减少儿童汞暴露伤害,补充叶酸很重要
创作:Epi汪 审核:Epi汪 2020年01月03日
  • 纳入1442名母婴对,在出生后1-3天内收集母亲血液,并检测其中红细胞和血浆汞暴露水平,同时随访儿童生长情况至15岁;
  • 母亲汞暴露水平与儿童超重/肥胖(OWO)发生风险呈正相关;
  • 汞暴露上四分位的母亲相较于最低四分位的,儿童发生OWO风险增加24%;
  • 其中母亲孕前本身有OWO、糖尿病的,其汞暴露与后代OWO的关联强度更大;
  • 汞暴露与体内叶酸水平对后代OWO的作用存在交互效应,叶酸水平高者,可部分抵消汞暴露对后代OMO的影响。
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Epi汪
本研究利用人群队列数据,分析发现儿童宫内汞暴露水平与其未来发生肥胖的风险呈正相关,这种关联一方面受到母亲超重/肥胖及糖尿病的负面影响,另一方面受到母亲体内叶酸水平的保护作用。即叶酸水平高者,其汞暴露“伤害”较弱。该研究提示了叶酸补充对于预防后代肥胖的潜在作用。
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BMC Medicine [IF:8.775]

In utero exposure to mercury and childhood overweight or obesity: counteracting effect of maternal folate status

宫内汞暴露与儿童超重/肥胖的关联:母亲叶酸水平的抵消作用

10.1186/s12916-019-1442-2

2019-11-28, Article

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Background: Low-dose mercury (Hg) exposure has been associated with cardiovascular diseases, diabetes, and obesity in adults, but it is unknown the metabolic consequence of in utero Hg exposure. This study aimed to investigate the association between in utero Hg exposure and child overweight or obesity (OWO) and to explore if adequate maternal folate can mitigate Hg toxicity.
Methods: This prospective study included 1442 mother-child pairs recruited at birth and followed up to age 15 years. Maternal Hg in red blood cells and plasma folate levels were measured in samples collected 1–3 days after delivery (a proxy for third trimester exposure). Adequate folate was defined as plasma folate ≥ 20.4 nmol/L. Childhood OWO was defined as body mass index ≥ 85% percentile for age and sex.
Results: The median (interquartile range) of maternal Hg levels were 2.11 (1.04–3.70) μg/L. Geometric mean (95% CI) of maternal folate levels were 31.1 (30.1–32.1) nmol/L. Maternal Hg levels were positively associated with child OWO from age 2–15 years, independent of maternal pre-pregnancy OWO, diabetes, and other covariates. The relative risk (RR = 1.24, 95% CI 1.05–1.47) of child OWO associated with the highest quartile of Hg exposure was 24% higher than those with the lowest quartile. Maternal pre-pregnancy OWO and/or diabetes additively enhanced Hg toxicity. The highest risk of child OWO was found among children of OWO and diabetic mothers in the top Hg quartile (RR = 2.06; 95% CI 1.56–2.71) compared to their counterparts. Furthermore, adequate maternal folate status mitigated Hg toxicity. Given top quartile Hg exposure, adequate maternal folate was associated with a 34% reduction in child OWO risk (RR = 0.66, 95% CI 0.51–0.85) as compared with insufficient maternal folate. There was a suggestive interaction between maternal Hg and folate levels on child OWO risk (p for interaction = 0.086).
Conclusions: In this US urban, multi-ethnic population, elevated in utero Hg exposure was associated with a higher risk of OWO in childhood, and such risk was enhanced by maternal OWO and/or diabetes and reduced by adequate maternal folate. These findings underscore the need to screen for Hg and to optimize maternal folate status, especially among mothers with OWO and/or diabetes.

First Authors:
Guoying Wang,Jessica DiBari

Correspondence Authors:
Guoying Wang

All Authors:
Guoying Wang,Jessica DiBari,Eric Bind,Andrew M Steffens,Jhindan Mukherjee,Tami R Bartell,David C Bellinger,Xiumei Hong,Yuelong Ji,Mei-Cheng Wang,Marsha Wills-Karp,Tina L Cheng,Xiaobin Wang

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