Attention-Deficit/Hyperactivity Disorder and Urinary Metabolites of Organophosphate Pesticides
Attention-Deficit/Hyperactivity Disorder and Urinary Metabolites of Organophosphate Pesticides
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DOI：
10.1542/peds.2009-3058
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发表时间：
2010-06-01
期刊：
影响因子：
8
通讯作者：
Weisskopf, Marc G.
中科院分区：
文献类型：
--
作者：
Bouchard, Maryse F.;Bellinger, David C.;Weisskopf, Marc G.
目的：我们的目标是研究尿中二烷基磷酸盐代谢产物的有机磷酸盐和注意力缺陷/多动障碍（ADHD）的儿童8至15岁的age.METHODS：横截面数据从全国健康和营养检查调查（2000-2004年）之间的关联，为1139名儿童，谁是美国一般人口的代表。一个结构化的采访与父母被用来确定ADHD的诊断状态，略修改标准的基础上，从精神疾病的诊断和统计手册，第四版。结果：119名儿童符合诊断标准ADHD。尿中磷酸二烷基酯浓度较高的儿童，尤其是磷酸二甲基酯（DMAP）浓度较高的儿童，更有可能被诊断为ADHD。DMAP浓度增加10倍与比值比1.55（95%置信区间：1.14-2.10）相关，并对性别、年龄、种族/民族、贫困/收入比、空腹时间和尿肌酐浓度进行了调整。对于最常检测到的DMAP代谢物二甲基硫代磷酸盐，水平高于可检测浓度中位数的儿童患ADHD的几率是正常儿童的两倍（校正比值比：1.93 [95%可信区间：1.23-3.02]），与未检测水平的儿童相比。这些发现支持了这样的假设，即美国儿童中常见的有机磷暴露水平可能导致ADHD的患病率。需要前瞻性研究来确定这种关联是否是因果关系。儿科2010; 125：e1270-e1277
OBJECTIVE: The goal was to examine the association between urinary concentrations of dialkyl phosphate metabolites of organophosphates and attention-deficit/hyperactivity disorder (ADHD) in children 8 to 15 years of age.METHODS: Cross-sectional data from the National Health and Nutrition Examination Survey (2000-2004) were available for 1139 children, who were representative of the general US population. A structured interview with a parent was used to ascertain ADHD diagnostic status, on the basis of slightly modified criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.RESULTS: One hundred nineteen children met the diagnostic criteria for ADHD. Children with higher urinary dialkyl phosphate concentrations, especially dimethyl alkylphosphate (DMAP) concentrations, were more likely to be diagnosed as having ADHD. A 10-fold increase in DMAP concentration was associated with an odds ratio of 1.55 (95% confidence interval: 1.14-2.10), with adjustment for gender, age, race/ethnicity, poverty/income ratio, fasting duration, and urinary creatinine concentration. For the most-commonly detected DMAP metabolite, dimethyl thiophosphate, children with levels higher than the median of detectable concentrations had twice the odds of ADHD (adjusted odds ratio: 1.93 [95% confidence interval: 1.23-3.02]), compared with children with undetectable levels.CONCLUSIONS: These findings support the hypothesis that organophosphate exposure, at levels common among US children, may contribute to ADHD prevalence. Prospective studies are needed to establish whether this association is causal. Pediatrics 2010; 125: e1270-e1277