Elongi Moyene Jean-Pierre, Scheers Hans, Tandu-Umba Barthélémy, Haufroid Vincent, Buassa-Bu-Tsumbu Baudouin, Verdonck Fons, Spitz Bernard, Nemery Benoit
Department of Gynecology and Obstetrics, University of Kinshasa, and General Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo.
Hôpital Général de Kinshasa, Avenue de l'Hôpital, Commune de la Gombe, Kinshasa, DR, Congo.
Environ Health. 2016 Apr 5;15:48. doi: 10.1186/s12940-016-0132-1.
Preeclampsia is frequent in Kinshasa (Democratic Republic of Congo), especially during the dry season. We tested whether preeclampsia was associated with exposure to environmental metals.
Using a case-control design, 88 women hospitalized with preeclampsia (cases) and 88 healthy pregnant women from the antenatal clinic (controls) were included in the study; 67 and 109 women were enrolled during the rainy and dry season, respectively. The concentrations of 24 elements were quantified by inductively coupled plasma mass spectrometry (ICP-MS) in 24-h urine collections. Differences in the urinary excretion of metals were investigated between cases and controls, and the interaction with season was assessed.
Cases and controls were well matched regarding age, parity and duration of pregnancy. In controls, the urinary concentrations of most elements were substantially higher than reference values for adults from industrially developed countries, e.g. for lead: geometric mean (GM) 8.0 μg/L [25(th)-75(th) percentile 3.1-13.8]. The daily urinary excretions of 14 metals were significantly higher in women with preeclampsia than in control women, e.g. for lead: GM 61 μg/day (25(th)-75(th) percentile 8-345) in women with preeclampsia vs 9 μg/day (25(th)-75(th) percentile 3-21) in controls (p < 0.001). A significant interaction was found between season and preeclampsia for several elements, with higher urinary excretions in preeclamptic women than controls during the dry season, but not during the rainy season.
This study revealed not only that women with preeclampsia excrete higher amounts of several toxic metals, especially lead, than control women, but also that this excretion exhibits seasonal variation, thus possibly explaining the high incidence and seasonal variation of preeclampsia in Kinshasa. Although the exact sources of this exposure are unknown, these findings underscore the need for preventing environmental exposures to lead and other toxic metals.
子痫前期在金沙萨（刚果民主共和国）很常见，尤其是在旱季。我们测试了子痫前期是否与环境金属暴露有关。
采用病例对照设计，该研究纳入了88例因子痫前期住院的女性（病例组）和88例来自产前诊所的健康孕妇（对照组）；分别有67例和109例女性在雨季和旱季入组。通过电感耦合等离子体质谱法（ICP-MS）对24小时尿液样本中的24种元素浓度进行定量分析。研究了病例组和对照组之间金属尿排泄的差异，并评估了与季节的相互作用。
病例组和对照组在年龄、产次和孕周方面匹配良好。在对照组中，大多数元素的尿浓度显著高于工业化发达国家成年人的参考值，例如铅：几何均值（GM）8.0μg/L [第25(th)-75(th)百分位数 3.1-13.8]。子痫前期女性的14种金属每日尿排泄量显著高于对照女性，例如铅：子痫前期女性为GM 61μg/天（第25(th)-75(th)百分位数 8-345），而对照组为9μg/天（第25(th)-75(th)百分位数 3-21）（p < 0.001）。在几个元素上发现季节与子痫前期之间存在显著的相互作用，子痫前期女性在旱季的尿排泄量高于对照组，但在雨季则不然。
这项研究不仅揭示了子痫前期女性比对照女性排泄更多的几种有毒金属，尤其是铅，而且这种排泄呈现季节性变化，这可能解释了金沙萨子痫前期的高发病率和季节性变化。尽管这种暴露的确切来源尚不清楚，但这些发现强调了预防环境中铅和其他有毒金属暴露的必要性。
