Ruan Fengyu, Zhang Jingjing, Liu Juan, Sun Xiaojie, Li Yuanyuan, Xu Shunqing, Xia Wei
Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
Environ Res. 2022 Apr 15;206:112615. doi: 10.1016/j.envres.2021.112615. Epub 2021 Dec 28.
The association between prenatal exposure to the metal mixture and allergic diseases is poorly understood. We aimed to explore the individual effect and the combined effect of prenatal exposure to vanadium (V), chromium (Cr), nickel (Ni), arsenic (As), cadmium (Cd), thallium (Tl), and lead (Pb) on early childhood allergic diseases based on a birth cohort study that included 628 mother-infant pairs. Metals were measured in maternal urine samples collected in the first, second, and third trimesters. Children were prospectively followed up at age 4 years to collect information on allergic rhinitis, wheeze, and eczema status. By applying logistic regression models, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR), the different statistical analyses revealed urinary metals were only associated with early childhood allergic rhinitis. The averaged prenatal As exposure was significantly associated with an increased OR for allergic rhinitis in both single-metal (OR = 2.04, 95% CI: 1.35, 3.07) and multiple-metal logistic regression models (OR = 1.78, 95% CI: 1.15, 2.78). The WQS index of mixed metal exposure was positively associated with allergic rhinitis (OR = 1.66, 95% CI: 1.26, 2.19), and As and Tl had the largest weights in the WQS index (weighted 0.51 and 0.29, respectively). The BKMR analysis also showed the overall effect of the metal mixture was significantly associated with allergic rhinitis when all the metals were at their 55th percentile or above, compared to their 50th percentile. The effect of As and Tl on the risk of allergic rhinitis was significant when all of the other metals were fixed at the specific percentiles. Our findings suggest that prenatal co-exposure to higher levels of the seven metals increases the risk of allergic rhinitis in children, and As and Tl may contribute most to the combined risk.
孕期暴露于金属混合物与过敏性疾病之间的关联尚不清楚。我们旨在基于一项包含628对母婴的出生队列研究，探究孕期暴露于钒（V）、铬（Cr）、镍（Ni）、砷（As）、镉（Cd）、铊（Tl）和铅（Pb）对儿童早期过敏性疾病的个体效应和联合效应。在孕早期、孕中期和孕晚期收集的母亲尿液样本中测量金属含量。对儿童进行前瞻性随访至4岁，以收集有关过敏性鼻炎、喘息和湿疹状况的信息。通过应用逻辑回归模型、加权分位数和（WQS）回归以及贝叶斯核机器回归（BKMR），不同的统计分析表明，尿金属仅与儿童早期过敏性鼻炎相关。在单金属（OR = 2.04，95% CI：1.35，3.07）和多金属逻辑回归模型（OR = 1.78，95% CI：1.15，2.78）中，孕期平均砷暴露与过敏性鼻炎的OR值增加显著相关。混合金属暴露的WQS指数与过敏性鼻炎呈正相关（OR = 1.66，95% CI：1.26，2.19），且砷和铊在WQS指数中的权重最大（分别加权0.51和0.29）。BKMR分析还表明，当所有金属处于其第55百分位数或以上时，与第50百分位数相比，金属混合物的总体效应与过敏性鼻炎显著相关。当所有其他金属固定在特定百分位数时，砷和铊对过敏性鼻炎风险的影响显著。我们的研究结果表明，孕期同时暴露于较高水平的七种金属会增加儿童患过敏性鼻炎的风险，且砷和铊可能对综合风险贡献最大。
