Huang Yujing, Tan Yao, Wang Lingqiao, Lan Lan, Luo Jiaohua, Wang Jia, Zeng Hui, Shu Weiqun
Department of Environmental Hygiene, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China.
Department of Communicable Disease Prevention and Management, Chongqing Municipal Corps of Integrated Health Administrative Law Enforcement, Chongqing, China.
Front Nutr. 2023 Mar 9;10:1133488. doi: 10.3389/fnut.2023.1133488. eCollection 2023.
Homocysteine (Hcy) is a critical factor for cardiovascular injury, and the elevation of Hcy in children will inevitably increase the risk of cardiovascular disease in adulthood. This study explored the effect of very low-mineral water on children's Hcy and cardiovascular health.
This was a retrospective cohort study that recruited two groups of 10-13-year-old children who had consumed direct drinking water (DDW) in school for 4 years. The control group (NW) (119 boys, 110 girls) consumed normal DDW (conductivity 345 μs/cm). The very low-mineral water consumption group (VLW) (223 boys, 208 girls) consumed very low-mineral DDW (conductivity 40.0 μs/cm). Serum Hcy, Hcy metabolites, cofactors of Hcy metabolism, and cardiovascular biomarkers were assessed and standardized by age- and sex-specific Z-scores, and the differences between the two groups were analyzed with independent -test. The relationships between Hcy metabolism biomarkers and key factors, cardiovascular biomarkers, serum Ca, and mineral intake were analyzed with linear regression.
Compared with the NW group, the VLW group had significantly higher serum Hcy, Apo-B, Apo-B/A1, and oxLDL, and lower serum 1,25,(OH)D, vitamin B6 and B12, 5-methyltetrahydrofolate, and Apo-A1. Serum Hcy was positively associated with serum Apo-B and Apo-B/A1, and negatively associated with Ca intake from water and serum 1,25,(OH)D.
This study suggested that drinking very low-mineral water may increase Hcy level and oxidative stress, worsen lipid profile, and threaten the cardiovascular system in children. Reducing 1,25,(OH)D, and disordering of calcium metabolism might play important roles. This study first established an association between demineralized drinking water and cardiovascular health in children, suggesting a new environmental concern risk to cardiovascular health.
同型半胱氨酸（Hcy）是心血管损伤的关键因素，儿童体内Hcy水平升高将不可避免地增加成年后患心血管疾病的风险。本研究探讨了极低矿物质水对儿童Hcy及心血管健康的影响。
这是一项回顾性队列研究，招募了两组在学校饮用直饮水4年的10至13岁儿童。对照组（NW）（119名男孩，110名女孩）饮用正常直饮水（电导率345μs/cm）。极低矿物质水饮用组（VLW）（223名男孩，208名女孩）饮用极低矿物质直饮水（电导率40.0μs/cm）。对血清Hcy、Hcy代谢产物、Hcy代谢辅助因子及心血管生物标志物进行评估，并按年龄和性别特异性Z分数进行标准化，两组间差异采用独立样本t检验分析。采用线性回归分析Hcy代谢生物标志物与关键因素、心血管生物标志物、血清钙及矿物质摄入量之间的关系。
与NW组相比，VLW组血清Hcy、载脂蛋白B（Apo-B）、Apo-B/A1及氧化型低密度脂蛋白（oxLDL）显著升高，而血清1,25-(OH)D、维生素B6和B12、5-甲基四氢叶酸及载脂蛋白A1（Apo-A1）降低。血清Hcy与血清Apo-B和Apo-B/A1呈正相关，与水中钙摄入量和血清1,25-(OH)D呈负相关。
本研究表明，饮用极低矿物质水可能会升高儿童的Hcy水平和氧化应激，恶化血脂状况，并威胁心血管系统。降低1,25-(OH)D水平及钙代谢紊乱可能起重要作用。本研究首次建立了软化饮用水与儿童心血管健康之间的关联，提示了心血管健康的一个新的环境关注风险。
