Kim Christine, Cathey Amber L, Watkins Deborah J, Mukherjee Bhramar, Rosario-Pabón Zaira Y, Vélez-Vega Carmen M, Alshawabkeh Akram N, Cordero José F, Meeker John D
Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan.
Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan.
Environ Epidemiol. 2022 Jul 5;6(4):e214. doi: 10.1097/EE9.0000000000000214. eCollection 2022 Aug.
Studies have revealed a link between aberrant levels of maternal C-reactive protein (CRP) and cell adhesion molecules (CAMs) with adverse birth outcomes. Some epidemiologic studies have indicated that long-term metal exposures can modulate the levels of CRP and CAMs, but the associations between prenatal metal exposures and the levels of CRP and CAMs have yet to be studied more extensively. In this study, we assessed associations between maternal blood metal levels and CRP/CAMs among 617 pregnant women in the Puerto Rico PROTECT birth cohort.
Blood samples were collected from participants at 16-20 (visit 1) and 24-28 (visit 3) weeks gestation. We measured concentrations of 11 metals using inductively coupled plasma mass spectrometry (ICP-MS). From the blood samples, CRP and CAMs intercellular adhesion molecule (ICAM) and vascular cell adhesion molecule (VCAM) were also quantified using a customized Luminex assay. Linear-mixed effects models (LMEs) were used to regress CRP and CAMs on metals and included random intercepts for study participants to account for correlated repeated outcome measures. Fetal sex and visit effects were estimated using interaction terms between metal exposure variables and fetal sex, as well as visit indicators, respectively.
We observed significant positive associations between nickel and CRP (Δ: 7.04, 95% CI = 0.75, 13.73) and between lead and VCAM (Δ: 4.57, 95% CI = 1.36, 7.89). The positive associations were mainly driven by mothers carrying male fetuses. We also observed various visit-specific associations. The significant associations between metals and CRP were predominantly driven by visit 3; however, the significant associations between metals and VCAM were mainly driven by visit 1.
Certain maternal blood metal levels were significantly associated with CRP and CAMs and most of these associations were differentially driven by fetal sex, as well as by timing in pregnancy. Future studies should further explore metal-CRP/CAMs associations for a better understanding of the underlying mechanism of metal-induced adverse birth outcomes.
研究表明，母体C反应蛋白（CRP）和细胞黏附分子（CAMs）水平异常与不良分娩结局之间存在关联。一些流行病学研究表明，长期接触金属可调节CRP和CAMs的水平，但产前金属暴露与CRP和CAMs水平之间的关联尚未得到更广泛的研究。在本研究中，我们评估了波多黎各PROTECT出生队列中617名孕妇的母体血金属水平与CRP/CAMs之间的关联。
在妊娠16 - 20周（第1次访视）和24 - 28周（第3次访视）时采集参与者的血样。我们使用电感耦合等离子体质谱法（ICP-MS）测量11种金属的浓度。从血样中，还使用定制的Luminex检测法对CRP和CAMs细胞间黏附分子（ICAM）和血管细胞黏附分子（VCAM）进行定量。线性混合效应模型（LMEs）用于将CRP和CAMs对金属进行回归，并包括研究参与者的随机截距，以考虑相关的重复结局测量。胎儿性别和访视效应分别使用金属暴露变量与胎儿性别之间的交互项以及访视指标进行估计。
我们观察到镍与CRP之间存在显著正相关（Δ：7.04，95%CI = 0.75，13.73），铅与VCAM之间存在显著正相关（Δ：4.57，95%CI = 1.36，7.89）。这些正相关主要由怀有男胎的母亲驱动。我们还观察到了各种特定访视的关联。金属与CRP之间的显著关联主要由第3次访视驱动；然而，金属与VCAM之间的显著关联主要由第1次访视驱动。
某些母体血金属水平与CRP和CAMs显著相关，并且这些关联大多因胎儿性别以及孕期时间的不同而有所差异。未来的研究应进一步探索金属 - CRP/CAMs之间的关联，以更好地理解金属诱导不良分娩结局的潜在机制。
