Environmental PCB exposure and risk of endometriosis

Louis, Germaine M. Buck; Weiner, John M.; Whitcomb, Brian W.; Sperrazza, R.; Schisterman, Enrique F.; Lobdell, Danelle T.; Crickard, Kent; Greizerstein, Hebe B.; Kostyniak, Paul J.

doi:10.1093/humrep/deh575

Cited by 121 publications

(38 citation statements)

References 38 publications

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“…It is important to note that our findings are at concentrations below those reported in biomonitoring data for U.S. women. In addition, the magnitude of our findings for PFCs is comparable relative to other POPs such as hexachlorobenzene, 4 polychlorinated biphenyls, 2,3 and dioxin-like compounds. 1,5 Still, cautious interpretation of the findings is needed, given the exploratory nature of our work.…”

Section: Discussionsupporting

confidence: 60%

“…The population sample comprised 131 women who resided within the 50-mile geographic radius of participating clinical sites. The size for the operative sample was powered based on published differences for available POPs at the time of study design, 2 whereas the population sample approximated sample sizes for publications reporting associations between various POPs and endometriosis. 1–3,5 Eighty percent of eligible women participated in the study (79% in the operative and 81% in the population samples), with a 96% completion rate.…”

Section: Methodsmentioning

confidence: 99%

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Perfluorochemicals and Endometriosis

et al. 2012

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Background: Environmental chemicals may be associated with endometriosis. No published research has focused on the possible role of perfluorochemicals (PFCs) despite their widespread presence in human tissues. Methods: We formulated two samples. The first was an operative sample comprising 495 women aged 18–44 years scheduled for laparoscopy/laparotomy at one of 14 participating clinical sites in the Salt Lake City or San Francisco area, 2007–2009. The second was a population-based sample comprising 131 women matched to the operative sample on age and residence within a 50-mile radius of participating clinics. Interviews and anthropometric assessments were conducted at enrollment, along with blood collection for the analysis of nine PFCs, which were quantified using liquid chromatography-tandem mass spectrometry. Endometriosis was defined based on surgical visualization (in the operative sample) or magnetic resonance imaging (in the population sample). Using logistic regression, we estimated odds ratios (ORs) and 95% confidence intervals (CIs) for each PFC (log-transformed), adjusting for age and body mass index, and then parity. Results: Serum perfluorooctanoic acid (PFOA; OR = 1.89 [95% CI = 1.17–3.06]) and perfluorononanoic acid (2.20 [1.02–4.75]) were associated with endometriosis in the operative sample; findings were moderately attenuated with parity adjustment (1.62 [0.99–2.66] and 1.99 [0.91–4.33], respectively). Perfluorooctane sulfonic acid (1.86 [1.05–3.30]) and PFOA (2.58 [1.18–5.64]) increased the odds for moderate/severe endometriosis, although the odds were similarly attenuated with parity adjustment (OR = 1.50 and 1.86, respectively). Conclusions: Select PFCs were associated with an endometriosis diagnosis. These associations await corroboration.

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Section: Discussionsupporting

confidence: 60%

Section: Methodsmentioning

confidence: 99%

Perfluorochemicals and Endometriosis

et al. 2012

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“…The findings add to the existing literature that suggests other hormonally active environmental chemicals such as PCBs [10] and dioxin [7] may affect likelihood of endometriosis. These preliminary findings await further corroboration before more definitive conclusions may be reached about the etiology of OCPs in the development of endometriosis.…”

Section: Discussionsupporting

confidence: 60%

Organochlorine pesticides and endometriosis

Cooney

Louis

Hediger

et al. 2010

Reproductive Toxicology

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Limited study of persistent organochlorine pesticides (OCPs) and endometriosis has been conducted. One hundred women aged 18-40 years who were undergoing laparoscopy provided 20 cc of blood for toxicologic analysis and surgeons completed operative reports regarding the presence of endometriosis. Gas chromatography with electron-capture was used to quantify (ng/g serum) six OCPs. Logistic regression was utilized to estimate the adjusted odds ratios (aOR) and 95% confidence intervals (CI) for individual pesticides and groups based on chemical structure adjusting for current cigarette smoking and lipids. The highest tertile of aromatic fungicide was associated with a five-fold risk of endometriosis (aOR = 5.3; 95% CI, 1.2-23.6) compared to the lowest tertile. Similar results were found for t-nonachlor and HCB. These are the first such findings in a laproscopic cohort that suggest an association between OCP exposure and endometriosis. More prospective studies are necessary to ensure temporal ordering and confirm these findings.

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“…To illustrate our method, we use PCBs, environmental toxicants, as potential indicators of endometriosis (Louis et al, 2005). Endometriosis is a gynecological disease exclusive to species that menstruate such as humans and other primates, occurring predominantly in women of reproductive age.…”

Section: Examplementioning

confidence: 99%

ROC curve inference for best linear combination of two biomarkers subject to limits of detection

Perkins¹,

Vexler²

2011

Biom. J.

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The receiver operating characteristic (ROC) curve is a tool commonly used to evaluate biomarker utility in clinical diagnosis of disease. Often, multiple biomarkers are developed to evaluate the discrimination for the same outcome. Levels of multiple biomarkers can be combined via best linear combination (BLC) such that their overall discriminatory ability is greater than any of them individually. Biomarker measurements frequently have undetectable levels below a detection limit sometimes denoted as limit of detection (LOD). Ignoring observations below the LOD or substituting some replacement value as a method of correction has been shown to lead to negatively biased estimates of the area under the ROC curve for some distributions of single biomarkers. In this paper, we develop asymptotically unbiased estimators, via the maximum likelihood technique, of the area under the ROC curve of BLC of two bivariate normally distributed biomarkers affected by LODs. We also propose confidence intervals for this area under curve. Point and confidence interval estimates are scrutinized by simulation study, recording bias and root mean square error and coverage probability, respectively. An example using polychlorinated biphenyl (PCB) levels to classify women with and without endometriosis illustrates the potential benefits of our methods.

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Environmental PCB exposure and risk of endometriosis

Abstract: These data suggest that anti-estrogenic PCBs may be associated with the development of endometriosis.

Cited by 121 publications

References 38 publications

Perfluorochemicals and Endometriosis

Perfluorochemicals and Endometriosis

Organochlorine pesticides and endometriosis

ROC curve inference for best linear combination of two biomarkers subject to limits of detection

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