Demir Nihat, Başaranoğlu Murat, Huyut Zübeyir, Değer İbrahim, Karaman Kamuran, Şekeroğlu M Ramazan, Tuncer Oğuz
a Department of Pediatrics, Division of Neonatology , Yuzuncu Yil University School of Medicine , Van , Turkey.
b Department of Medical Biochemistry , Yuzuncu Yil University School of Medicine , Van , Turkey.
J Matern Fetal Neonatal Med. 2019 May;32(9):1433-1440. doi: 10.1080/14767058.2017.1408064. Epub 2017 Dec 3.
To determine levels of trace elements [copper (Cu), zinc (Zn), selenium (Se), and cobalt (Co)] and heavy metals [arsenic (As), mercury (Hg), lead (Pb), and cadmium (Cd)] in the plasma of mothers and infants and investigate the relationship between those levels and neural tube defects (NTD).
A total of 100 neonates diagnosed with NTD and placed in the Neonatal Intensive Care Unit of Yuzuncu Yil University, Turkey between May 2013 and December 2016 comprised the study group. The control group consisted of 70 healthy neonates not diagnosed with NTD or any other congenital anomalies. For both the groups, mother and infant plasma levels of Cu, Zn, Co, Cd, Se, Hg, As, and Pb were measured and compared. Plasma levels of Cu, Zn, Co, Cd, Se, Hg, As, and Pb were measured and compared between two groups of mothers and infants.
Mother and infant plasma levels of trace elements Zn and Se were determined to be significantly lower in the study group compared with the control group, while Cu levels were significant elevated in the study group (all p values < .05). Plasma levels of heavy metals As, Pb, and Cd were found to be significantly higher in the NTD control group (p < .05 for all). There was no association between maternal infection, maternal smoking status, history of miscarriage, or history of NTD with the development of NTD (p > .05). Differences in maternal age, birth weight, length of gestation, and infant gender for the two groups were also determined not to be statistically significant.
High plasma levels of heavy metals As, Pb, and Cd and trace element Cu were identified as risk factors for the development of NTD. At the same time, low plasma levels of trace elements Zn and Se were also found to be risk factors for NTD. However, no association between Hg and Co plasma levels and increased risk for the development of NTD was observed. This study, while being the most comprehensive case study to date investigating the relationship between heavy metals and trace element levels and increased risk of NTD, nonetheless highlights the need for further research in order to make definite statements regarding this relationship.
测定母婴血浆中微量元素[铜（Cu）、锌（Zn）、硒（Se）和钴（Co）]及重金属[砷（As）、汞（Hg）、铅（Pb）和镉（Cd）]的水平，并研究这些水平与神经管缺陷（NTD）之间的关系。
2013年5月至2016年12月期间，共有100例被诊断为神经管缺陷并入住土耳其于祖尔恰伊大学新生儿重症监护病房的新生儿组成研究组。对照组由70例未被诊断为神经管缺陷或任何其他先天性异常的健康新生儿组成。对两组母婴的血浆铜、锌、钴、镉、硒、汞、砷和铅水平进行测量并比较。对两组母婴的血浆铜、锌、钴、镉、硒、汞、砷和铅水平进行测量并比较。
研究组母婴血浆中微量元素锌和硒水平显著低于对照组，而研究组铜水平显著升高（所有p值<0.05）。神经管缺陷组中重金属砷、铅和镉的血浆水平显著更高（所有p值<0.05）。母亲感染、母亲吸烟状况、流产史或神经管缺陷史与神经管缺陷的发生之间没有关联（p>0.05）。两组母亲年龄、出生体重、妊娠时长和婴儿性别差异也无统计学意义。
血浆中重金属砷、铅和镉以及微量元素铜水平升高被确定为神经管缺陷发生的危险因素。同时，微量元素锌和硒的血浆低水平也被发现是神经管缺陷的危险因素。然而，未观察到汞和钴血浆水平与神经管缺陷发生风险增加之间的关联。本研究虽然是迄今为止调查重金属和微量元素水平与神经管缺陷发生风险增加之间关系的最全面的案例研究，但仍强调需要进一步研究以便对这种关系做出明确的论断。
