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杜伊斯堡出生队列研究:产前接触多氯二苯并对二噁英/多氯二苯并呋喃及类二噁英多氯联苯对新生儿甲状腺激素状态及24个月龄以下婴儿神经发育的影响。

The Duisburg birth cohort study: influence of the prenatal exposure to PCDD/Fs and dioxin-like PCBs on thyroid hormone status in newborns and neurodevelopment of infants until the age of 24 months.

作者信息

Wilhelm Michael, Wittsiepe Jürgen, Lemm Friederike, Ranft Ulrich, Krämer Ursula, Fürst Peter, Röseler Stefan-Christian, Greshake Michaela, Imöhl Matthias, Eberwein Georg, Rauchfuss Knut, Kraft Martin, Winneke Gerhard

机构信息

Department of Hygiene, Social and Environmental Medicine, Ruhr-University Bochum, Universitätsstr. 150, 44801 Bochum, Germany.

出版信息

Mutat Res. 2008 Jul-Aug;659(1-2):83-92. doi: 10.1016/j.mrrev.2007.11.002. Epub 2007 Nov 12.

Abstract

Prenatal exposure to polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) can affect neurobehavioral development of infants and children. This effect may be mediated through disruption of thyroid hormone homeostasis. However, epidemiological studies reveal no consistent influence of PCDD/Fs and PCBs on thyroid status and neurodevelopment at environmental background levels. The effects may resolve with time of further decreasing exposure to these compounds. The aim of this study was to find out if there are still effects related to prenatal PCDD/F and PCB observable at the meanwhile decreased levels of exposure by using the same methods which have been applied in similar studies during the last 10 years in Europe. The birth cohort study was initiated in the year 2000 in the industrialized city of Duisburg, Germany. 232 healthy mother-infant pairs were recruited between 2000 and 2002. Dioxins, dioxin-like PCBs and six indicator PCBs were analyzed in maternal blood during pregnancy and in maternal milk following extraction and sample clean-up by HRGC/HRMS. Thyroid stimulating hormone (TSH), total thyroxine (T4), total triiodothyronine (T3), free thyroxine (FT4) and free triiodothyronine (FT3) were measured in serum samples of the pregnant women and in cord serum samples by chemiluminescent immunometric assay. Neurological examinations were performed at ages 2 weeks and 18 months using the neurological optimality score (NOS), mental and motor development were assessed using the Bayley Scales of Infant Development (BSID) at ages 12 and 24 months. Multiple linear regression analysis was used to describe the association of PCDD/F and PCB in maternal blood or milk with the outcome measurements after adjustment for confounding. Blood levels (n=182) of WHO 2005 toxic equivalents (TEQ) (PCDD/F+PCB) were in the range of 3.8-58.4 pg/glipid base (median: 19.3 pg/glipid base). The corresponding data for human milk (n=149) were 2.6-52.4 pg/glipid base (median: 19.7 pg/glipid base). Multiple regression analysis showed no decrease of thyroid hormones related to WHO 2005 TEQ in blood and milk of mothers and their newborns. Furthermore, no associations between exposure and neurological and developmental measures were observed. This study supports the view that the current decreased exposure to PCDD/Fs and PCBs does not impair thyroid function of newborns and neurodevelopment of infants until the age of 24 months.

摘要

产前接触多氯联苯(PCBs)以及多氯二苯并对二恶英和二苯并呋喃(PCDD/Fs)会影响婴幼儿的神经行为发育。这种影响可能是通过破坏甲状腺激素稳态介导的。然而,流行病学研究表明,在环境背景水平下,PCDD/Fs和PCBs对甲状腺状态和神经发育并没有一致的影响。随着对这些化合物接触的进一步减少,这种影响可能会逐渐消失。本研究的目的是通过使用过去10年在欧洲类似研究中所采用的相同方法,来查明在接触水平同时降低的情况下,是否仍然存在与产前PCDD/F和PCB相关的影响。这项出生队列研究于2000年在德国工业化城市杜伊斯堡启动。在2000年至2002年期间招募了232对健康的母婴。通过高分辨气相色谱/高分辨质谱仪(HRGC/HRMS)对孕期母亲血液以及提取和样品净化后的母乳中的二恶英、类二恶英多氯联苯和六种指示性多氯联苯进行分析。通过化学发光免疫分析法测量孕妇血清样本和脐带血清样本中的促甲状腺激素(TSH)、总甲状腺素(T4)、总三碘甲状腺原氨酸(T3)、游离甲状腺素(FT4)和游离三碘甲状腺原氨酸(FT3)。在2周龄和18月龄时使用神经优化评分(NOS)进行神经学检查,在12月龄和24月龄时使用贝利婴儿发育量表(BSID)评估智力和运动发育。在对混杂因素进行调整后,使用多元线性回归分析来描述母亲血液或母乳中PCDD/F和PCB与测量结果之间的关联。世界卫生组织2005年毒性当量(TEQ)(PCDD/F + PCB)的血液水平(n = 182)在3.8 - 58.4 pg/脂质基范围内(中位数:19.3 pg/脂质基)。母乳(n = 149)的相应数据为2.6 - 52.4 pg/脂质基(中位数:19.7 pg/脂质基)。多元回归分析表明,母亲及其新生儿血液和母乳中与世界卫生组织2005年TEQ相关的甲状腺激素没有下降。此外,未观察到接触与神经学和发育指标之间存在关联。本研究支持以下观点:目前PCDD/Fs和PCBs接触水平的降低,在24月龄之前不会损害新生儿的甲状腺功能和婴儿的神经发育。

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