Zhang Zhuxia, Xie Bo, Zhong Qi, Dai Chenxu, Xu Xijin, Huo Xia
Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, College of Environment and Climate, Jinan University, Guangzhou, 511443, Guangdong, China.
Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China.
Biometals. 2024 Dec;37(6):1537-1549. doi: 10.1007/s10534-024-00624-y. Epub 2024 Aug 17.
The link between exposure to a particular heavy metal or metalloid and the development of anemia is well established. However, the association between combined exposure to multiple heavy metal(loid)s and anemia in children is still lacking in evidence. In this study, a total of 266 children aged 3 to 7 were recruited from Guiyu, China. Inductively coupled plasma mass spectrometry (ICP-MS) was used to measure blood heavy metal(loid) concentrations. Blood cell count, hemoglobin (HGB), mean corpuscular hemoglobin (MCH), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), hematocrit (HCT), and red blood cell distribution width (RDW) were measured by an automated hematology analyzer. Erythrocyte-related parameters were negatively correlated with the Cu and Cu/Zn ratios and positively correlated with Cr, Ni, Zn, and Se by Spearman correlation analysis. Only blood Cu level was negatively correlated with HGB [β = -2.74, (95% Cl: -4.49, -0.995)], MCH [β = -0.505, (95% Cl: -0.785, -0.226)], MCV [β = -1.024, (95% Cl: -1.767, -0.281)], and MCHC [β = -2.137, (95% Cl: -3.54, -0.734)] by multiple linear regression analysis. The Bayesian Kernel Machine Regression (BKMR) model analysis indicated a negative correlation between the combined exposure to Cu, Zn, Pb, and Cr and MCH and MCV. The single-factor analysis showed a considerable statistical difference only with Cu on MCV, MCH, and HGB. Furthermore, the interaction analysis highlighted the interdependent effects of Cu and Zn, Pb and Zn, and Cr and Zn on MCH and MCV levels. Additionally, the oxidation and/or antioxidation reactions may play a significant role in the development of metal(loid)-induced anemia risk. It is crucial to investigate the effects of co-exposure to multiple heavy metal(loid) elements on anemia, especially the interrelationships and mechanisms among them.
接触特定重金属或类金属与贫血发展之间的联系已得到充分证实。然而，儿童同时接触多种重金属（类金属）与贫血之间的关联仍缺乏证据。在本研究中，从中国贵屿招募了266名3至7岁的儿童。采用电感耦合等离子体质谱法（ICP-MS）测量血液中重金属（类金属）浓度。通过自动血液分析仪测量血细胞计数、血红蛋白（HGB）、平均红细胞血红蛋白含量（MCH）、平均红细胞体积（MCV）、平均红细胞血红蛋白浓度（MCHC）、血细胞比容（HCT）和红细胞分布宽度（RDW）。通过Spearman相关性分析，红细胞相关参数与铜及铜/锌比值呈负相关，与铬、镍、锌和硒呈正相关。多元线性回归分析显示，仅血液铜水平与HGB [β = -2.74，（95%置信区间：-4.49，-0.995）]、MCH [β = -0.505，（95%置信区间：-0.785，-0.226）]、MCV [β = -1.024，（95%置信区间：-1.767，-0.281）]和MCHC [β = -2.137，（95%置信区间：-3.54，-0.734）]呈负相关。贝叶斯核机器回归（BKMR）模型分析表明，同时接触铜、锌、铅和铬与MCH和MCV呈负相关。单因素分析显示，仅铜对MCV、MCH和HGB有显著统计学差异。此外，交互作用分析突出了铜与锌、铅与锌以及铬与锌对MCH和MCV水平的相互依存效应。此外，氧化和/或抗氧化反应可能在金属（类金属）诱导的贫血风险发展中起重要作用。研究多种重金属（类金属）元素共同暴露对贫血的影响，尤其是它们之间的相互关系和机制至关重要。
