Hoeke Henrike, Roeder Stefan, Bertsche Thilo, Lehmann Irina, Borte Michael, von Bergen Martin, Wissenbach Dirk K
Department of Pharmaceutical and Medicinal Chemistry, Institute of Pharmacy, University of Leipzig, Leipzig, Germany.
Department of Environmental Immunology, Helmholtz Centre for Environmental Research-UFZ, Leipzig, Germany.
Drug Test Anal. 2015 Aug;7(8):695-702. doi: 10.1002/dta.1767. Epub 2014 Dec 28.
Various studies pointed towards a relationship between chronic diseases such as asthma and allergy and environmental risk factors, which are one aspect of the so-called Exposome. These environmental risk factors include also the intake of drugs. One critical step in human development is the prenatal period, in which exposures might have critical impact on the child's health outcome. Thereby, the health effects of drugs taken during gestation are discussed controversially with regard to newborns' disease risk. Due to this, the drug intake of pregnant women in the third trimester was monitored by questionnaire, in addition to biomonitoring using a local birth cohort study, allowing correlations of drug exposure with disease risk. Therefore, 622 urine samples were analyzed by an untargeted liquid chromatography-tandem mass spectrometry (LC-MS/MS) urine screening and the results were compared to self-administered questionnaires. In total, 48% (n = 296) reported an intake of pharmaceuticals, with analgesics as the most frequent reported drug class in addition to dietary supplements. 182 times compounds were detected by urine screening, with analgesics (42%; n = 66) as the predominantly drug class. A comparison of reported and detected drug intake was performed for three different time spans between completion of the questionnaires and urine sampling. Even if the level of accordance was low in general, similar percentages (~25%, ~19%, and ~ 20%) were found for all groups. This study illustrates that a comprehensive evaluation of drug intake is neither achieved by questionnaires nor by biomonitoring alone. Instead, a combination of both monitoring methods, providing complementary information, should be considered.
多项研究表明，哮喘和过敏等慢性疾病与环境风险因素之间存在关联，而环境风险因素是所谓暴露组的一个方面。这些环境风险因素还包括药物摄入。人类发育的一个关键阶段是孕期，在此期间的暴露可能会对儿童的健康结局产生重大影响。因此，关于孕期服用药物对新生儿疾病风险的健康影响存在争议。鉴于此，除了通过一项本地出生队列研究进行生物监测外，还通过问卷调查对孕晚期孕妇的药物摄入情况进行了监测，以便将药物暴露与疾病风险进行关联分析。为此，采用非靶向液相色谱-串联质谱法（LC-MS/MS）对622份尿液样本进行了分析，并将结果与自行填写的问卷进行了比较。共有48%（n = 296）的人报告服用了药物，除膳食补充剂外，镇痛药是报告中最常见的药物类别。通过尿液筛查检测到了182种化合物，其中镇痛药（42%；n = 66）是主要的药物类别。在问卷填写完成至尿液采样之间的三个不同时间段内，对报告的和检测到的药物摄入情况进行了比较。尽管总体上一致性水平较低，但所有组的比例相似（约25%、约19%和约20%）。这项研究表明，仅通过问卷调查或仅通过生物监测都无法对药物摄入情况进行全面评估。相反，应考虑将这两种监测方法结合起来，以提供互补信息。
