尿液中鄰苯二甲酸酯(塑化劑)與尿液中尿酸之相關性

黃鶴翔^1,2盧則宏¹ 廖寶琦³

國立成功大學醫學院附設醫院泌尿部¹

國立成功大學醫學院泌尿學科²

國立成功大學工業衛生學科暨環境醫學研究所³

The association between phthalate levels in urine and urinary uric acid

Ho-Shiang Huang ^1,2, Ze-Hong Lu ¹, Pao-Chi Liao ³

Department of Urology, National Cheng Kung University Hospital, College of

Medicine, National Cheng Kung University, Tainan, Taiwan ¹

Department of Urology, College of Medicine, National Cheng Kung University, Tainan, Taiwan ²

Department of Environmental and Occupational Health, College of Medicine, Tainan, Taiwan ³

Purpose:

Phthalate is used widely in food packages, and it can enter human body which can affect health by ingestion. It is a rising food safety issue currently. To our best knowledge, phthalates are excreted by urine after intake. Those chemical compounds are unstable, and they are metabolized rapidly within 24 hours. It is been known phthalates affect respiratory tract, sex hormones, and enlarged prostate. The effect of urinary phthalate metabolites and urolithiasis is underdetermined. This study aims to establish the relationship between phthalate and urinary urolithiasis parameters.      

Materials and Methods:

All cases were recruited from urologic clinic including urolithiasis patients and healthy control group. Basic information of those volunteers was recorded. All those cases were divided into three groups. Male and female patients with calcium oxalate stone (CaOx), calcium phosphate stone (CaP), uric acid stones, or struvite stones (MgP) were enrolled in group 1. Male patients with CaOx were in group 2. Healthy control ones were control group. Urine samples of those cases were collected to send phthalate metabolites analysis and urinary urolithiasis parameters checkup. Linear regression of urinary uric acid and phthalate metabolites was done.

Results:

Total 213 cases were included, and 194 cases had medical history of urolithiasis. The rest of 19 cases were healthy volunteers. 75 men and 44 women with four types of urolithiasis were enrolled into group 1, and 75 males with calcium oxalate stone were group 2. 19 males without urolithiasis history were control group. From basic characteristics, urinary oxalate, citrate and pH value showed significant differences between control group and group 1, and significant differences in BMI, calcium, citrate, and uric acid between control and group 2 were found. Linear regression of phthalate metabolites and urinary uric acid showed significant negative correction between MMP, MEP, MCHP, MBzP, 5oxo-MEHP, 5OH-MEHP, 5cx-MEPP and the sum of DEHP metabolites and uric acid.

Conclusion:

The use of phthalate plays an important role in modern life. However, phthalate ingestion makes impacts on human health. From this study, there is the link between urinary phthalate metabolites level and urinary uric acid level of patients with calcium oxalate stones. It needs further study to investigate mechanism.