Association between phthalate exposure and accelerated bone maturation in Chinese girls with early puberty onset: a propensity score-matched case-control analysis

Huang, Shurong1,2; Su, Zhe1,2; Su, Huiping2; Jiao, Yanhua2; Su, Qiru3; Yao, Yao4; Zhou, Li5; Zheng, Xiuxin2; Zhang, Xingliang3

2022-09-07

10.1038/s41598-022-19470-4

Scientific Reports   Impact Factor & Quartile

2045-2322

Estrogen can promote the acceleration of bone maturation and phthalate esters (PAEs) have estrogen-mimicking effects. We investigated whether PAEs are associated with the acceleration of bone age (BA) in girls with early onset of puberty (EOP). This case-control study enrolled 254 girls with EOP from the Endocrinology Department at Shenzhen Children's Hospital between December 2018 and August 2019. Ultra-performance liquid chromatography and tandem mass spectrometry were used to analyze the 10 metabolites of PAEs (mPAEs) in urine samples. BA was measured using an artificial intelligence system. BA exceeding the chronological age (CA) by > 2 years (BA-CA >= 2 years) was referred to as significant BA advancement. Participants were divided into groups A (BA-CA >= 2 years; case group) and B (BA-CA < 2 years; control group). Propensity score matching (PSM) was performed for both groups in a 1:2 ratio with a caliper of 0.25. To identify potential dose-response relationships between PAEs exposure and BA advancement, we grouped the participants after PSM according to the tertiles of the mPAE concentrations. After PSM, 31 and 62 girls in groups A and B were selected. The concentration of Mono-ethyl phthalate (MEP) in group A was significantly higher than in group B (11.83 mu g/g vs. 7.11 mu g/g, P < 0.05); there was no significant difference in the levels of other mPAEs between the groups. The degree of BA advancement and proportion of significantly advanced BA in the lowest, middle, and highest tertiles of the MEP sequentially increased, as well as in the lowest, middle, and highest tertiles of Mono-(2-ethyl-5-carboxypentyl) phthalate; however, these were only statistically different between the highest and lowest MEP tertiles (both P < 0.05). For the remaining mPAEs, differences in the degree of BA advancement among the lowest, middle, and highest tertiles, as well as differences in the proportion of significantly advanced BA among the lowest, middle, and highest tertiles, were not significant (all P > 0.05). Our findings suggested that MEP was positively associated with BA advancement in girls with EOP. Exposure to PAEs may promote accelerated bone maturation.

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First ; Corresponding

High-level Key Clinical Specialty project of Guangdong Provincial Health Commission (Supporting construction funds of Shenzhen)[SZGSP012] ; Shenzhen Science and Technology program["JCYJ20210324123610028","KCXFZ20201221173400002"]

Science & Technology - Other Topics

Multidisciplinary Sciences

WOS:000852630800059

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1.Southern Univ Sci & Technol, Sch Med, Shenzhen 518055, Guangdong, Peoples R China
2.Shenzhen Childrens Hosp, Dept Endocrinol, Shenzhen 518038, Guangdong, Peoples R China
3.Shenzhen Childrens Hosp, Pediat Res Inst, Shenzhen 518038, Guangdong, Peoples R China
4.Longgang Dist Maternal & Child Healthcare Hosp, Cent Lab, Shenzhen, Guangdong, Peoples R China
5.Shenzhen Ctr Dis Control & Prevent, Shenzhen 518055, Guangdong, Peoples R China

Huang, Shurong,Su, Zhe,Su, Huiping,et al. Association between phthalate exposure and accelerated bone maturation in Chinese girls with early puberty onset: a propensity score-matched case-control analysis[J]. Scientific Reports,2022,12(1).

Huang, Shurong.,Su, Zhe.,Su, Huiping.,Jiao, Yanhua.,Su, Qiru.,...&Zhang, Xingliang.(2022).Association between phthalate exposure and accelerated bone maturation in Chinese girls with early puberty onset: a propensity score-matched case-control analysis.Scientific Reports,12(1).

Huang, Shurong,et al."Association between phthalate exposure and accelerated bone maturation in Chinese girls with early puberty onset: a propensity score-matched case-control analysis".Scientific Reports 12.1(2022).