多金属暴露与儿童智商得分的关系：一项前瞻性队列研究。
Association of multi-metals exposure with intelligence quotient score of children: A prospective cohort study.
机构信息
Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China; Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.
Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China; Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, China.
出版信息
Environ Int. 2021 Oct;155:106692. doi: 10.1016/j.envint.2021.106692. Epub 2021 Jun 18.
BACKGROUND
Associations between most single metals and children's intelligence quotient (IQ) scores have been evaluated in previous studies. However, associations between multi-metal exposures and children's IQ scores have not been analyzed.
OBJECTIVES
To assess the joint effects of lead (Pb), manganese (Mn), antimony (Sb), tin (Sn) and titanium (Ti) co-exposure on children's IQ scores.
METHODS
A prospective cohort study was conducted in Shimen and Huayuan, Hunan Province, China. Urine metals levels were measured by inductively coupled plasma mass spectrometry (ICP-MS) at baseline. Children's IQ scores were repeatedly measured at baseline and follow-up following the method of Raven's Standard Progressive Matrices (SPM) and standardized as z scores. We fitted linear regression models and Bayesian kernel machine regression (BKMR) models to investigate the associations of metal levels with children's IQ scores after adjusting for covariates.
RESULTS
A total of 633 participants aged 7-10 years completed the survey. Urinary Pb (β = -0.028, P = 0.022) and urinary Ti (β = -0.0003, P = 0.001) were inversely associated with children's IQ scores. The BKMR analyses revealed significant negative overall effects of the five metals on children's IQ scores when all the metals were above their median levels, while significant positive associations were shown when all the metal concentrations were below their median levels. The model also showed negative trends of Sn and Ti on children's IQ. Furthermore, Ti and Sn had a synergistic relationship, with a decline in IQ score when Sn exposure was relatively high. The urinary Sn concentration was significantly higher but the urinary Ti concentration was significantly lower in participants from the Shimen area than in those from the Huayuan area. Decreasing trends of the overall effects were observed in both the Shimen and Huayuan areas.
CONCLUSION
Our findings revealed that multi-metal exposures caused a decline in children's IQ scores according to traditional linear regression models and the BKMR model. Our results provide some evidence of the association between multi-metal exposure and children's IQ. Meanwhile, interactions between multi-metal exposures on children's IQ should be given more attention.
背景
先前的研究评估了大多数单一金属与儿童智商（IQ）得分之间的关联。然而，多金属暴露与儿童智商得分之间的关联尚未得到分析。
目的
评估铅（Pb）、锰（Mn）、锑（Sb）、锡（Sn）和钛（Ti）联合暴露对儿童智商得分的联合影响。
方法
在中国湖南省石门和花园进行了一项前瞻性队列研究。基线时通过电感耦合等离子体质谱法（ICP-MS）测量尿液金属水平。根据 Raven 的标准渐进矩阵（SPM）方法，在基线和随访时反复测量儿童的智商得分，并将其标准化为 z 分数。我们拟合线性回归模型和贝叶斯核机器回归（BKMR）模型，以调整协变量后研究金属水平与儿童智商得分之间的关联。
结果
共有 633 名 7-10 岁的参与者完成了调查。尿铅（β=-0.028，P=0.022）和尿钛（β=-0.0003，P=0.001）与儿童智商得分呈负相关。BKMR 分析显示，当所有金属均高于中位数水平时，五种金属对儿童智商得分的总体影响呈显著负相关，而当所有金属浓度均低于中位数水平时，呈显著正相关。该模型还显示了 Sn 和 Ti 对儿童智商的负向趋势。此外，Ti 和 Sn 之间存在协同关系，当 Sn 暴露较高时，智商得分下降。石门地区参与者的尿 Sn 浓度显著较高，但尿 Ti 浓度显著较低。在石门和花园地区，均观察到总体影响的下降趋势。
结论
根据传统线性回归模型和 BKMR 模型，我们的研究结果表明，多金属暴露导致儿童智商下降。我们的结果提供了多金属暴露与儿童智商之间关联的一些证据。同时，应更加关注多金属暴露对儿童智商的相互作用。
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