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镉暴露与 10 岁时的认知能力和行为:一项前瞻性队列研究。

Cadmium exposure and cognitive abilities and behavior at 10 years of age: A prospective cohort study.

机构信息

Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden.

International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.

出版信息

Environ Int. 2018 Apr;113:259-268. doi: 10.1016/j.envint.2018.02.020. Epub 2018 Feb 17.

Abstract

BACKGROUND

We have previously reported inverse associations of prenatal and childhood cadmium exposure with cognition in 5-year-old Bangladeshi children.

OBJECTIVES

To assess if cadmium exposure affected cognition and behavior in the Bangladeshi children at 10 years.

METHODS

Cadmium exposure was assessed by urinary concentrations at 10 (n = 1498) and 5 years of age (n = 1453), and of the mothers in early pregnancy (n = 1299), measured by ICP-MS. Cognitive abilities were assessed with Wechsler Intelligence Scale for Children (4th edition) and behavior with the parent-rated Strengths and Difficulties Questionnaire.

RESULTS

In multivariable-adjusted models, urinary cadmium at 10 years was inversely associated with Full scale IQ and most of the sub-scales. Associations were mainly observed in boys, in whom the difference in Full scale IQ was 7.0 scores (95% CI: -11, -2.7), corresponding to 0.21 SD, when comparing those in the highest (range: 0.30-2.6 μg/L) and lowest tertile of urinary cadmium (0.036-0.18 μg/L). Urinary cadmium at 5 years was inversely, but not significantly, associated with IQ. Children in the highest exposure tertile at 10 years also had poorer Prosocial behavior scores. The association appeared strongest in girls, in whom the corresponding OR for Prosocial scores in relation to cadmium exposure at 10 years and prenatally was 0.58 (95% CI: 0.34, 0.99) and 0.48 (95% CI: 0.25, 0.93), respectively.

CONCLUSION

Childhood cadmium exposure was associated with lower intelligence in boys, and there were indications of altered behavior in girls for both prenatal and childhood exposures. Findings are of concern as similar exposure levels are common world-wide.

摘要

背景

我们之前曾报道过,在 5 岁的孟加拉国儿童中,产前和儿童期的镉暴露与认知能力呈负相关。

目的

评估 10 岁时镉暴露是否会影响孟加拉国儿童的认知和行为。

方法

通过电感耦合等离子体质谱法(ICP-MS)检测 10 岁(n=1498)和 5 岁(n=1453)时儿童以及母亲妊娠早期(n=1299)的尿液浓度来评估镉暴露。使用韦氏儿童智力量表(第四版)评估认知能力,使用父母评定的长处和困难问卷评估行为。

结果

在多变量调整模型中,10 岁时的尿镉与全量表智商和大多数子量表呈负相关。在男孩中主要观察到这些关联,与尿镉浓度最高(范围:0.30-2.6μg/L)和最低三分位(0.036-0.18μg/L)相比,男孩全量表智商的差异为 7.0 分(95%CI:-11,-2.7),相当于 0.21 个标准差。5 岁时的尿镉与智商呈负相关,但无统计学意义。10 岁时暴露水平最高的儿童的亲社会行为评分也较差。在女孩中,这种关联似乎最强,在女孩中,与 10 岁和产前镉暴露相关的亲社会评分的相应 OR 值分别为 0.58(95%CI:0.34,0.99)和 0.48(95%CI:0.25,0.93)。

结论

儿童期的镉暴露与男孩的智力低下有关,而且产前和儿童期暴露都表明女孩的行为发生了改变。由于类似的暴露水平在全球范围内很常见,因此这些发现令人担忧。

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