母亲红细胞锰浓度与 6-12 岁儿童血压之间的非线性关系：一项前瞻性出生队列研究。
A Nonlinear Relation Between Maternal Red Blood Cell Manganese Concentrations and Child Blood Pressure at Age 6-12 y: A Prospective Birth Cohort Study.
机构信息
Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
出版信息
J Nutr. 2021 Mar 11;151(3):570-578. doi: 10.1093/jn/nxaa368.
BACKGROUND
Although manganese (Mn) is an essential trace element and a common component of most multivitamins on the market, an adverse effect on blood pressure (BP) has been reported in adults. In addition, the longitudinal relation between prenatal Mn status and childhood BP is still unknown.
OBJECTIVE
This study investigated the association between prenatal Mn concentrations and risk of elevated BP at ages 3-12 y.
METHOD
The analyses included 1268 mother-child dyads who were enrolled at birth and followed prospectively at the Boston Medical Center. Maternal RBC Mn concentrations were measured by inductively coupled plasma mass spectrometry, using RBCs collected within 1-3 d after delivery (reflecting late-pregnancy Mn exposure). Child elevated BP was defined as systolic or diastolic BP ≥90th percentile for a given age, sex and height. Multivariate logistic regression models were conducted. Path analysis was applied to mediation estimation.
RESULTS
The median (IQR) maternal RBC Mn concentration was 37.5 (29.2-48.5) μg/L. The rate of child elevated BP at ages 3-12 y was 25%. Both the lowest and highest quartiles of maternal RBC Mn concentrations were associated with higher risk of elevated BP among children aged 6-12 y (OR: 1.52; 95% CI: 1.04, 2.21 and OR: 1.65; 95% CI: 1.13, 2.40, respectively) compared with those in the second and third quartiles. Gestational age and fetal growth mediated the association between low maternal RBC Mn (first quartile) and child elevated BP, explaining 25% of the association, but not for high (fourth quartile) maternal RBC Mn concentrations. No association was found between maternal RBC Mn concentrations and BP among children aged 3-5 y.
CONCLUSION
We found a nonlinear association between maternal RBC Mn concentrations and elevated BP among children aged 6-12 y from a high-risk, predominantly minority population. Our findings warrant further investigation.
背景
尽管锰（Mn）是一种必需的微量元素，也是市场上大多数多种维生素的常见成分，但已有研究报道其对成年人的血压（BP）有不良影响。此外，关于产前 Mn 水平与儿童期 BP 之间的纵向关系仍不清楚。
目的
本研究旨在探讨产前 Mn 浓度与 3-12 岁儿童血压升高风险之间的关联。
方法
本研究共纳入了 1268 对母子，他们在波士顿医疗中心出生时被纳入研究并进行前瞻性随访。采用电感耦合等离子体质谱法检测产妇 RBC 中的 Mn 浓度，采集时间为分娩后 1-3 天（反映妊娠晚期的 Mn 暴露情况）。儿童血压升高定义为收缩压或舒张压≥相应年龄、性别和身高的第 90 百分位数。采用多变量逻辑回归模型进行分析。应用路径分析进行中介效应估计。
结果
产妇 RBC 中 Mn 的中位数（IQR）为 37.5（29.2-48.5）μg/L。在 3-12 岁的儿童中，血压升高的发生率为 25%。与第二和第三四分位数的儿童相比，最低和最高四分位数的产妇 RBC 中 Mn 浓度均与 6-12 岁儿童的血压升高风险增加相关（OR：1.52；95%CI：1.04，2.21 和 OR：1.65；95%CI：1.13，2.40）。胎龄和胎儿生长解释了低水平（第一四分位数）的产妇 RBC 中 Mn 与儿童血压升高之间关联的 25%，但不能解释高水平（第四四分位数）的产妇 RBC 中 Mn 浓度与儿童血压升高之间的关联。产妇 RBC 中 Mn 浓度与 3-5 岁儿童的 BP 之间没有关联。
结论
我们从一个高危、以少数族裔为主的人群中发现了产妇 RBC 中 Mn 浓度与 6-12 岁儿童血压升高之间的非线性关联。我们的研究结果需要进一步研究。
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