPA concentration was measured and serum levels of 5 thyroid function indicators were measured: free triiodothyronine (FT3), free thyroxine (FT4), thyrotropin (TSH), thyroglobulin antibody (TGAb ), Thyroid peroxidase antibody (TPOAb). To understand the different levels of pregnant women during pregnancy BPA exposure, Pearson correlation and multiple linear regression analysis of urinary BPA and serum thyroid function indicators. [Results] The detection rate of urine BPA in pregnant women was 95.7%, the concentration range was undetected ~ 11.99μg / L, the overall level was skewed distribution, and the BPA mass concentration M (P 25 ), P_ (75)) was 0.53 (0.36,0.83) μg / L. There was no significant difference in BPA concentration in early, middle and late pregnancy. Pearson correlation analysis showed that urine BPA concentration corrected by urinary specific gravity in early pregnancy and late pregnancy was positively correlated with serum TGAb level (r = 0.396, P = 0.002; r = 0.440, P = 0.000). After adjusting for covariates such as age, gestational BMI and gestational age, the two were still positively correlated (b = 0.369, 95% CI: 0.206-0.532, P = 0.000). Urinary BPA and other thyroid function index no correlation. [Conclusion] BPA exposure is widespread in pregnant women in Shanghai. BPA exposure during pregnancy may affect serum TGAb levels.