Format

Send to

Choose Destination
Environ Int. 2019 May;126:184-192. doi: 10.1016/j.envint.2019.02.006. Epub 2019 Feb 22.

Sex hormones and oxidative stress mediated phthalate-induced effects in prostatic enlargement.

Author information

1
Research Center of Environmental Trace Toxic Substance, National Cheng Kung University, Tainan, Taiwan.
2
Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan.
3
Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
4
Research Center of Environmental Trace Toxic Substance, National Cheng Kung University, Tainan, Taiwan; Department of Food Safety/Hygiene and Risk Management, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
5
Research Center of Environmental Trace Toxic Substance, National Cheng Kung University, Tainan, Taiwan; Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Electronic address: cclee@mail.ncku.edu.tw.

Abstract

Prostatic enlargement might affect up to 30% of men and can cause signs and symptoms in the lower urinary tract in the elderly. Imbalanced estrogen and androgen secretions are important in prostatic physiopathology. Phthalates-environmental endocrine disruptors-affect androgen secretion and disrupt sexual organs, including testes and the prostate, but the underlying mechanisms are unclear. Using European Association of Urology (EAU) guidelines, we recruited from urology clinics in southern Taiwan 207 elderly men diagnosed with benign prostatic hyperplasia (BPH) and prostatic enlargement between 2015 and 2017. We took blood and urine samples from all patients on the same day. We used multivariate linear regression, associations, and potential interactions after we had measured and analyzed oxidative stress (OS) markers, steroidal hormones, and 11 urinary phthalate metabolites, and then we adjusted for confounders. Di(2-ethylhexyl) phthalate (DEHP) metabolite levels, particularly urinary mono-(2-ethylhexyl) phthalate, were positively associated with androgen, estrogen, hormone ratios, inducible nitric oxide synthetase (iNOS), 8-hydroxy-2'-deoxyguanosine (8-OHdG), prostate specific antigen (PSA), and prostate volume (PV) (p < 0.05). PV and PSA were positively associated with androgen, estrogen, hormone ratios and OS markers (p < 0.05). The estimated percentages of exposure to phthalates in prostatic enlargement mediated by androgen, estrogen, and OS markers ranged from 3.5% to 63.1%. Exposure to DEHP promoted the progress of BPH by increasing dihydrotestosterone (DHT), estradiol (E2), the converted enzymes aromatase and 5α reductase, and reactive oxygen species (ROS) (8-OHdG and iNOS) production. Sex hormones and OS might be important hyperplasia-promoters after a patient has been exposed to phthalates, especially to DEHP.

KEYWORDS:

Inflammation; Mediation effect; Oxidative stress; Phthalate metabolites; Prostatic enlargement; Steroid hormones

PMID:
30798199
DOI:
10.1016/j.envint.2019.02.006
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center