Rondó Patrícia H C, Carvalho Maria de Fátima H, Souza Miriam C, Moraes Flávio
Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil.
Rev Saude Publica. 2006 Feb;40(1):71-6. doi: 10.1590/s0034-89102006000100012. Epub 2006 Jan 4.
To assess the relationship of blood lead and hemoglobin, zinc protoporphyrin, and ferritin concentrations in children.
A cross-sectional study was carried out in 136 anemic and non-anemic children from two rural villages near a lead smelter in Adrianópolis, Southern Brazil, from July to September 2001. Hemoglobin electrophoresis was performed to exclude children with hemoglobin variants and thalassemia syndromes associated with anemia. Lead was determined by atomic absorption spectrophotometry; hemoglobin by automated cell counting; zinc protoporphyrin by hematofluorometry; ferritin by chemiluminescence. Student's t-test, Mann-Whitney test, and the c(2) test were used to assess the significance of the differences between the variables investigated in anemic and non-anemic children. Stepwise multivariate linear regression analysis was performed using two models for anemic and non-anemic children respectively.
Lead was negatively associated to hemoglobin (p<0.017) in the first model, and in the second model lead was positively associated to zinc protoporphyrin (p<0.004) after controlling for ferritin, age, sex, and per capita income. There was an inverse association between hemoglobin and blood lead in anemic children. It was not possible to confirm if anemic children had iron deficiency anemia or subclinical infection, considering that the majority (90.4%) had normal ferritin.
The study detected a relationship between anemia and elevated blood lead concentrations. Further epidemiological studies are necessary to investigate the impact of iron nutritional interventions as an attempt to decrease blood lead in children.
评估儿童血铅与血红蛋白、锌原卟啉和铁蛋白浓度之间的关系。
2001年7月至9月，在巴西南部阿德里亚诺波利斯一家铅冶炼厂附近的两个乡村，对136名贫血和非贫血儿童进行了一项横断面研究。进行血红蛋白电泳以排除患有与贫血相关的血红蛋白变异体和地中海贫血综合征的儿童。采用原子吸收分光光度法测定铅；通过自动血细胞计数法测定血红蛋白；采用血液荧光测定法测定锌原卟啉；通过化学发光法测定铁蛋白。使用学生t检验、曼-惠特尼检验和卡方检验来评估贫血和非贫血儿童所研究变量之间差异的显著性。分别使用两个模型对贫血和非贫血儿童进行逐步多元线性回归分析。
在第一个模型中，铅与血红蛋白呈负相关（p<0.017），在第二个模型中，在控制了铁蛋白、年龄、性别和人均收入后，铅与锌原卟啉呈正相关（p<0.004）。贫血儿童的血红蛋白与血铅之间存在负相关。鉴于大多数（90.4%）儿童的铁蛋白正常，无法确定贫血儿童是否患有缺铁性贫血或亚临床感染。
该研究发现贫血与血铅浓度升高之间存在关联。有必要进行进一步的流行病学研究，以调查铁营养干预措施对降低儿童血铅水平的影响。
