Influences of fluoride exposure in drinking water on serum androgen binding protein and testosterone of adult males

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doi: 10.3969/j.issn. 1671-6825.2013.06.010 Influences of exposure in drinking water on serum androgen binding protein and testosterone of adult males CUI Ruirui 1, DING Zhong 2, CUI Liuxin 1, YANGR upu 2, XI Yu 3, CHENG Xuemin 1, REN Lijun 2, DUAN Liju 2, HOU Jaxiang 1, BA Yue 1# 1) Department of Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou 450001 2) Department of Endemic Disease, Center for Disease Control and Prevention of Kaifeng City,Kaifeng 475000 3) Department of Endemic Disease, Center for Disease Control and Prevention of Tongxu County, Tongxu 475400 # Corresponding author, female, born in Jul. 1963, doctor, professor, research direction: molecular pathogenesis of diseases related to environment, E-mail: byyue@zzu.edu.cn Abstract Aim: To explore the relation between male testosterone (T) and androgen binding protein (ABP) with exposure in drinking water. Method: Cross-sectional study was conducted in 7 villages of a county in Henan Province as investigation points including 2 high villages, 2 villages with water improvements and 3 control villages for collecting drinking water in all investigation points. Males who were 18 to 50 years old and born in the [abovementioned] villages were selected from investigation points as investigation subjects through sampling. Morning urine and fasting venous blood were collected respectively. Fluoride content in drinking water and urine was determined by ion selective electrode method; serum ABP level was determined by ELISA method and serum T was determined by chemiluminescence immunoassay. Result: Fluoride concentration of drinking water for high- is (2.44 ± 1.88) mg/l which is higher than (0.37 ± 0.15) mg/l of control and higher than (0.36 ± 0.30) mg/l of improvedwater (F = 12.289, P < 0.001). concentration of high- is (2.49 ± 1.40) mg/l which is higher than (1.04 ± 0.49) mg/l of control and higher than (1.38 ± 0.67) mg/l of improved-water (F = 71.563, P < 0.001); [the urinary concentration] of improved-water is also higher than that of control (P < 0.05). Serum ABP content of high- is (16.01 ± 10.83) nmol/l which is lower than (27.94 ± 31.90) nmol/l of control and lower than (22.42 ± 28.12) nmol/l of improved-water (F = 28.807, P < 0.001). Serum T content of control, improved-water and high- is (4.31 ± 1.30), (4.42 ± 1.37) and (4.74 ± 2.17) nmol/l [respectively]. The difference was of no statistical significance (F = 0.268, P = 0.765). In control and improved-water, negative correlation exists between serum T content and age (β = -0.238, -0.262, P < 0.05 for both s). Conclusion: Environmental exposure may influence serum ABP level in males. Key Words: ; androgen binding protein; testosterone; male High will influence sperm count and quality and damage testis, epididymis and prostate structure so as to influence male reproductive ability [1-4]. Studies [5-6] indicate that reflects certain reproductive damage and endocrine-disrupting effects through influencing multiple hormone levels of the hypothalamic-pituitary-gonadal axis in animal serum. Androgen binding protein (ABP) as an important testis protein for Sertoli cell secretion has the function of finely adjusting spermatogenesis [7]. It can promote spermatogenesis and sperm maturation. Due to its functional importance, ABP is commonly used as one marker of Sertoli cell function [8]. Animal experiments [9] have proven that will damage rat Sertoli cells; however, currently there are few reports on whether ABP secreted by Sertoli cells is influenced. The purpose of this study is to explore the influence of exposure on ABP in adult males and provide a basis for studying the effect of body ABP in sex hormone regulation through determining serum ABP and testosterone (T) levels in s with different exposure levels. 1 Materials and methods 1.1 Selection of investigation points Seven villages were selected as investigation areas in a county of

Kaifeng City, Henan Province, including 2 endemic fluorosis villages, 2 villages with water improvement projects for decreasing levels, and 3 control villages; the economic level, natural conditions, crop types, living habits and population composition in all investigation areas were basically the same. Furthermore, there was no industrial pollution. 1.2 Selection of investigation subjects Males who were 18 to 50 years old and born in the [abovementioned] villages were selected from investigation points as investigation subjects through sampling. People with occupational exposure to, those who worked outside for a long term, suffered from consumptive diseases and took calcium preparations for a long term or recently were excluded. Subjects composed of 175 persons in the control, 75 persons in the improved-water and 65 persons in the high- were included. 1.3 Specimen collection Collecting water samples from each village: collected 16 tap water samples (control ) from control areas; collected 13 deep well water samples (high- ) from high areas, and collected 8 tap water samples (improved-water ) from water improvement areas; after obtaining consent from investigation subjects and having the informed consent form signed, collected morning urine and fasting venous blood as marker determination. Urine was stored at -20 C for testing. When serum was separated from blood on the same day, the blood was stored under low temperature of - 80 C. 1.4 Marker determination Water determination procedures were implemented strictly according to standard method (ion selective electrode method, WS/T106-1999). Determination was implemented according to standard addition method. Parallel determination was used for each sample twice; the relative error was less than 2%. Coefficient of variation was 0.4% 2.9%. determination procedures were implemented strictly according to standard method (ion selective electrode method, WS/T89-1996). The standard curve method was adopted for determination. The ELISA method was adopted for serum ABP determination; the reagent kit was provided by American R & D Company; the automatic enzymelabeling measuring instrument was provided by American Bio-Rad Company. Chemiluminescence immunoassay was adopted for serum T determination; chemiluminescence apparatus and determination reagent kit were all provided by Zhengzhou Autobio Company. Parallel samples were set for determination and averages were taken. In addition, sampling for re-inspection was conducted at the proportion of 10% 15%. 1.5 Statistical treatment SPSS 12.0 was used to analyze the data. Single-factor variance analysis was used to analyze comparisons among water, urinary and serum ABP and T levels in the three s. Pairwise comparisons used the LSD-t test; multiple linear regression was used to test the relation of serum T and ABP with age and urinary level for analysis. Inspection level α = 0.05. 2 Results 2.1 Fluoride level comparison in drinking water of three s See Table 1 for the result. Table 1 shows that the comparative differences of water levels in 3 investigation points are of statistical significance. Furthermore, the level of drinking water in the high- was higher than that of the improved-water and control. Table 1 Fluoride Level Comparison of Drinking Water for 3 Groups mg/l Group n Drinking water Control 16 0.37 + 0.15* Improved-water 8 0.36 + 0.30* High- 13 2.44 + 1.88 F = 12.289, P < 0.001; *: Comparison with high-, P < 0.05. 2.2 Comparison among urinary, serum ABP and T levels of three s See Table 2 for the result. Table 2 shows that the comparative differences of urinary levels for the three

s are of statistical significance. Furthermore, the pairwise comparative differences are of statistical significance. The comparative differences of serum ABP levels for the three s are of statistical significance. Furthermore, [the ABP level] of the high- was lower than that of the control and improved-water. The serum T level comparison between the three s was of no statistical significance. Table 2 Fluoride, Serum ABP and T Level Comparison for 3 Groups Group n ρ ( )/(mg L -1 ) c (ABP)/(nmol L - c (T)/ (nmol L -1 ) Control 175 1.04 + 0.49 27.94 + 31.90* 4.31 + 1.30 Improved-water High- 75 1.38 + 0.67 22.42 + 28.12* 4.42 + 1.37 65 2.49 + 1.40 16.01 + 10.83 4.74 + 2.17 F 71.563 28.807 0.268 P <0.001 <0.001 0.765 * For pairwise comparison between the 3 s, P < 0.05 for all s; #: Comparison with high-, P < 0.05 for both s. 1 ) 2.3 Relation of serum T and ABP with age and urinary level See Table 3 for the result. Table 3 indicates that a negative correlation exists between T and age for the control and improved-water. Table 3 Relation of Serum T and ABP to Age and Fluoride Level Group Dependent Independent ß t P variable variable Control T ABP 0.103 1.371 0.172 0.015 0.201 0.841 Age - 0.238 3.178 0.002 ABP - 0.087 1.148 0.253 Age 0.093 1.217 0.225 Improved-water High- T ABP - 0.072 0.632 0.529 0.019 0.169 0.867 Age - 0.262 2.279 0.026 ABP 0.040 0.339 0.375 Age 0.066 0.561 0.576 T ABP 0.050 0.383 0.703 0.201 1.578 0.120 Age - 0.024 0.187 0.852 ABP - 0.084 0.673 0.503 Age 0.221 1.775 0.081

3 Discussion 3.1 Influence of exposure on male serum ABP level ABP can buffer androgen fluctuation in tubes, leading to constant androgen release and reduced fluctuation so as to favor spermatogenesis; secondly, when ABP combines with T, it will reach the epididymis with testis fluid so as to promote sperm maturation. The lack of ABP will influence sperm count and quality. Furthermore, normal synthesis of ABP is closely related to maintaining in vivo endocrine balance and reproductive function [10-12]. Due to its functional importance, ABP is commonly used as one marker of Sertoli cell function. [This] study s results indicate that the ABP level in the high- is lower than that of the control and improved-water, suggesting that long-term exposure in drinking water may cause reduced ABP level. As a kind of secretory protein, ABP will enter the endoplasmic reticulum lumen for folding and modification of polypeptide chain after synthesis, then it is transported outside of the cell for playing its role. Increased content will damage the endoplasmic reticulum so as to cause oxidative stress [13-14] and influence the folding and modification process of ABP; this may be an important reason for reduced ABP level. Many studies [15-16] indicate that heavy metals will influence ABP expression. The mentioned study result suggests that high will influence ABP level. Although the serum ABP level of the improved-water is lower than that of the control, the difference is of no statistical significance, prompting that such influence is reversible. When the exposure environment is removed, the damage can be repaired. Furthermore, such repair needs some time. 3.2 Influence of exposure on male serum T level T secreted by interstitial cells has broad physiological functions such as: promoting and maintaining the maturation of spermatogenesis, stimulating the development of accessory sexual organs, and promoting the appearance of male secondary sexual characteristics and maintaining their normal state. Moreover, another study has found [17] that serum T can be regarded as one of the indexes for judging the state of serious trauma, craniocerebral injury and prognosis. When T level is elevated, it worsens the reconstructive heart pathological reaction. T level is mainly regulated by luteinizing hormone (LH) and follicle-stimulating hormone which are secreted by the hypothalamus and pituitary. A study found [18] that high can decrease serum T level and increase LH level, and it presents a dose-response relation with the content. CHEN Peizhong et al. [19] found that, when feeding rats with sodium for 28 d, the plasma T level [began to] decrease. The result of this study shows that the comparative differences in terms of serum T levels between the three s were of no statistical significance. The reason may be that the abovementioned studies were mainly conducted on animals, or the water level is far higher in the areas investigated [in the abovementioned studies] than that in the areas studied here. A higher water level may lead to organic disease in the testis, leading to a phenomenon whereby T level decreases with the increase of urinary level [7]. The water level in the areas studied here may not yet have greatly influenced the serum T level of the investigated population. Secondly, the body serum T level is regulated by the hypothalamic-pituitarygonadal axis, and the multiple positive or negative feedback pathways may have comprehensive effects on the synthesis and secretion of T. In the control and improved-water, there is a negative correlation between the serum T level and age, which conforms to normal physiological conditions of the human body [20-21]. However, in the high-, this correlation is not found, indicating a certain effect of exposure on male serum T [level]. In conclusion, environmental exposure may affect the ABP level in males. The serum ABP level in the high- is evidently lower than that in the control and improved-

water, suggesting that may cause reproductive and endocrine disruption through affecting the ABP level. Acknowledgements: Many thanks go to LI Shiqun, LI Ping, and TANG Chunyu from Zhengzhou University and staff members from Center for Disease Control and Prevention of Kaifeng City and Department of Endemic Diseases, Center for Disease Control and Prevention of Tongxu County involved in field investigations as well as all the investigation subjects for taking part in this study. References [1] Prystupa J. Fluorine: a current literature review. An NRC and ATSDR based review of safety standards for exposure to fluorine and s [J]. Toxicol Mech Methods, 2011, 21(2):103 [2] Sun Z, Niu R, Wang B, et al. Fluoride-induced apoptosis and gene expression profiling in mice sperm in vivo [J]. Arch Toxicol, 2011, 85(1):1441 [3] Hu L, Ying J, Mu L, et al. Fluoride toxicity in the male reproductive system [J]. Fluoride, 2009, 42(4):260 [4] Luke J. Fluoride deposition in the aged human pineal gland [J]. Caries Res, 2001, 35(2):125. [5] MA Xiaoying, CHENG Xuemin, LI Furan et al. Experimental study on endocrine-disturbing effect of on hypothalamic-pituitary-gonadal axis in male rats [J]. Journal of Hygiene Research, 2008, 37(6): 733 [6] HAO Pengfei, MA Xiaoying, CHENG Xuemin et al. Effect of on hypothalamic-pituitarygonadal axis hormone levels in exposed humans [J]. Journal of Hygiene Research, 2010, 39(1): 53 [7] Godet M, Sabido O, Gilleron J, et al. Meiotic progression of rat spermatocytes requires mitogenactivated protein kinases of Sertoli cells and close contacts between the germ cells and the Sertoli cells [J]. Dev Biol, 2008, 315:173 [8] Griswold MD. Protein secretion of Sertoli cells [J]. Int Rev Cytol, 1988, 110:133 [9] CUI Liuxin, JIANG Chunxia, WANG Xilin, et al. Experimental study on effect of on reproductive function of male rats [J]. Chinese Journal of Endemiology, 2003, 22(3): 195 [10] Senthil Kumar J, Banudevi S, Sharmila M, et al. Effects of Vitamin C and E on PCB (Aroclor 1254) induced oxidative stress, androgen binding protein and lactate in rat Sertoli cells [J]. Reprod Toxicol, 2004, 19(2):201 [11] WANG Yubang, SONG Ling, ZHU Zhengping et al. Effect of dibutyl phthalate on Sertoli cells of rat testis [J]. Chinese Journal of Preventive Medicine, 2005, 39(3): 179 [12] Chang C, Chen YT, Yeh SD, et al. Infertility with defective spermatogenesis and hypotestosteronemia in male mice lacking the androgen receptor in Sertoli cells [J]. Proc Natl Acad Sci USA, 2004, 101(18):6876 [13] YU Yanni, MENG Bingjie Influence of on the endoplasmic reticulum of in vitrocultured chondrocytes and antagonizing effect of SOD on [J]. Chinese Journal of Endemiology, 2006, 25(5): 507 [14] Sharma R, Tsuchiya M, Bartlett JD. Fluoride induces endoplasmic reticulum stress and inhibits protein synthesis and secretion [J]. Environ Health Perspect, 2008, 116(19):1142 [15] SU Xiaodong. Effect of mercuric chloride on expressions of ABP and inhibin in rat Sertoli cells [D]. Zhengzhou: Zhengzhou University, 2010. [16] SONG Zhongli, LIU Haidong, WANG Zuoyi, et al. Effect of potassium dichromate on expressions of ABP, transferrin and inhibin protein in rat Sertoli cells [J]. Journal of Zhengzhou University (Medical Sciences), 2012, 47(4): 479 [17] WU Gang, WANG Zanzhi, WANG Yang et al. Changes and clinical significance of serum testosterone and estradiol in early stage after trauma [J]. Journal of Southern Medical University, 2009, 29(11): 2262 [18] LIU Wei, LI Weimin, Sally A. Huber. Effect of sex hormones on cardiac remodeling [J]. Chinese Journal of Practical Internal Medicine 2010, 30(11): 1035 [19] CHEN Peizhong, YUN Zhongjie, SUN Guodong, et al. Effects of high on levels of endocrine hormones in the body [J]. Endemic Diseases Bulletin, 2004, 19 (2): 14

[20] Sarkar SD, Maiti R, Ghosh D. Management of induced testicular disorders by calcium and vitamin E co-administration in the albino rat [J]. Reprod Toxicol, 2006, 22(4):606 [21] YING Jun, YAO Dehong, ZHANG Qinghua. Study on relation of serum testosterone, free testosterone, [and] dihydrotestosterone concentrations to age in males [J]. Chinese Journal of Andrology, 2000, 14(1): 13 (Received on: Mar. 18, 2013 Editor in Charge: JIANG Chunxia)