CAJ | 학술논문

目的分析出生时抗氧化维生素和重金属水平与2岁时智力发育的关系,探讨早期抗氧化维生素对重金属损害智力发育的保护作用.方法采取前瞻性队列研究,随机选取重庆远郊150对产妇及其新生儿.分别采用反相高效液相色谱法(HPLC)、AMA-254液/固相水银分析仪和PE-800 Zeeman原子吸收光谱仪测定母血和脐血维生素A、E、C及铅、镉和汞水平,对产妇问卷调查,幼儿2岁时用Gesell发育量表评估智力发育.结果资料齐全共111对,校正混杂因素后,脐血汞水平与Gesell各能区发育商(DQ)均呈负相关(β=-0.486,β=-0.716,β=-0.846,p=-0.935,β=-0.702,P均＜0.05);脐血维生素E水平与运动、适应、语言和平均DQ均呈正相关(β=0.475,β=0.458,β=0.403,β=0.395,P均＜0.05).将重金属和维生素水平同时纳入回归模型后,脐血维生素E水平与运动、适应和平均DQ仍呈正相关(β=0.449,β=0.412,β=0.349,P均＜0.05);脐血汞水平与适应、语言、个人-社会及平均DQ均呈负相关(B=-0.397,β=-0.727,β=-0.935,β=-0.628,P均＜0.05),与运动DQ的相关性无统计学意义(P=0.0890).维生素A和维生素c不同水平组对Gesell各能区发育商均无明显影响(P均＞0.05);而维生素E水平＞14.8 μmol/L组各能区发育商均高于≤14.8 μmol/L组,除个人-社会发育商外,差异均有显著意义(t=2.93,t=2.06,t=2.13,t=2.27,P均＜0.05);脐血铅水平高组,其个人-社会DQ较低(x2=5.56,P=0.015);脐血镉水平高组,其脐血维生素C水平较低(x2=7.62,P=0.006);脐血汞水平高组,其维生素A胎盘转运率较低(x2=8.02,P=0.005).结论抗氧化维生素A、E、C与重金属铅、镉、汞之间可能有交互作用,出生时抗氧化维生素在重金属对儿童早期智力发育的影响中可能具有保护作用.
목적 분석출생시항양화유생소화중금속수평여2세시지력발육적관계,탐토조기항양화유생소대중금속손해지력발육적보호작용.방법 채취전첨성대렬연구,수궤선취중경원교150대산부급기신생인.분별채용반상고효액상색보법(HPLC)、AMA-254액/고상수은분석의화PE-800 Zeeman원자흡수광보의측정모혈화제혈유생소A、E、C급연、력화홍수평,대산부문권조사,유인2세시용Gesell발육량표평고지력발육.결과 자료제전공111대,교정혼잡인소후,제혈홍수평여Gesell각능구발육상(DQ)균정부상관(β=-0.486,β=-0.716,β=-0.846,p=-0.935,β=-0.702,P균＜0.05);제혈유생소E수평여운동、괄응、어언화평균DQ균정정상관(β=0.475,β=0.458,β=0.403,β=0.395,P균＜0.05).장중금속화유생소수평동시납입회귀모형후,제혈유생소E수평여운동、괄응화평균DQ잉정정상관(β=0.449,β=0.412,β=0.349,P균＜0.05);제혈홍수평여괄응、어언、개인-사회급평균DQ균정부상관(B=-0.397,β=-0.727,β=-0.935,β=-0.628,P균＜0.05),여운동DQ적상관성무통계학의의(P=0.0890).유생소A화유생소c불동수평조대Gesell각능구발육상균무명현영향(P균＞0.05);이유생소E수평＞14.8 μmol/L조각능구발육상균고우≤14.8 μmol/L조,제개인-사회발육상외,차이균유현저의의(t=2.93,t=2.06,t=2.13,t=2.27,P균＜0.05);제혈연수평고조,기개인-사회DQ교저(x2=5.56,P=0.015);제혈력수평고조,기제혈유생소C수평교저(x2=7.62,P=0.006);제혈홍수평고조,기유생소A태반전운솔교저(x2=8.02,P=0.005).결론 항양화유생소A、E、C여중금속연、력、홍지간가능유교호작용,출생시항양화유생소재중금속대인동조기지력발육적영향중가능구유보호작용.
Objective Epidemiologic study on the perinatal interaction of antioxidant vitamins and heavy metals on offspring's intellectual development is extremely limited.The aim of this prospective cohort study was to investigate the status of maternal and cord blood antioxidant vitamins(Vitamin A,E and C)and heavy metMs(lead, cadmium and mercury)at delivery and correlations between these antioxidant vitamins or metals and neurodevelopment of early childhood,and to explore the protective effect of antioxidant vitamins against the injure of heavy metals to intellectual development in children in Tongliang,Chongqing, China.Method A total of 150 pairs of mothers-neonates were recruited.Serum concentrations of vitamin(V)A,vitamin E, vitamin C,lead, cadmium and mercury in maternal and cord blood after delivery were determined and intellectual development was evaluated by Gesell Development Schedule (GDS)at two years of age.Result A total of 111 pairs of maternal-neonatal subjects with completed data were iticluded into statistical analysis.After aajusting for potential confounders.cord blood mercury level was found negatively associated with all the development quotients(DQs)(β=-0.486,β=-0.716,β=-0.846,β=-0.935,β=-0.702,P＜0.05).Cord VE level was positively correlated with motor,adaptation,language and average DQ(β=0.475,β=0.458,β=0.403,β=0.395,P＜0.05).When antioxidant vitamins and heavy metals levels were all included into the multiple regression model, cord vitamin E level was statistically positively related with motor,adaptation and average DQs(β=0.449,β=0.412,β=0.349,P＜0.05).While cord blood mercury level was negatively correlated with adaptation,language,social and average DQ(β=-0.397,β=-0.727,β=-0.935,β=-0.628,P＜0.05),the relationship between cord mercury level and motor DQ was not statistically significant(β=0.0890).The motor,adaptation,language and average DQs in high cord VE group were higher than those in low VE group (t=2.93,t=2.06,t=2.13,t=2.27,P＜0.05).Social DQ in high cord lead group was significantly lower than that in low lead group(x2=5.56,P=0.015).Cord VC level in high cadmium group was significantly lower than that in low cadmium group(x2=7.62,P=0.006).VA placental transport ratio in high mercury group was significantly lower than those in low mercury group(x2=8.02,P=0.005).Conclusion Our data suggested that there may be certain interaction between antioxidant vitamin A,E.C and heavy metals lead,cadmium,mercury.Antioxidant vitamins at delivery may have protective effect on the early neurodevelopment via interaction with the heavy metals.