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[与因习惯性食用海鱼而接触低剂量汞相关的神经内分泌和神经行为影响]

[Neuroendocrine and neurobehavioral effects associated with exposure to low doses of mercury from habitual consumption of marine fish].

作者信息

Carta P, Flore C, Alinovi R, Ibba A, Tocco M, Aru G, Carta R, Girei M, Mutti A, Sanna F Randaccio

机构信息

Università degli Studi di Cagliari, Dipartimento di Sanità Pubblica-Sezione di Medicina del Lavoro, Via S. Giorgio 12, 09124 Cagliari.

出版信息

Med Lav. 2002 May-Jun;93(3):215-24.

Abstract

OBJECTIVES

To evaluate neuroendocrine and neurobehavioral effects possibly associated with increased dietary intake of organic mercury (Hg), a group of 22 subjects living on the island of Carloforte (south-west Sardinia) was examined, who were regular consumers of tuna fish with relatively high Hg content. This group, never exposed occupationally to either Hg or to other neurotoxic substances, was compared with 22 age-matched controls employed at a chemical plant in Portotorres (northern Sardinia).

METHODS

Hg in urine (HgU) and serum prolactin (PRL) were measured in all cases, whereas measurements of total (HgB) and organic blood mercury were available only for 10 subjects from Carloforte and 6 controls. Data about working history and lifestyle (education, smoking habit, alcohol and sea fish consumption) were collected by an interviewer using a standardised questionnaire. Neurotoxic symptoms were evaluated by a self-administered questionnaire, whereas a test battery, including some computerised tests of the Swedish Performance Evaluation System (SPES) to assess vigilance and psychomotor performance, some tests on motor coordination (Luria-Nebraska and Branches Alternate Movement Task) and one memory test for numbers (Digit Span) was administered to assess neurobehavioral changes associated with exposure to dietary intake of organic mercury. In all cases, characteristics of hand tremor were evaluated by the CATSYS System 7.0.

RESULTS

HgU values were significantly higher in the Carloforte group (median 6.5, range 1.8-21.5 micrograms/g creatinine) compared with controls (median 1.5, range 0.5-5.3 micrograms/g creatinine). Serum PRL was significantly higher among subjects from Carloforte and correlated with both urine and blood Hg levels. The scores of each item of the questionnaire investigating neurological symptoms were not statistically different in the two groups. In some tests of the SPES battery (Color Word Vigilance, Digit Symbol and Finger Tapping) the performance of the Carloforte group was significantly worse than that of controls, whereas in the other neurobehavioral tests poorer performances by the Carloforte group were not statistically significant. None of the tremor parameters was significantly different comparing the two groups. Multivariate analysis--controlling for education level and other covariates--carried out for the Symbol-Digit Reaction Time and for the Branches Alternate Movement Task (BAMT) showed that organic Hg concentration in blood was the most significant factor negatively affecting individual performance in these tests. Serum PRL was correlated with some neurobehavioral tests (Digit Symbol, Finger Tapping and BAMT).

CONCLUSIONS

Some of the neurobehavioral tests were sensitive enough to discriminate groups with different Hg body burden, even in the low-dose range. However, the pattern of results suggests adverse neurobehavioral effects, especially on psycho-motor coordination, with a significant dose-effect relationship, mostly associated with long-term exposure to low levels of organic mercury due to the usual consumption of large fish with relatively high levels of Hg in the flash.

摘要

目的

为评估与膳食中有机汞摄入量增加可能相关的神经内分泌和神经行为影响,对居住在卡洛福泰岛(撒丁岛西南部)的22名受试者进行了检查,这些受试者经常食用汞含量相对较高的金枪鱼。该组受试者从未在职业上接触过汞或其他神经毒性物质,将其与在托雷斯港(撒丁岛北部)一家化工厂工作的22名年龄匹配的对照组进行比较。

方法

对所有受试者测量尿汞(HgU)和血清催乳素(PRL),而仅对来自卡洛福泰岛的10名受试者和6名对照组测定了总血汞(HgB)和有机血汞。通过访员使用标准化问卷收集工作史和生活方式(教育程度、吸烟习惯、饮酒和海鱼消费)的数据。通过自我管理问卷评估神经毒性症状,同时进行一组测试,包括瑞典性能评估系统(SPES)的一些计算机化测试以评估警觉性和精神运动性能、一些运动协调测试(鲁利亚 - 内布拉斯加和分支交替运动任务)以及一项数字记忆测试(数字广度),以评估与膳食中有机汞摄入相关的神经行为变化。在所有情况下,通过CATSYS系统7.0评估手部震颤特征。

结果

卡洛福泰岛组的尿汞值(中位数6.5,范围1.8 - 21.5微克/克肌酐)显著高于对照组(中位数1.5,范围0.5 - 5.3微克/克肌酐)。来自卡洛福泰岛的受试者血清催乳素显著更高,且与尿汞和血汞水平均相关。两组中调查神经症状的问卷各项目得分无统计学差异。在SPES测试组的一些测试(颜色词警觉性、数字符号和手指敲击)中,卡洛福泰岛组的表现显著差于对照组,而在其他神经行为测试中,卡洛福泰岛组较差的表现无统计学意义。两组之间的震颤参数均无显著差异。对符号 - 数字反应时间和分支交替运动任务(BAMT)进行多变量分析(控制教育水平和其他协变量)表明,血中有机汞浓度是对这些测试中个体表现产生负面影响的最显著因素。血清催乳素与一些神经行为测试(数字符号、手指敲击和BAMT)相关。

结论

一些神经行为测试足够敏感,能够区分汞体内负荷不同的组,即使在低剂量范围内。然而,结果模式表明存在不良神经行为影响,尤其是对精神运动协调,存在显著的剂量 - 效应关系,主要与长期接触低水平有机汞有关,这是由于通常食用汞含量相对较高的大型鱼类所致。

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