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尿砷与孟加拉国农村地区幼儿消瘦和体重不足有关。

Urinary arsenic is associated with wasting and underweight status in young children in rural Bangladesh.

机构信息

Department of International Health, Program in Global Disease Epidemiology and Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

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

出版信息

Environ Res. 2021 Apr;195:110025. doi: 10.1016/j.envres.2020.110025. Epub 2020 Aug 10.

Abstract

BACKGROUND

Deficits in child growth are associated with poor cognitive outcomes and an increased risk for infection and mortality globally. One hundred forty million people are chronically exposed to arsenic from contaminated drinking water worldwide. While arsenic exposure has been associated with cognitive developmental delays in children, there is limited research on the association between arsenic exposure and growth deficits in young children.

PURPOSE

The objective of this study was to assess the association between chronic arsenic exposure and deficits in growth among children under 5 years in a rural setting in Bangladesh.

METHODS

Urinary arsenic measurements were collected from 465 children between the ages of 28 days-59 months in rural Matlab, Bangladesh, and analyzed by graphite furnace atomic absorption. Height and weight measurements were collected from children according to World Health Organization child growth standards. A z-score cutoff2 standard deviations below the mean was used to define stunting (height-for-age z-score), underweight (weight-for-age z-score), and wasting (weight-for-height z-score).

RESULTS

Children under 5 years with urinary arsenic concentrations in the third tertile (greater than 31 μg per liter (μg/L)) had a two times higher odds of being underweight after adjustment for age, creatinine, paternal education, breastfeeding, number of individuals using the same sleeping room, and physician-diagnosed pneumonia (Odds Ratio (OR): 2.29 (95% Confidence Interval (CI): 1.16, 4.52)). Children under 2 years of age had a two times higher odds of being wasted after adjustment for age, creatinine, paternal education, breastfeeding, number of individuals using the same sleeping room, and physician-diagnosed pneumonia (OR: 2.85 (95% CI: 1.18, 6.89)).

CONCLUSIONS

These findings suggest that arsenic exposure is associated with an increased odds of being wasted and underweight among young children in rural Bangladesh.

摘要

背景

儿童生长发育迟缓与全球范围内认知能力下降以及感染和死亡风险增加有关。全世界有 1.4 亿人长期饮用受砷污染的水而受到慢性砷暴露。虽然砷暴露与儿童认知发育迟缓有关,但关于砷暴露与幼儿生长发育迟缓之间的关系,研究有限。

目的

本研究旨在评估孟加拉国农村地区 5 岁以下儿童慢性砷暴露与生长发育迟缓之间的关系。

方法

从孟加拉国农村 Matlab 的 465 名 28 天至 59 个月大的儿童中收集尿液砷测量值,并通过石墨炉原子吸收进行分析。根据世界卫生组织儿童生长标准,从儿童收集身高和体重测量值。使用低于平均值 2 个标准差的 z 分数截定点来定义发育迟缓(身高年龄 z 分数)、消瘦(体重年龄 z 分数)和消瘦(体重身高 z 分数)。

结果

在调整年龄、肌酐、父亲教育程度、母乳喂养、使用同一卧室的人数和医生诊断的肺炎后,尿液砷浓度处于第三 tertile(大于 31μg/L)的 5 岁以下儿童体重不足的可能性是对照组的两倍(比值比(OR):2.29(95%置信区间(CI):1.16,4.52))。在调整年龄、肌酐、父亲教育程度、母乳喂养、使用同一卧室的人数和医生诊断的肺炎后,2 岁以下儿童消瘦的可能性是对照组的两倍(比值比(OR):2.85(95%置信区间(CI):1.18,6.89))。

结论

这些发现表明,砷暴露与孟加拉国农村地区幼儿消瘦和体重不足的风险增加有关。

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