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Sun X, Deng Y, Fang L, Ni M, Wang X, Zhang T, Chen Y, Cai G, Pan F. Association of Exposure to Heavy Metal Mixtures with Systemic Immune-Inflammation Index Among US Adults in NHANES 2011-2016. Biol Trace Elem Res 2024; 202:3005-3017. [PMID: 37817047 DOI: 10.1007/s12011-023-03901-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/30/2023] [Indexed: 10/12/2023]
Abstract
In reality, people are often co-exposed to multiple heavy metals; however, current research has focused on the association between individual heavy metals and inflammation. Therefore, it is more relevant to explore the combined effects of multiple heavy metal exposure on inflammation. The study included data from the National Health and Nutrition Examination Survey (NHANES), 2011-2016. The systemic immune-inflammation index (SII) was used to reflect systemic immune-inflammation status. In this study, single variable models were used to assess the linear and non-linear relationships between single heavy metal exposures and SII. To analyze the combined effect of mixed heavy metals exposure on SII, we constructed three statistical models, including weighted quantile sum (WQS) regression, quantile-based g computation (qgcomp), and Bayesian kernel machine regression (BKMR). The single-exposure analysis found positive associations between multiple heavy metals and SII, while mercury in blood was negatively associated with SII, and U-shaped correlations were observed between blood lead, urine barium and strontium, and SII. In the WQS model, SII increased significantly with increasing concentrations of mixed heavy metals, while consistent results in the qgcomp model, but not statistically significant. In the BKMR model, exposure to heavy metal mixtures was positively associated with SII, with mercury, cadmium, and cobalt in urine contributing the most to the mixed exposure. In addition, synergistic and antagonistic effects between heavy metals on increasing SII were found in our study. In summary, our results reveal that combined exposure to multiple heavy metals is positively associated with SII in the US adults.
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Affiliation(s)
- Xiaoya Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Rd, Hefei, 230032, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yujie Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Rd, Hefei, 230032, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Lanlan Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Rd, Hefei, 230032, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Man Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Rd, Hefei, 230032, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xinqi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Rd, Hefei, 230032, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Tao Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Rd, Hefei, 230032, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yuting Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Rd, Hefei, 230032, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Guoqi Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Rd, Hefei, 230032, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Rd, Hefei, 230032, Anhui, China.
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
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Yanai T, Yoshida S, Takeuchi M, Kawakami C, Kawakami K, Ito S. Association between maternal heavy metal exposure and Kawasaki Disease, the Japan Environment and Children's Study (JECS). Sci Rep 2024; 14:9947. [PMID: 38689029 PMCID: PMC11061304 DOI: 10.1038/s41598-024-60830-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/27/2024] [Indexed: 05/02/2024] Open
Abstract
Kawasaki disease (KD) is an acute systemic vasculitis primarily affecting young children, with an unclear etiology. We investigated the link between maternal heavy metal exposure and KD incidence in children using the Japan Environment and Children's Study, a large-scale nationwide prospective cohort with approximately 100,000 mother-child pairs. Maternal blood samples collected during the second/third trimester were analyzed for heavy metals [mercury (Hg), cadmium (Cd), lead (Pb), selenium (Se), manganese (Mn)], divided into four quartiles based on concentration levels. KD incidence within the first year of life was tracked via questionnaire. Among 85,378 mother-child pairs, 316 children (0.37%) under one year were diagnosed with KD. Compared with the lowest concentration group (Q1), the highest (Q4) showed odds ratios (95% confidence interval) for Hg, 1.29 (0.82-2.03); Cd, 0.99 (0.63-1.58); Pb, 0.84 (0.52-1.34); Se, 1.17 (0.70-1.94); Mn, 0.70 (0.44-1.11), indicating no concentration-dependent increase. Sensitivity analyses with logarithmic transformation and extended outcomes up to age 3 yielded similar results. No significant association was found between maternal heavy metal levels and KD incidence, suggesting that heavy metal exposure does not increase KD risk.
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Affiliation(s)
- Takanori Yanai
- Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine and Public Health, Yoshida-Konoecho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Satomi Yoshida
- Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine and Public Health, Yoshida-Konoecho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Masato Takeuchi
- Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine and Public Health, Yoshida-Konoecho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Chihiro Kawakami
- Kanagawa Regional Center for JECS, Yokohama City University Graduate School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Koji Kawakami
- Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine and Public Health, Yoshida-Konoecho, Sakyo-ku, Kyoto, 606-8501, Japan.
| | - Shuichi Ito
- Kanagawa Regional Center for JECS, Yokohama City University Graduate School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan
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Zhou Y, Zhou J, He Y, Fang J, Tang J, Li S, Guo J, Luo Q, Zhong K, Huang K, Chen G. Associations between prenatal metal exposure and growth rate in children: Based on Hangzhou Birth Cohort Study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 916:170164. [PMID: 38242450 DOI: 10.1016/j.scitotenv.2024.170164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/27/2023] [Accepted: 01/12/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND It has been reported that prenatal metal exposure is associated with child anthropometry. However, studies focusing on the growth rate of anthropometry among children have not been conducted. This study aimed to examine associations between the exposure of multiple metals during pregnancy and the growth rate of anthropometry among offspring. METHODS 743 mother-child pairs from the Hangzhou Birth Cohort Study (HBCS) were included. Levels of eleven metals in mother's blood during pregnancy were measured. Offspring had a mean of 5.7 measurements on anthropometric indicators including weight, length/height, head circumference, and body mass index (BMI) within 1.5 years of birth. Generalized estimating equation (GEE) model was used to investigate the associations between maternal metal exposure and growth rate of anthropometric indicators in children. Stratification analysis by sex was also examined. RESULTS Levels of selenium (Se, β = 0.213, 95 % CI = 0.017 to 0.409, P = 0.033) were positively associated with length/height gain per month in children. Levels of chromium (Cr, β = 0.025, 95 % CI = 0.018 to 0.033, P < 0.001) were positively associated with the rate of weight gain. Levels of manganese (Mn, β = -0.030, 95 % CI = -0.052 to -0.008, P = 0.009) and cobalt (Co, β = -0.012, 95 % CI = -0.024 to -0.000, P = 0.044) were inversely associated with growth rate of head circumference. Children with higher maternal Mn levels had a lower BMI change rate. Associations between metals and growth rate were stronger in girls than in boys. Besides, significant associations between metal mixtures and growth rate were found. CONCLUSION Prenatal exposure to Se, Cr, Mn, and Co was associated with growth rate in children, with sex-specific disparities. Our results suggested important effects of maternal exposure to multiple metals on development in offspring.
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Affiliation(s)
- Yexinyi Zhou
- Department of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Jiena Zhou
- Department of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Yinyin He
- Department of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Jiawei Fang
- Department of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Jun Tang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang 310052, China
| | - Shuai Li
- Department of Clinical Laboratory, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, China
| | - Jing Guo
- Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, China
| | - Qiong Luo
- Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, China
| | - Kunhong Zhong
- Department of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Kegui Huang
- Department of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Guangdi Chen
- Department of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China.
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Takatani T, Takatani R, Eguchi A, Yamamoto M, Sakurai K, Taniguchi Y, Kobayashi Y, Mori C, Kamijima M. Association between maternal blood or cord blood metal concentrations and catch-up growth in children born small for gestational age: an analysis by the Japan environment and children's study. Environ Health 2024; 23:18. [PMID: 38336787 PMCID: PMC10858588 DOI: 10.1186/s12940-024-01061-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 02/04/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Catch-up growth issues among children born small for gestational age (SGA) present a substantial public health challenge. Prenatal exposure to heavy metals can cause adverse effects on birth weight. However, comprehensive studies on the accurate assessment of individual blood concentrations of heavy metals and their effect on the failure to achieve catch-up growth remain unavailable. This study aimed to evaluate the effects of uterine exposure to toxic metals cadmium, lead, and mercury and essential trace metals manganese and selenium at low concentrations on the postnatal growth of children born SGA. METHODS Data on newborn birth size and other factors were obtained from the medical record transcripts and self-administered questionnaires of participants in the Japan Environment and Children's Study. The blood concentrations of lead, cadmium, mercury, selenium, and manganese in pregnant women in their second or third trimester were determined by inductively coupled plasma mass spectrometry. These heavy metal concentrations were also assessed in pregnant women's cord blood. Furthermore, the relationship between each heavy metal and height measure/catch-up growth in SGA children aged 4 years was analyzed using linear and logistic regression methods. These models were adjusted for confounders. RESULTS We studied 4683 mother-child pairings from 103,060 pregnancies included in the Japan Environment and Children's Study. Of these, 278 pairs were also analyzed using cord blood. At 3 and 4 years old, 10.7% and 9.0% of children who were born below the 10th percentile of body weight had height standard deviation scores (SDSs) below 2, respectively. Cord blood cadmium concentrations were associated with the inability to catch up in growth by 3 or 4 years old and the height SDS at 3 years old. In maternal blood, only manganese was positively associated with the height SDS of SGA children aged 2 years; however, it was not significantly associated with catch-up growth in these children. CONCLUSION Cadmium exposure is associated with failed catch-up development in SGA children. These new findings could help identify children highly at risk of failing to catch up in growth, and could motivate the elimination of heavy metal (especially cadmium) pollution to improve SGA children's growth.
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Affiliation(s)
- Tomozumi Takatani
- Department of Pediatrics, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
| | - Rieko Takatani
- Center for Preventive Medical Sciences, Chiba University, Chiba, 263-8522, Japan
| | - Akifumi Eguchi
- Center for Preventive Medical Sciences, Chiba University, Chiba, 263-8522, Japan
| | - Midori Yamamoto
- Center for Preventive Medical Sciences, Chiba University, Chiba, 263-8522, Japan
| | - Kenichi Sakurai
- Center for Preventive Medical Sciences, Chiba University, Chiba, 263-8522, Japan
| | - Yu Taniguchi
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Ibaraki, 305- 8506, Japan
| | - Yayoi Kobayashi
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Ibaraki, 305- 8506, Japan
| | - Chisato Mori
- Center for Preventive Medical Sciences, Chiba University, Chiba, 263-8522, Japan
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, Chiba, 260-8670, Japan
| | - Michihiro Kamijima
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
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Issah I, Duah MS, Arko-Mensah J, Bawua SA, Agyekum TP, Fobil JN. Exposure to metal mixtures and adverse pregnancy and birth outcomes: A systematic review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 908:168380. [PMID: 37963536 DOI: 10.1016/j.scitotenv.2023.168380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/04/2023] [Accepted: 11/04/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Prenatal exposure to metal mixtures is associated with adverse pregnancy and birth outcomes like low birth weight, preterm birth, and small for gestational age. However, prior studies have used individual metal analysis, lacking real-life exposure scenarios. OBJECTIVES This systematic review aims to evaluate the strength and consistency of the association between metal mixtures and pregnancy and birth outcomes, identify research gaps, and inform future studies and policies in this area. METHODS The review adhered to the updated Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) checklist, along with the guidelines for conducting systematic reviews and meta-analyses of observational studies of etiology (COSMOS-E). Our data collection involved searching the PubMed, MEDLINE, and SCOPUS databases. We utilized inclusion criteria to identify relevant studies. These chosen studies underwent thorough screening and data extraction procedures. Methodological quality evaluations were conducted using the NOS framework for cohort and case-control studies, and the AXIS tool for cross-sectional studies. RESULTS The review included 34 epidemiological studies, half of which focused on birth weight, and the others investigated neonate size, preterm birth, small for gestational age, miscarriage, and placental characteristics. The findings revealed significant associations between metal mixtures (including mercury (Hg), nickel (Ni), arsenic (As), cadmium (Cd), manganese (Mn), cobalt (Co), lead (Pb), zinc (Zn), barium (Ba), cesium (Cs), copper (Cu), selenium (Se), and chromium (Cr)) and adverse pregnancy and birth outcomes, demonstrating diverse effects and potential interactions. CONCLUSION In conclusion, this review consistently establishes connections between metal exposure during pregnancy and adverse consequences for birth weight, gestational age, and other vital birth-related metrics. This review further demonstrates the need to apply mixture methods with caution but also shows that they can be superior to traditional approaches. Further research is warranted to deeper understand the underlying mechanisms and to develop effective strategies for mitigating the potential risks associated with metal mixture exposure during pregnancy.
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Affiliation(s)
- Ibrahim Issah
- West Africa Center for Global Environmental & Occupational Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana; Department of Surgery, Tamale Teaching Hospital, Tamale, Ghana.
| | - Mabel S Duah
- West Africa Center for Global Environmental & Occupational Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana; Department of Biological, Environmental and Occupational Health, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana; West African Center for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - John Arko-Mensah
- West Africa Center for Global Environmental & Occupational Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana; Department of Biological, Environmental and Occupational Health, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Serwaa A Bawua
- West Africa Center for Global Environmental & Occupational Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana; Department of Biological, Environmental and Occupational Health, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Thomas P Agyekum
- Department of Occupational and Environmental Health and Safety, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana
| | - Julius N Fobil
- West Africa Center for Global Environmental & Occupational Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana; Department of Biological, Environmental and Occupational Health, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
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Iwata H, Kobayashi S, Itoh M, Itoh S, Mesfin Ketema R, Tamura N, Miyashita C, Yamaguchi T, Yamazaki K, Masuda H, Ait Bamai Y, Saijo Y, Ito Y, Nakayama SF, Kamijima M, Kishi R. The association between prenatal per-and polyfluoroalkyl substance levels and Kawasaki disease among children of up to 4 years of age: A prospective birth cohort of the Japan Environment and Children's study. ENVIRONMENT INTERNATIONAL 2024; 183:108321. [PMID: 38061246 DOI: 10.1016/j.envint.2023.108321] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 01/25/2024]
Abstract
Kawasaki disease (KD) is common among pediatric patients and is associated with an increased risk of later cardiovascular complications, though the precise pathophysiology of KD remains unknown. Per- and polyfluoroalkyl substances (PFAS) have gathered notoriety as the causal pathogens of numerous diseases as well as for their immunosuppressive effects. The present epidemiological study aims to assess whether PFAS may affect KD risk. We evaluated research participants included in the ongoing prospective nationwide birth cohort of the Japan Environment and Children's Study (JECS). Among the over 100,000 pregnant women enrolled in the JECS study, 28 types of PFAS were measured in pregnancy in a subset of participants (N = 25,040). The JECS followed their children born between 2011 and 2014 (n total infants = 25,256; n Kawasaki disease infants = 271), up to age four. Among the 28 types of PFAS, those which were detected in >60 % of participants at levels above the method reporting limit (MRL) were eligible for analyses. Multivariable logistic regressions were implemented on the seven eligible PFAS, adjusting for multiple comparison effects. Finally, we conducted Weighted Quantile Sum (WQS) and Bayesian kernel machine regression (BKMR) to assess the effects of the PFAS mixture on KD. Therefore, we ran the BKMR model using kernel mechanical regression equations to examine PFAS exposure and the outcomes of KD. Upon analysis, the adjusted multivariable regression results did not reach statistical significance for the seven eligible substances on KD, while odds ratios were all under 1.0. WQS regression was used to estimate the mixture effect of the seven eligible PFAS, revealing a negative correlation with KD incidence; similarly, BKMR implied an inverse association between the PFAS mixture effect and KD incidence. In conclusion, PFAS exposure was not associated with increased KD incidence.
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Affiliation(s)
- Hiroyoshi Iwata
- Center for Environmental and Health Sciences, Hokkaido University, North-12, West-7, Kita-ku, Sapporo 060-0812, Japan
| | - Sumitaka Kobayashi
- Center for Environmental and Health Sciences, Hokkaido University, North-12, West-7, Kita-ku, Sapporo 060-0812, Japan; Division of Epidemiological Research for Chemical Disorders, Research Center for Chemical Information and Management, National Institute of Occupational Safety and Health, 6-21-1, Nagao, Tama-ku, Kawasaki 214-8585, Japan
| | - Mariko Itoh
- Center for Environmental and Health Sciences, Hokkaido University, North-12, West-7, Kita-ku, Sapporo 060-0812, Japan
| | - Sachiko Itoh
- Center for Environmental and Health Sciences, Hokkaido University, North-12, West-7, Kita-ku, Sapporo 060-0812, Japan
| | - Rahel Mesfin Ketema
- Center for Environmental and Health Sciences, Hokkaido University, North-12, West-7, Kita-ku, Sapporo 060-0812, Japan; Faculty of Health Sciences, Hokkaido University, North-12, West-5, Kita-ku, Sapporo 060-0812, Japan
| | - Naomi Tamura
- Center for Environmental and Health Sciences, Hokkaido University, North-12, West-7, Kita-ku, Sapporo 060-0812, Japan
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University, North-12, West-7, Kita-ku, Sapporo 060-0812, Japan
| | - Takeshi Yamaguchi
- Center for Environmental and Health Sciences, Hokkaido University, North-12, West-7, Kita-ku, Sapporo 060-0812, Japan
| | - Keiko Yamazaki
- Center for Environmental and Health Sciences, Hokkaido University, North-12, West-7, Kita-ku, Sapporo 060-0812, Japan
| | - Hideyuki Masuda
- Pharmaceutical Sciences, Musashino University, 1-1-20 Shinmachi, Nishitokyo, Tokyo 202-8585, Japan
| | - Yu Ait Bamai
- Center for Environmental and Health Sciences, Hokkaido University, North-12, West-7, Kita-ku, Sapporo 060-0812, Japan; Department of Pharmaceutical Sciences, University of Antwerp, University Square 1, 2610 Wilrijk, Belgium
| | - Yasuaki Saijo
- Division of Public Health and Epidemiology, Department of Social Medicine, Asahikawa Medical University, 1-1-1 Midorigaoka-higashi-2-jo, Asahikawa 078-8510, Japan
| | - Yoshiya Ito
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, 664-1 Akebono-cho, Kitami 090-0011, Japan
| | - Shoji F Nakayama
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba 305-8506, Japan
| | - Michihiro Kamijima
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, North-12, West-7, Kita-ku, Sapporo 060-0812, Japan.
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Chen C, Ma C, Li Q, Hang JG, Shen J, Nakayama SF, Kido T, Lin Y, Feng H, Jung C, Sun XL, Lou J. Prenatal Exposure to Heavy Metals and Adverse Birth Outcomes: Evidence From an E-Waste Area in China. GEOHEALTH 2023; 7:e2023GH000897. [PMID: 38023386 PMCID: PMC10680130 DOI: 10.1029/2023gh000897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 12/01/2023]
Abstract
Electronic waste that has not been properly treated can lead to environmental contamination including of heavy metals, which can pose risks to human health. Infants, a sensitive group, are highly susceptible to heavy metals exposure. The aim of this study was to investigate the association between prenatal heavy metal exposure and infant birth outcomes in an e-waste recycling area in China. We analyzed cadmium (Cd), chromium (Cr), manganese (Mn), lead (Pb), copper (Cu), and arsenic (As) concentrations in 102 human milk samples collected 4 weeks after delivery. The results showed that 34.3% of participants for Cr, which exceeds the World Health Organization (WHO) guidelines, as well as the mean exposure of Cr exceeded the WHO guidelines. We collected data on the birth weight (BW) and length of infants and analyzed the association between metal concentration in human milk and birth outcomes using multivariable linear regression. We observed a significant negative association between the Cd concentration in maternal milk and BW in female infants (β = -162.72, 95% CI = -303.16, -22.25). In contrast, heavy metals did not associate with birth outcomes in male infants. In this study, we found that 34.3% of participants in an e-waste recycling area had a Cr concentration that exceeded WHO guidelines, and there was a significant negative association between prenatal exposure to the Cd and infant BW in females. These results suggest that prenatal exposure to heavy metals in e-waste recycling areas may lead to adverse birth outcomes, especially for female infants.
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Affiliation(s)
- Chen Chen
- School of Medicine, and Huzhou Key Laboratory for Precise Prevention and Control of Major Chronic DiseasesHuzhou UniversityHuzhouChina
| | | | - Qiyao Li
- School of Medicine, and Huzhou Key Laboratory for Precise Prevention and Control of Major Chronic DiseasesHuzhou UniversityHuzhouChina
| | - Jin Guo Hang
- Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical UniversityTaizhouChina
| | - Jiantong Shen
- School of Medicine, and Huzhou Key Laboratory for Precise Prevention and Control of Major Chronic DiseasesHuzhou UniversityHuzhouChina
| | - Shoji F. Nakayama
- Japan Environment and Children's Study Programme OfficeNational Institute for Environmental StudiesTsukubaJapan
| | - Teruhiko Kido
- Faculty of Health SciencesInstitute of Medical, Pharmaceutical, and Health SciencesKanazawa UniversityKanazawaJapan
| | - Yibin Lin
- School of Medicine, and Huzhou Key Laboratory for Precise Prevention and Control of Major Chronic DiseasesHuzhou UniversityHuzhouChina
| | - Hao Feng
- School of MedicineJiaxing UniversityJiaxingChina
| | - Chau‐Ren Jung
- Department of Public HealthCollege of Public HealthChina Medical UniversityTaichungTaiwan
| | - Xian Liang Sun
- School of Medicine, and Huzhou Key Laboratory for Precise Prevention and Control of Major Chronic DiseasesHuzhou UniversityHuzhouChina
- Faculty of Health SciencesInstitute of Medical, Pharmaceutical, and Health SciencesKanazawa UniversityKanazawaJapan
| | - Jianlin Lou
- School of Medicine, and Huzhou Key Laboratory for Precise Prevention and Control of Major Chronic DiseasesHuzhou UniversityHuzhouChina
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8
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Nakamura Y, Kobayashi S, Cho K, Itoh S, Miyashita C, Yamaguchi T, Iwata H, Tamura N, Saijo Y, Ito Y, Seto Y, Honjo R, Ando A, Furuse Y, Manabe A, Kishi R. Prenatal metal concentrations and physical abnormalities in the Japan Environment and Children's Study. Pediatr Res 2023:10.1038/s41390-023-02851-4. [PMID: 37857850 DOI: 10.1038/s41390-023-02851-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 08/22/2023] [Accepted: 09/27/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND The association between prenatal metal exposure and congenital anomalies is unclear. We aimed to examine the association between exposure to cadmium, lead, mercury, selenium, and manganese and physical abnormalities. METHODS Data from 89,887 pregnant women with singleton pregnancies who participated in the Japan Environment and Children's Study (JECS) were used. The correlation between maternal blood metal concentrations and physical abnormalities during the second or third trimester was investigated using logistic regression models. Physical anomalies included those observed at birth or at 1 month, primarily from ICD-10 Chapter 17, particularly congenital anomalies associated with environmental factors (e.g., hypospadias, cryptorchidism, cleft lip and palate, digestive tract atresia, congenital heart disease, and chromosomal abnormalities) and minor abnormalities. RESULTS After adjusting for covariates, the OR (95% CIs) of physical abnormalities for a one-unit rise in Mn concentrations in all individuals were 1.26 (1.08, 1.48). The OR (95% CIs) of physical abnormalities in the 4th quartile (≥18.7 ng/g) were 1.06 (1.01, 1.13) (p-value for the trend = 0.034) compared with those in the 1st quartile (≤12.5 ng/g). CONCLUSION In Japan, maternal blood Mn concentrations above threshold during pregnancy may slightly increase the incidence of physical abnormalities. IMPACT Physical abnormalities (including minor anomalies and congenital anomalies) are associated with prenatal manganese concentrations. They are not associated with cadmium, lead, mercury, and selenium concentrations.
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Affiliation(s)
- Yuichi Nakamura
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Maternity and Perinatal Care Center, Hokkaido University Hospital, Sapporo, Japan
| | - Sumitaka Kobayashi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan.
| | - Kazutoshi Cho
- Maternity and Perinatal Care Center, Hokkaido University Hospital, Sapporo, Japan
| | - Sachiko Itoh
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Takeshi Yamaguchi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Hiroyoshi Iwata
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Naomi Tamura
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Yasuaki Saijo
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Yoshiya Ito
- Division of Clinical Medicine, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
| | - Yoshitaka Seto
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Maternity and Perinatal Care Center, Hokkaido University Hospital, Sapporo, Japan
| | - Ryota Honjo
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Maternity and Perinatal Care Center, Hokkaido University Hospital, Sapporo, Japan
| | - Akiko Ando
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Maternity and Perinatal Care Center, Hokkaido University Hospital, Sapporo, Japan
| | - Yuta Furuse
- Maternity and Perinatal Care Center, Hokkaido University Hospital, Sapporo, Japan
| | - Atsushi Manabe
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Maternity and Perinatal Care Center, Hokkaido University Hospital, Sapporo, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
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9
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Liu Q, Wang D, Li W, Li X, Yang Z, Zhang A, He J, Chen X, Chang Y, Chen X, Tang NJ. Association of chromosomal abnormalities with prenatal exposure to heavy metals: A nested case-control study in high-risk pregnant women in China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 265:115518. [PMID: 37776819 DOI: 10.1016/j.ecoenv.2023.115518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/02/2023]
Abstract
Prenatal exposure to heavy metals causes multiple hazards to fetal growth and development. Epidemiological studies on the association between heavy metals and fetal chromosomal abnormalities (CAs) are lacking. We conducted a nested case-control study in a cohort of high-risk pregnant women in China from September 2018 to June 2021. A total of 387 participants were diagnosed with fetal CAs in the case group and 699 were diagnosed with a normal karyotype in the control group. Amniotic fluid concentrations of 10 metals (barium, cobalt, antimony, manganese, ferrum, copper, selenium, strontium, vanadium, and chromium) were measured using inductively coupled plasma-mass spectrometry. We applied quantile g-computation and weighted quantile sum regression to assess the overall effect of metal mixtures and identify metals with significant weight. Logistic and Poisson regression analyses were used to estimate the effects of metals on CAs and CAs subtypes. Our results showed that the metal mixture concentrations were positively associated with the risk of fetal CAs. In adjusted logistic models, Sb was associated with fetal CAs (OR=1.15, 95% CI: 1.02-1.30), and revealed a linear dose-response relationship between Sb level and the risk of fetal CAs. Additionally, the exploratory analysis revealed that Sb levels were associated with Klinefelter syndrome (OR=1.452, 95% CI: 1.063-1.984) and Turner syndrome (OR=1.698; 95% CI,1.048-2.751). Our study revealed that metal mixtures are associated with a higher risk of fetal CAs and that this association may be driven primarily by Sb. Moreover, we provide a genetic perspective on the effects of heavy metals on sexual development in humans.
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Affiliation(s)
- Qianfeng Liu
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Dan Wang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Wen Li
- Tianjin Central Hospital of Obstetrics and Gynecology, No. 156, Sanma Road, Nankai District, Tianjin 300100, China; Nankai University, Tianjin 30071, China; Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin 300100, China
| | - Xiaoyu Li
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Ze Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Ai Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Jiayu He
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Xu Chen
- Tianjin Central Hospital of Obstetrics and Gynecology, No. 156, Sanma Road, Nankai District, Tianjin 300100, China; Nankai University, Tianjin 30071, China; Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin 300100, China
| | - Ying Chang
- Tianjin Central Hospital of Obstetrics and Gynecology, No. 156, Sanma Road, Nankai District, Tianjin 300100, China; Nankai University, Tianjin 30071, China; Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin 300100, China
| | - Xi Chen
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China.
| | - Nai-Jun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
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10
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Li L, Xu J, Zhang W, Wang Z, Liu S, Jin L, Wang Q, Wu S, Shang X, Guo X, Huang Q, Deng F. Associations between multiple metals during early pregnancy and gestational diabetes mellitus under four statistical models. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:96689-96700. [PMID: 37578585 DOI: 10.1007/s11356-023-29121-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 07/29/2023] [Indexed: 08/15/2023]
Abstract
Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy. Metal exposure is an emerging factor affecting the risk of GDM. However, the effects of metal mixture on GDM and key metals within the mixture remain unclear. This study was aimed at investigating the association between metal mixture during early pregnancy and the risk of GDM using four statistical methods and further at identifying the key metals within the mixture associated with GDM. A nested case-control study including 128 GDM cases and 318 controls was conducted in Beijing, China. Urine samples were collected before 13 gestational weeks and the concentrations of 13 metals were measured. Single-metal analysis (unconditional logistic regression) and mixture analyses (Bayesian kernel machine regression (BKMR), quantile g-computation, and elastic-net regression (ENET) models) were applied to estimate the associations between exposure to multiple metals and GDM. Single-metal analysis showed that Ni was associated with lower risk of GDM, while positive associations of Sr and Sb with GDM were observed. Compared with the lowest quartile of Ni, the ORs of GDM in the highest quartiles were 0.49 (95% CI 0.24, 0.98). In mixture analyses, Ni and Mg showed negative associations with GDM, while Co and Sb were positively associated with GDM in BKMR and quantile g-computation models. No significant joint effect of metal mixture on GDM was observed. However, interestingly, Ni was identified as a key metal within the mixture associated with decreased risk of GDM by all three mixture methods. Our study emphasized that metal exposure during early pregnancy was associated with GDM, and Ni might have important association with decreased GDM risk.
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Affiliation(s)
- Luyi Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Jialin Xu
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA, 02115, USA
| | - Wenlou Zhang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Zhaokun Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Shan Liu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Lei Jin
- Institute of Reproductive and Child Health, Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Qi Wang
- Department of Toxicology, School of Public Health, Peking University, Beijing, 100191, China
| | - Shaowei Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, 710061, Shaanxi, China
| | - Xuejun Shang
- Department of Andrology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, 210002, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Qingyu Huang
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, 1799 Jimei Road, Xiamen, 361021, China.
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
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11
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Yim G, McGee G, Gallagher L, Baker E, Jackson BP, Calafat AM, Botelho JC, Gilbert-Diamond D, Karagas MR, Romano ME, Howe CG. Metals and per- and polyfluoroalkyl substances mixtures and birth outcomes in the New Hampshire Birth Cohort Study: Beyond single-class mixture approaches. CHEMOSPHERE 2023; 329:138644. [PMID: 37031836 PMCID: PMC10208216 DOI: 10.1016/j.chemosphere.2023.138644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/10/2023] [Accepted: 04/06/2023] [Indexed: 05/03/2023]
Abstract
We aimed to investigate the joint, class-specific, and individual impacts of (i) PFAS, (ii) toxic metals and metalloids (referred to collectively as "metals"), and (iii) essential elements on birth outcomes in a prospective pregnancy cohort using both established and recent mixture modeling approaches. Participants included 537 mother-child pairs from the New Hampshire Birth Cohort Study. Concentrations of 6 metals and 5 PFAS were measured in maternal toenail clippings and plasma, respectively. Birth weight, birth length, and head circumference at birth were abstracted from medical records. Joint, index-wise, and individual associations of the metals and PFAS concentrations with birth outcomes were evaluated using Bayesian Kernel Machine Regression (BKMR) and Bayesian Multiple Index Models (BMIM). After controlling for potential confounders, the metals-PFAS mixture was associated with a larger head circumference at birth, which was driven by manganese. When using BKMR, the difference in the head circumference z-score when changing manganese from its 25th to 75th percentiles while holding all other mixture components at their medians was 0.22 standard deviations (95% posterior credible interval [CI]: -0.02, 0.46). When using BMIM, the posterior mean of index weight estimates assigned to manganese for head circumference z-score was 0.72 (95% CI: 0, 0.99). Prenatal exposure to the metals-PFAS mixture was not associated with birth weight or birth length by either BKMR or BMIM. Using both traditional and new mixture modeling approaches, prenatal exposure to manganese was associated with a larger head circumference at birth after accounting for exposure to PFAS and multiple toxic and essential metals.
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Affiliation(s)
- Gyeyoon Yim
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
| | - Glen McGee
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada
| | - Lisa Gallagher
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Emily Baker
- Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Brian P Jackson
- Department of Earth Sciences, Dartmouth College, Hanover, NH, USA
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Julianne Cook Botelho
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA; Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH, USA; Dartmouth-Hitchcock Weight and Wellness Center, Department of Medicine at Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA; Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Megan E Romano
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Caitlin G Howe
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
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12
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Okubo H, Nakayama SF. Periconceptional diet quality and its relation to blood heavy metal concentrations among pregnant women: The Japan environment and Children's study. ENVIRONMENTAL RESEARCH 2023; 225:115649. [PMID: 36894116 DOI: 10.1016/j.envres.2023.115649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/01/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Diets contain toxic chemical contaminants as well as essential nutrients, both of which influence the intrauterine environment for foetal growth. However, whether a high-quality diet that is nutritionally healthy also results in lower exposure to chemical contaminants is unknown. OBJECTIVE We examined associations between periconceptional maternal diet quality and circulating concentrations of heavy metals during pregnancy. DESIGN Dietary intake over the year prior to the first trimester of pregnancy was assessed using a validated, self-administered food frequency questionnaire among 81,104 pregnant Japanese women who participated in the Japan Environment and Children's Study. Overall diet quality was determined using the Balanced Diet Score (BDS) based on the Japanese Food Guide Spinning Top, the Healthy Eating Index-2015 (HEI-2015), the Dietary Approaches to Stop Hypertension (DASH) score and the Mediterranean diet score (MDS). We measured whole-blood concentrations of mercury (Hg), lead (Pb) and cadmium (Cd) during the second or third trimester of pregnancy. RESULTS After controlling for confounders, all diet quality scores were positively associated with blood Hg concentrations. By contrast, higher BDS, HEI-2015 and DASH scores were associated with lower concentrations of Pb and Cd. Although the MDS was positively associated with concentrations of Pb and Cd, when dairy products were classified as a beneficial (rather than detrimental) food component, these associations were attenuated. CONCLUSION A high-quality diet may reduce exposure to Pb and Cd but not Hg. Further studies are required to determine the optimal balance between mercury exposure risk and nutritional benefits of high-quality diets prior to pregnancy.
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Affiliation(s)
- Hitomi Okubo
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Ibaraki, Japan; Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan.
| | - Shoji F Nakayama
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Ibaraki, Japan.
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13
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Okubo H, Nakayama SF. Periconceptional maternal diet quality influences blood heavy metal concentrations and their effect on low birth weight: the Japan Environment and Children's Study. ENVIRONMENT INTERNATIONAL 2023; 173:107808. [PMID: 36827813 DOI: 10.1016/j.envint.2023.107808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/09/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Both poor maternal nutrition and toxic heavy metal exposure influence foetal growth and development. However, whether consumption of a variety of healthy foods modifies the association between prenatal heavy metal exposure and foetal growth is unknown. OBJECTIVE We examined whether long-term maternal diet quality in periconception modifies the associations between maternal circulating concentrations of heavy metals and foetal growth. DESIGN Data of 72,317 Japanese women who delivered singleton infants was extracted from the Japan Environment and Children's Study. Maternal diet over a 1-year before the first trimester of pregnancy was assessed using a validated food frequency questionnaire, and overall diet quality was determined using the balanced diet score based on the Japanese Food Guide Spinning Top. Maternal whole-blood concentrations of mercury (Hg), lead (Pb) and cadmium (Cd) were measured during the second/third trimester of pregnancy. Bayesian inference of multiple linear regression analysis was performed to evaluate the relationships between maternal diet quality and the blood concentrations of heavy metals; Bayesian logistic regression was used to analyse the risk of low birth weight (LBW; <2,500 g). RESULTS After controlling for confounders, a high maternal balanced diet score was associated with low concentrations of blood Pb and Cd and high Hg. While all heavy metals assessed were positively associated with LBW risk, a higher maternal balanced diet score was negatively associated with LBW risk. A high-quality maternal diet attenuated the effect of Pb on LBW, an effect that was more marked at high blood Pb concentrations. CONCLUSION A high-quality, 'well-balanced' diet prior to conception may reduce exposure to some heavy metals and mitigate the elevated risk of LBW associated with prenatal Pb exposure in Japanese mother-child pairs.
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Affiliation(s)
- Hitomi Okubo
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Ibaraki, Japan; Research Fellow of Japan Society for the Promortion of Science, Tokyo, Japan.
| | - Shoji F Nakayama
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Ibaraki, Japan.
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14
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Santana AB, Spelta LEW, Sobalvarro JVM, Podestá MHMC, Garcia RCT, Dos Reis TM, Torres LH. Gestational lead exposure and its effects on fetal/infant development - A systematic review. Reprod Toxicol 2023; 117:108342. [PMID: 36758879 DOI: 10.1016/j.reprotox.2023.108342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/05/2023] [Indexed: 02/10/2023]
Abstract
Studies suggest that gestational exposure to lead (Pb) is related to spontaneous abortions, preterm birth, lower infant birth weight and length, and neurological dysfunctions. However, the evidence about its effects during pregnancy exposure on fetal and child development is still poor. Thus, the aim of this systematic review was to verify the association between prenatal exposure to Pb and the occurrence of neurobehavioral deficits, miscarriages, and child mortality. Observational studies with pregnant women exposed to Pb during pregnancy were included, without gender or ethnicity restrictions. The MEDLINE, Cochrane Library, EMBASE, Scopus, Web of Science, and LILACS databases were searched. The reading of titles and abstracts was conducted, followed by reading in full format and data extraction, that were performed independently by two reviewers. The included studies were evaluated by Downs and Black tool and qualitatively synthesized. Certainty of evidence was assessed by Grading of Recommendations Assessment, Development, and Evaluations (GRADE). The study protocol was registered with the Prospective Registry of Systematic Reviews (PROSPERO; CRD42022296750). Among twenty-one studies included, sixteen were classified as prospective cohort, two case-control, one nested case-control, one cohort, and one longitudinal study. No study that evaluated child mortality associated with gestational Pb exposure was found. There is a very low certainty of evidence in the association of gestational Pb exposure and neurobehavioral deficits or miscarriages. This systematic review reflects the poor evidence and the challenges of human toxicology studies, since it was not possible to associate gestational Pb exposure to neurobehavioral deficits, miscarriages, and child mortality.
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Affiliation(s)
- Aleksander Brandão Santana
- Department of Food and Drugs, School of Pharmaceutical Sciences, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700, Alfenas 37130-001, MG, Brazil
| | - Lídia Emmanuela Wiazowski Spelta
- Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, Av. Prof. Lineu Prestes, 580, Butantã, São Paulo 05508-000, SP, Brazil
| | - Joselin Valeska Martinez Sobalvarro
- Department of Food and Drugs, School of Pharmaceutical Sciences, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700, Alfenas 37130-001, MG, Brazil; Department of Health Sciences, Federal University of Paraná, Av. Mayor Lothário Meissner, 623, Jardim Botânico, Curitiba 80210-170, PR, Brazil
| | - Márcia Helena Miranda Cardoso Podestá
- Department of Food and Drugs, School of Pharmaceutical Sciences, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700, Alfenas 37130-001, MG, Brazil
| | - Raphael Caio Tamborelli Garcia
- Department of Pharmaceutical Sciences, Institute of Environmental, Chemical and Pharmaceutical Sciences, Federal University of São Paulo, Diadema, SP, Brazil
| | - Tiago Marques Dos Reis
- Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700, Alfenas 37130-001, MG, Brazil
| | - Larissa Helena Torres
- Department of Food and Drugs, School of Pharmaceutical Sciences, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700, Alfenas 37130-001, MG, Brazil.
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15
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Dou Y, Yin Y, Li Z, Du J, Jiang Y, Jiang T, Guo W, Qin R, Li M, Lv H, Lu Q, Qiu Y, Lin Y, Jin G, Lu C, Ma H, Hu Z. Maternal exposure to metal mixtures during early pregnancy and fetal growth in the Jiangsu Birth Cohort, China. ENVIRONMENTAL RESEARCH 2022; 215:114305. [PMID: 36096164 DOI: 10.1016/j.envres.2022.114305] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/26/2022] [Accepted: 09/06/2022] [Indexed: 06/15/2023]
Abstract
Previous epidemiological studies have reported that prenatal exposure to metals might have influence on fetal growth. Most studies assessed the effect of individual metals, while the investigation on the relationship between multiple metal exposure and fetal growth is sparse. The objective of the present study is to assess the joint impact of metal mixtures on fetal growth during pregnancy. A total of 1275 maternal-infant pairs from the Jiangsu Birth Cohort (JBC) Study were included to investigate the effect of maternal metal exposure on fetal biometry measures at 22-24, 30-32, and 34-36 weeks of gestation. Lead (Pb), arsenic (As), cadmium (Cd), mercury (Hg), chromium (Cr), vanadium(V), thallium (Tl) and barium (Ba) were measured by inductively coupled plasma mass spectrometry (ICP-MS) in maternal urine samples collected in the first trimester. We used general linear models and restricted cubic splines to test dose-response relationships between single metals and fetal growth. The weighted quantile sum (WQS) models were then applied to evaluate the overall effect of all these metals. We observed inverse associations of exposure to Pb, V and Cr with estimated fetal weight (EFW) at 34-36 weeks of gestation. Notably, maternal exposure to metal mixtures was significantly associated with reduced EFW at 34-36 weeks of gestation after adjusting for some covariates and confounders (aβ -0.05 [95% CI: 0.09, -0.01], P = 0.023), and this association was mainly driven by Cr (30.41%), Pb (23.92%), and Tl (15.60%). These findings indicated that prenatal exposure to metal mixtures might impose adverse effects on fetal growth.
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Affiliation(s)
- Yuanyan Dou
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Yin Yin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Obstetrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, 210029, Jiangsu, China
| | - Zhi Li
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Jiangbo Du
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215002, Jiangsu, China
| | - Yangqian Jiang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Tao Jiang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Wenhui Guo
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Rui Qin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Mei Li
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Hong Lv
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215002, Jiangsu, China
| | - Qun Lu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Yun Qiu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215002, Jiangsu, China
| | - Yuan Lin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215002, Jiangsu, China; Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Guangfu Jin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215002, Jiangsu, China
| | - Chuncheng Lu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
| | - Hongxia Ma
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215002, Jiangsu, China.
| | - Zhibin Hu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215002, Jiangsu, China.
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