Serum Concentrations of Polychlorinated Biphenyls and Risk of Uterine Leiomyomata

摘要

Polychlorinated biphenyls (PCB) are persistent endocrine-disrupting chemicals with varying types and degrees of hormonal activity. Animal and human evidence suggests that sex steroid hormones are involved in the etiology of uterine leiomyomata (UL), common gynecologic neoplasms that can cause severe reproductive morbidity. Three retrospective studies have shown positive associations between PCB exposure and UL risk. We performed a case-cohort analysis examining the association between serum concentrations of PCBs and risk of UL in a cohort of premenopausal Black women from the Detroit, Michigan metropolitan area (2011-12). Eligible women were age 23-34 years and had no prior diagnosis of UL, autoimmune disease, or cancer. We collected demographic, behavioral, dietary, and medical data via self-administered questionnaires, telephone interviews, and in-person clinic visits. To identify UL, participants underwent transvaginal ultrasounds at baseline and at 20- and 40-month follow-ups. We collected non-fasting blood samples from a random subset of 454 participants at baseline, in which we measured 24 PCB congeners at the Centers for Disease Control and Prevention. We lipid-adjusted PCB concentrations and set values below the limit of detection (LOD) to LOD/sqrt(2). We examined total PCB concentration and groupings determined by hormonal activity. We used Cox proportional hazards regression models to estimate adjusted incidence rate ratios (IRR) and 95% confidence intervals (CI). Over 40 months of follow-up, we identified 132 incident UL cases. IRRs for total serum PCB concentrations of 30-39, 40-49, 50-59, and ≥60 vs. <30 ppb were 1.06 (95% CI: 0.67-1.66), 1.20 (95% CI: 0.69-2.08), 0.55 (95% CI: 0.21-1.41), and 0.87 (95% CI: 0.48-1.58), respectively. Estrogenic and anti-estrogenic PCB concentrations were not associated with UL risk. This study does not support the hypothesis that serum concentrations of PCBs measured in adulthood increase risk of UL among Black women.