Department of Epidemiology and Environmental Health, University at Buffalo, The State University of New York, USA.
Department of Epidemiology and Environmental Health, University at Buffalo, The State University of New York, USA.
Environ Res. 2021 Jun;197:111086. doi: 10.1016/j.envres.2021.111086. Epub 2021 Mar 27.
Dysregulation of systolic, diastolic blood pressure (SBP, DBP), and pulse pressure (PP) in children may predict elevated blood pressure (BP) in adulthood. Toxicant exposure is widely studied as a risk factor for high BP in adults, but not in children. We assessed the joint associations between lead (Pb), mercury (Hg), arsenic (As), and cadmium (Cd) exposure and SBP, DBP, and PP among 8-17 year-old participants (n = 1642) of the 2009-2016 National Health and Nutrition Examination Survey (NHANES).
Participants with at least two BP measures were included. Urinary As and Cd were adjusted for urinary creatinine concentrations. Blood Pb, Hg, and urinary As, Cd were natural log-transformed. Bayesian Kernel Machine Regression (BKMR) analyses were conducted to assess the associations between the toxicant mixture and BP measures. Multivariable regression models assessed the associations between individual toxicants, and the four toxicants simultaneously with each of the outcomes. Interactions with sodium intake were tested.
Exposure to all toxicants was low, with median (5%, 95%) level: Pb, 0.57 (0.26, 1.60) μg/dL; Hg, 0.37 (0.19, 2.12) μg/L; As, 5.61 (1.37, 33.2) μg/g creatinine, Cd, 0.06 (0.03, 0.23) μg/g creatinine. Toxicant mixture showed a statistically significant, inverse association with DBP, but not other BP measures. Linear regressions revealed no association between toxicants, individually or together, and BP measures. No evidence of interaction of sodium intake with any of the toxicants was observed.
In a nationally representative sample of 8-17 year-olds, we found suggestive inverse association of the mixture of low-level Pb, Hg, As, and Cd, with DBP. Longitudinal studies with multiple toxicants are needed to understand the interactive effects of toxicants on children's BP.
儿童的收缩压、舒张压（SBP、DBP）和脉压（PP）失调可能预示着成年后血压升高。毒物暴露被广泛研究为成人高血压的危险因素，但在儿童中却没有。我们评估了铅（Pb）、汞（Hg）、砷（As）和镉（Cd）暴露与 2009-2016 年全国健康和营养调查（NHANES）中 8-17 岁参与者（n=1642）的 SBP、DBP 和 PP 之间的联合关联。
至少有两次血压测量的参与者被纳入研究。尿砷和镉浓度经尿肌酐浓度调整。血铅、汞和尿砷、镉均自然对数转换。贝叶斯核机器回归（BKMR）分析用于评估毒物混合物与血压测量值之间的关联。多变量回归模型评估了个体毒物与各结局之间的关联，以及同时存在四种毒物时的关联。测试了与钠摄入量的相互作用。
所有毒物的暴露水平均较低，中位数（5%，95%）水平为：Pb，0.57（0.26，1.60）μg/dL；Hg，0.37（0.19，2.12）μg/L；As，5.61（1.37，33.2）μg/g 肌酐，Cd，0.06（0.03，0.23）μg/g 肌酐。毒物混合物与 DBP 呈统计学上显著的负相关，但与其他血压测量值无关。线性回归显示，毒物个体或联合均与血压测量值无关。未观察到钠摄入量与任何毒物之间存在交互作用的证据。
在一个具有全国代表性的 8-17 岁样本中，我们发现低水平 Pb、Hg、As 和 Cd 混合物与 DBP 呈负相关。需要进行包含多种毒物的纵向研究，以了解毒物对儿童血压的交互影响。
