Shao Wentao, Liu Qian, He Xiaowei, Liu Hui, Gu Aihua, Jiang Zhaoyan
Center of Gallbladder Disease, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Road, Shanghai, 201200, China.
State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, No. 818 East Tianyuan Road, Nanjing, Jiangsu Province, 211166, China.
Environ Sci Pollut Res Int. 2017 Apr;24(12):11573-11581. doi: 10.1007/s11356-017-8803-1. Epub 2017 Mar 21.
Global prevalence of obesity has been increasing dramatically in all ages. Although traditional causes for obesity development have been studied widely, it is unclear whether environmental exposure of substances such as trace heavy metals affects obesity development among children and adolescents so far. Data from the National Health and Nutrition Examination Survey (1999-2011) were retrieved, and 6602 US children were analyzed in this study. Urinary level of nine trace heavy metals, including barium, cadmium, cobalt, cesium, molybdenum, lead, antimony, thallium, and tungsten, was analyzed for their association with the prevalence of obesity among children aged 6-19 years. Multiple logistic regression was performed to assess the associations adjusted for age, race/ethnicity, gender, urinary creatinine, PIR, serum cotinine, and television, video game, and computer usage. A remarkable association was found between barium exposure (OR 1.43; 95% CI 1.09-1.88; P < 0.001) and obesity in children aged 6-19 years. Negative association was observed between cadmium (OR 0.46; 95% CI 0.33-0.64; P < 0.001), cobalt (OR 0.56; 95% CI: 0.41-0.76; P < 0.001), and lead (OR 0.57; 95% CI 0.41-0.78; P = 0.018), and obesity. All the negative associations were stronger in the 6-12 years group than in the 13-19 years group. The present study demonstrated that barium might increase the occurrence of obesity, but cadmium, cobalt, and lead caused weight loss among children. The results imply that trace heavy metals may represent critical risk factors for the development of obesity, especially in the area that the state of metal contamination is serious.
全球各年龄段的肥胖患病率都在急剧上升。尽管传统的肥胖成因已得到广泛研究，但目前尚不清楚诸如微量重金属等物质的环境暴露是否会影响儿童和青少年的肥胖发展。本研究检索了美国国家健康与营养检查调查（1999 - 2011年）的数据，并对6602名美国儿童进行了分析。分析了包括钡、镉、钴、铯、钼、铅、锑、铊和钨在内的九种微量重金属的尿液水平，以研究它们与6 - 19岁儿童肥胖患病率之间的关联。采用多元逻辑回归分析，对年龄、种族/族裔、性别、尿肌酐、贫困收入比、血清可替宁以及看电视、玩电子游戏和使用电脑的情况进行了校正，以评估关联。研究发现，6 - 19岁儿童的钡暴露（比值比1.43；95%置信区间1.09 - 1.88；P < 0.001）与肥胖之间存在显著关联。镉（比值比0.46；95%置信区间0.33 - 0.64；P < 0.001）、钴（比值比0.56；95%置信区间：0.41 - 0.76；P < 0.001）和铅（比值比0.57；95%置信区间0.41 - 0.78；P = 0.018）与肥胖之间存在负相关。所有负相关在6 - 12岁组中比在13 - 19岁组中更强。本研究表明，钡可能会增加肥胖的发生率，但镉、钴和铅会导致儿童体重减轻。研究结果表明，微量重金属可能是肥胖发展的关键危险因素，尤其是在金属污染状况严重的地区。
