Centers for Disease Control and Prevention (CDC), National Center for Environmental Health (NCEH) , Division of Laboratory Sciences (DLS), Atlanta, Georgia.
CDC-Kenya, Center for Global Health (CGH) , Division of Global Health Protection, Nairobi, Kenya.
Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2021 Jan;38(1):136-147. doi: 10.1080/19440049.2020.1825826. Epub 2020 Nov 20.
Aflatoxins are carcinogenic mycotoxins that contaminate a variety of crops worldwide. Acute exposure can cause liver failure, and chronic exposure can lead to stunting in children and liver cancer in adults. We estimated aflatoxin exposure across Uganda by measuring a serum biomarker of aflatoxin exposure in a subsample from the 2011 Uganda AIDS Indicator Survey, a nationally representative survey of HIV prevalence, and examined its association with geographic, demographic, and socioeconomic variables. We analysed a subsample of 985 serum specimens selected among HIV-negative participants from 10 survey-defined geographic regions for serum aflatoxin B1-lysine (AFB1-lys) by use of isotope dilution LC-MS/MS and calculated results normalised to serum albumin. We used statistical techniques for censored data to estimate geometric means (GMs), standard deviations, and percentiles. We detected serum AFB1-lys in 71.7% of specimens (LOD = 0.5 pg/mg albumin). Unadjusted GM AFB1-lys (pg/mg albumin) was 1.33 (95% CI: 1.21-1.47). Serum AFB1-lys was higher in males (GM: 1.57; 95% CI: 1.38-1.80) vs. females (GM: 1.12; 95% CI: 0.97-1.30) ( = .0019), and higher in persons residing in urban settings (GM: 2.83; 95% CI: 2.37-3.37) vs. rural (GM: 1.10; 95% CI: 0.99-1.23) ( < .0001). When we used a multivariable censored regression model to assess confounding and interactions among variables we found that survey region, gender, age, occupation, distance to marketplace, and number of meals per day were statistically significant predictors of aflatoxin exposure. While not nationally representative, our findings provide an improved understanding of the widespread burden of aflatoxin exposure throughout Uganda and identify key geographic, demographic, and socioeconomic factors that may modulate aflatoxin exposure risk.
黄曲霉毒素是一种致癌的真菌毒素，会污染世界各地的多种农作物。急性暴露会导致肝功能衰竭，慢性暴露则会导致儿童发育迟缓，以及成年人患肝癌。我们通过测量乌干达艾滋病指标调查（Uganda AIDS Indicator Survey）中一个亚组的血清黄曲霉毒素暴露生物标志物，来估计乌干达的黄曲霉毒素暴露情况。这是一项全国性的艾滋病毒流行情况调查。我们还检查了黄曲霉毒素暴露与地理、人口统计学和社会经济变量之间的关系。我们使用同位素稀释液 LC-MS/MS 对来自 10 个调查定义的地理区域的 985 份血清样本中的血清黄曲霉毒素 B1-赖氨酸（AFB1-lys）进行了亚组分析，并将结果按血清白蛋白进行了标准化。我们使用针对删失数据的统计技术来估计几何平均值（GM）、标准差和百分位数。我们在 71.7%的标本中检测到了血清 AFB1-lys（LOD=0.5 pg/mg 白蛋白）。未调整的血清 AFB1-lys GM（pg/mg 白蛋白）为 1.33（95%CI：1.21-1.47）。男性（GM：1.57；95%CI：1.38-1.80）的血清 AFB1-lys 高于女性（GM：1.12；95%CI：0.97-1.30）（ =0.0019），城市地区（GM：2.83；95%CI：2.37-3.37）的血清 AFB1-lys 高于农村地区（GM：1.10；95%CI：0.99-1.23）（<0.0001）。当我们使用多元删失回归模型来评估变量之间的混杂和相互作用时，我们发现调查区域、性别、年龄、职业、离市场的距离和每天用餐的次数是黄曲霉毒素暴露的统计学显著预测因素。虽然我们的研究结果不是全国性的代表性，但它们提供了对乌干达黄曲霉毒素暴露普遍负担的更深入了解，并确定了可能调节黄曲霉毒素暴露风险的关键地理、人口统计学和社会经济因素。
