空气中细颗粒物2.5暴露与自闭症谱系障碍儿童之间的关联。
The association between particulate matter 2.5 exposure and children with autism spectrum disorder.
作者信息
Geng Ruihua, Fang Suqin, Li Guizhi
机构信息
Department of Pediatrics, People's Hospital of Kenli District, Dongying City, Shandong Province, 257500, China.
Department of Pediatrics, People's Hospital of Kenli District, Dongying City, Shandong Province, 257500, China.
出版信息
Int J Dev Neurosci. 2019 Jun;75:59-63. doi: 10.1016/j.ijdevneu.2019.05.003. Epub 2019 May 9.
OBJECTIVE
Particulate matter (PM) as an environmental pollutant is suspected to be associated with autism spectrum disorder (ASD). The aim of this study was to assess whether exposures to PM during the first three years of life in relation to the risk and degree of the severity of ASD.
METHODS
A total of two hundred and ninety-seven 3-6 years old Chinese children (99 confirmed autism cases and 198 their age-gender matched control subjects) were included. Children's exposures to PM (particulate matter with aerodynamic diameter <2.5 μm) during the first three years after birth were estimated. Logistic regression analysis was used to examine the PM-ASD association.
RESULTS
The mean levels of PM exposures in ASD and typical developmental children during the first three years of life were 89.8[standard deviations (SD): 6.1] μg/m and 87.3(6.6) μg/m3, respectively (p = 0.002). A statistically significant positive correlation was found between the serum levels of PM and the Childhood Autism Rating Scale (CARS) score indicating severity of autism (r = 0.259; p = 0.010). Based on the receiver operating characteristic (ROC) curve, the optimal cutoff value of PM levels as an indicator for auxiliary diagnosis of ASD was projected to be 89.5ug/m, which yielded a sensitivity of 65.4% and a specificity of 63.2%, with the area under the curve at 0.61 (95% confidence intervals [CIs], 0.54-0.68; P < 0.001). Multivariate analysis models were used to assess ASD risk according to PM quartiles (the lowest quartile [Q1] as the reference), with the adjusted odds ratios (ORs) (95% CIs) were recorded. As shown in the Table 2, the 3rd and 4th quartile of PM were compared against the Q1, and the risks were increased by 103% (OR = 2.03; 95%CI: 1.13-5.54; p = 0.015) and 311% (4.15; 2.04-9.45; p = 0.002), respectively.
CONCLUSIONS
To conclude, the evidence from this study allowed us to conclude that there was an association between PM exposure and ASD risk and severity.
目的
环境污染物颗粒物（PM）被怀疑与自闭症谱系障碍（ASD）有关。本研究的目的是评估生命最初三年接触PM与ASD风险及严重程度之间的关系。
方法
共纳入297名3至6岁的中国儿童（99例确诊自闭症病例及198名年龄和性别匹配的对照受试者）。估算儿童出生后前三年接触PM（空气动力学直径<2.5μm的颗粒物）的情况。采用逻辑回归分析来检验PM与ASD之间的关联。
结果
ASD儿童和发育正常儿童在生命最初三年的PM平均暴露水平分别为89.8[标准差（SD）：6.1]μg/m³和87.3（6.6）μg/m³（p = 0.002）。发现PM血清水平与表明自闭症严重程度的儿童自闭症评定量表（CARS）评分之间存在统计学显著正相关（r = 0.259；p = 0.010）。根据受试者工作特征（ROC）曲线，预测PM水平作为ASD辅助诊断指标的最佳截断值为89.5μg/m³，其敏感性为65.4%，特异性为63.2%，曲线下面积为0.61（95%置信区间[CIs]，0.54 - 0.68；P < 0.001）。使用多变量分析模型根据PM四分位数评估ASD风险（以最低四分位数[Q1]作为参照），记录调整后的比值比（ORs）（95% CIs）。如表2所示，将PM的第3和第4四分位数与Q1进行比较，风险分别增加了103%（OR = 2.03；95%CI：1.13 - 5.54；p = 0.015）和311%（4.15；2.04 - 9.45；p = 0.002）。
结论
总之，本研究证据使我们得出结论，PM暴露与ASD风险及严重程度之间存在关联。
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