Burns Jane S, Williams Paige L, Lee Mary M, Revich Boris, Sergeyev Oleg, Hauser Russ, Korrick Susan A
Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.
Department of Biostatistics, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
Environ Int. 2017 Sep;106:53-59. doi: 10.1016/j.envint.2017.05.023. Epub 2017 Jun 7.
Childhood blood lead levels (BLL) have been associated with growth impairment.
We assessed associations of peripubertal BLL with adolescent growth and near adult height in a longitudinal cohort of Russian boys.
481 boys were enrolled at ages 8-9years and followed annually to age 18. At enrollment, BLL was measured, and height, weight, and pubertal staging were obtained annually during 10years of follow-up. Mixed effects models were used to assess the associations of BLL with longitudinal age-adjusted World Health OrganizationZ-scores for height (HT-Z) and body mass index (BMI-Z), and annual height velocity (HV). Interactions between boys' age and BLL on growth outcomes were evaluated.
The median (range) BLL was 3.0 (0.5-31.0) μg/dL. At age 18years, 79% of boys had achieved near adult height (HV <1.0cm/year), and means (SD) for HT-Z and BMI-Z were 0.15 (0.92) and -0.32 (1.24). Over 10years of follow-up, after covariate adjustment, boys with higher (≥5μg/dL) BLL compared with lower BLL were shorter (adjusted mean difference in HT-Z=-0.43, 95% CI -0.60, -0.25, p-value <0.001), translating to a 2.5cm lower height at age 18years. The decrement in height for boys with higher BLL was most pronounced at 12 to 15years of age (interaction p=0.03). Boys with higher BLL were leaner (adjusted mean difference in BMI-Z=-0.22, 95% CI: -0.45, 0.01, p=0.06).
Higher peripubertal BLLs were associated with shorter height through age 18years, suggesting a persistent effect of lead on linear growth.
儿童血铅水平（BLL）与生长发育受损有关。
我们在一个俄罗斯男孩的纵向队列中评估了青春期前BLL与青少年生长及接近成人身高之间的关联。
481名男孩在8至9岁时入组，并每年随访至18岁。入组时测量BLL，并在10年随访期间每年获取身高、体重和青春期分期。使用混合效应模型评估BLL与按年龄调整的纵向世界卫生组织身高Z评分（HT-Z）、体重指数Z评分（BMI-Z）以及年身高增长速度（HV）之间的关联。评估男孩年龄与BLL对生长结局的相互作用。
BLL的中位数（范围）为3.0（0.5 - 31.0）μg/dL。在18岁时，79%的男孩达到了接近成人的身高（HV <1.0cm/年），HT-Z和BMI-Z的均值（标准差）分别为0.15（0.92）和 -0.32（1.24）。在10年的随访中，经过协变量调整后，与低BLL的男孩相比，高（≥5μg/dL）BLL的男孩更矮（HT-Z的调整均值差异 = -0.43，95%CI -0.60，-0.25，p值<0.001），这意味着在18岁时身高低2.5cm。高BLL男孩的身高下降在12至15岁时最为明显（相互作用p = 0.03）。高BLL的男孩更瘦（BMI-Z的调整均值差异 = -0.22，95%CI：-0.45，0.01，p = 0.06）。
青春期前较高的BLL与18岁时较矮的身高有关，这表明铅对线性生长有持续影响。
