Egwunye Jacob, Cardoso Barbara R, Braat Sabine, Ha Tran, Hanieh Sarah, Hare Dominic, Duan Alex Xiaofei, Doronila Augustine, Tran Thach, Tuan Tran, Fisher Jane, Biggs Beverley-Ann
Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Victoria, 3000, Australia.
Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC3004, Australia.
Br J Nutr. 2023 May 14;129(9):1589-1597. doi: 10.1017/S0007114522001374. Epub 2022 May 10.
As, Pb and Hg are common environmental contaminants in low- and middle-income countries. We investigated the association between child toxicant exposure and growth and development and determined if this association was mitigated by Se concentration. Toxicant concentrations in fingernail samples, anthropometry and Bayley's Scales of Infant Development, 3rd edition domains were assessed in 36-month-old children whose mothers had been part of a randomised controlled trial in rural Vietnam. Multivariable regression analyses were performed to estimate the effect of toxicant exposure on clinical outcomes with adjustments for potential confounders and interaction with fingernail Se concentration. We analysed 658 children who had data for at least one physical or developmental outcome, and at least one toxicant measurement, and each of the covariates. Fingernail As concentration was negatively associated with language (estimate per 10 % increase in As: -0·19, 95 % CI: (-0·32, -0·05)). Pb was negatively associated with cognition (estimate per 10 % increase in Pb: -0·08 (-0·15, -0·02)), language (estimate per 10 % increase in Pb: -0·18 (-0·28, -0·10)) and motor skills (estimate per 10 % increase in Pb: -0·12 (-0·24, 0·00)). Hg was negatively associated with cognition (estimate per 10 % increase in Hg: -0·48, (-0·72, -0·23)) and language (estimate per 10 % increase in Hg -0·51, (-0·88, -0·13)) when Se concentration was set at zero in the model. As Se concentration increased, the negative associations between Hg and both cognition and language scores were attenuated. There was no association between toxicant concentration and growth. As, Pb and Hg concentrations in fingernails of 3-year-old children were associated with lower child development scores. The negative association between Hg and neurological development was reduced in magnitude with increasing Se concentration. Se status should be considered when assessing heavy metal toxicants in children and their impact on neurodevelopmental outcomes.
砷、铅和汞是低收入和中等收入国家常见的环境污染物。我们调查了儿童接触有毒物质与生长发育之间的关联，并确定这种关联是否会因硒浓度而减轻。对越南农村地区参与一项随机对照试验的母亲所生的36个月大儿童，评估其指甲样本中的有毒物质浓度、人体测量指标以及贝利婴幼儿发展量表第三版各领域的情况。进行多变量回归分析，以估计有毒物质暴露对临床结局的影响，并对潜在混杂因素以及与指甲硒浓度的相互作用进行调整。我们分析了658名儿童的数据，这些儿童至少有一项身体或发育结局的数据、至少一项有毒物质测量数据以及每项协变量的数据。指甲砷浓度与语言能力呈负相关（砷每增加10%的估计值：-0.19，95%置信区间：(-0.32, -0.05)）。铅与认知能力呈负相关（铅每增加10%的估计值：-0.08 (-0.15, -0.02)）、与语言能力呈负相关（铅每增加10%的估计值：-0.18 (-0.28, -0.10)）以及与运动技能呈负相关（铅每增加10%的估计值：-0.12 (-0.24, 0.00)）。在模型中当硒浓度设定为零时，汞与认知能力呈负相关（汞每增加10%的估计值：-0.48，(-0.72, -0.23)）以及与语言能力呈负相关（汞每增加10%的估计值 -0.51，(-0.88, -0.13)）。随着硒浓度增加，汞与认知和语言分数之间的负相关减弱。有毒物质浓度与生长之间没有关联。3岁儿童指甲中的砷、铅和汞浓度与较低的儿童发育分数相关。随着硒浓度增加，汞与神经发育之间的负相关程度降低。在评估儿童重金属有毒物质及其对神经发育结局的影响时，应考虑硒状态。
