Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, NY, USA.
Independent Researcher, Mitrovica, Kosovo.
J Environ Public Health. 2020 Dec 28;2020:3646252. doi: 10.1155/2020/3646252. eCollection 2020.
Epidemiologic cross-sectional studies examining the relationship between environmental lead (Pb) exposure and erythropoietin (EPO) production have reported contrasting results. It is unknown, however, if exposure to Pb earlier in life has an effect on EPO production later in life. Here, using a prospective study, we evaluate the association between prenatal, early childhood, and concurrent Pb exposure and EPO concentration in young adulthood.
From our prospective birth cohort study in Mitrovica (a mining town) and Pristina (a control town), Kosovo, from 1985 to 1998, we located and assessed blood lead concentration (BPb) and serum EPO in 101 participants (mean age 24.9 years) in 2011. We examined the association between BPb and EPO, stratified by hemoglobin (Hgb), and controlling for potential confounders.
These results resemble the findings in the original full cohort at 4.5 and 6.5 years of age, at which time we reported that the maintenance of a normal Hgb required increased EPO production among participants exposed to high levels of environmental Pb. In contrast, when the original cohort was 9.5 and 12 years of age, they were no longer capable of hyper-production of EPO in order to maintain normal levels of Hgb, suggestive of cumulative toxicity to the peritubular cells of the kidney that are responsible for EPO synthesis.
Our results, along with previously reported findings on this cohort, suggest that a dramatic reduction of Pb exposure may allow for a reversal of the impact that prolonged Pb exposure may have on EPO production.
研究环境铅（Pb）暴露与促红细胞生成素（EPO）产生之间关系的横断面流行病学研究报告结果相互矛盾。然而，目前尚不清楚生命早期接触 Pb 是否会对生命后期的 EPO 产生产生影响。在这里，我们使用前瞻性研究评估了产前、幼儿期和同时期 Pb 暴露与年轻人 EPO 浓度之间的关联。
来自 1985 年至 1998 年在科索沃米特罗维察（一个矿区城镇）和普里什蒂纳（一个对照城镇）进行的前瞻性出生队列研究，我们找到了并评估了 101 名参与者（平均年龄 24.9 岁）在 2011 年的血液 Pb 浓度（BPb）和血清 EPO。我们检查了 BPb 与 EPO 之间的关联，按血红蛋白（Hgb）分层，并控制了潜在的混杂因素。
这些结果与我们在 4.5 岁和 6.5 岁时的原始全队列研究结果相似，当时我们报告说，在接触高水平环境 Pb 的参与者中，维持正常 Hgb 需要增加 EPO 的产生。相比之下，当原始队列年龄为 9.5 岁和 12 岁时，他们不再能够产生大量的 EPO 以维持正常的 Hgb 水平，这表明对负责 EPO 合成的肾小管细胞的累积毒性。
我们的结果以及之前对该队列的研究结果表明，大幅度减少 Pb 暴露可能会逆转长期 Pb 暴露对 EPO 产生的影响。
