Metal exposure and bone remodeling during pregnancy: Results from the PROGRESS cohort study.
Metal exposure and bone remodeling during pregnancy: Results from the PROGRESS cohort study.
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DOI：
10.1016/j.envpol.2021.116962
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发表时间：
2021-03
影响因子：
8.9
通讯作者：
C. Osorio-Yáñez;M. Sanchez-Guerra;M. Solano;A. Baccarelli;R. Wright;Alison P. Sanders;M. Téllez-Rojo;M. Tamayo-Ortiz
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作者：
C. Osorio-Yáñez;M. Sanchez-Guerra;M. Solano;A. Baccarelli;R. Wright;Alison P. Sanders;M. Téllez-Rojo;M. Tamayo-Ortiz
妊娠的特点是高骨重建，可能是一个窗口的敏感性金属对骨组织的毒性作用。本研究的目的是评估血液中的金属[铅（Pb），镉（Cd）和砷（As）]与妊娠期间骨重建之间的关系。我们研究了来自PROGRESS队列（肥胖、生长、环境和社会压力规划研究）的孕妇。我们测量了血液中的金属浓度，并通过定量超声（QUS）测量了妊娠中期和晚期桡骨的骨重建。考虑到慢性铅暴露，我们测量了铅在胫骨和髌骨产后一个月的K壳X射线荧光。我们使用线性回归模型和线性混合模型评估了多金属浓度与QUS z评分之间的横向和纵向相关性，并对潜在混杂因素进行了调整。妊娠晚期血镉浓度与较低的QUS z评分存在边际相关性[-0.16（95% CI：-0.33，0.007）; P值= 0.06]。混合模型显示，在整个妊娠过程中，血液Cd与平均-0.10 z评分（95% CI：-0.21，0.002; P值= 0.06）纵向和边缘相关。铅和砷的关联都是相反的，但没有达到显着性。此外，髌骨中的骨铅浓度（累积暴露指数）与妊娠期间桡骨z评分为-0.06显著相关（95% CI：-0.10，-0.01; P值= 0.03）。铅和镉的血液水平与较低的QUS桡骨远端z分数在孕妇。髌骨中的骨铅浓度与桡骨中的z分数呈负相关，表明铅对骨组织的长期影响。然而，我们不能排除髌骨Pb和桡骨z评分相关性的反向因果关系的可能性。我们的研究结果支持减少妇女在怀孕期间的金属暴露的重要性，因为在怀孕期间的金属暴露可能会对以后的生活中的骨强度的后果。我们的研究的主要发现是镉的血液水平和半径z分数之间的关联在怀孕期间。髌骨中的骨铅也与半径z评分呈负相关。
Pregnancy is characterized by high bone remodeling and might be a window of susceptibility to the toxic effects of metals on bone tissue. The aim of this study was to assess associations between metals in blood [lead (Pb), cadmium (Cd)and arsenic (As)] and bone remodeling during pregnancy. We studied pregnant woman from the PROGRESS Cohort (Programming Research in Obesity, Growth, and Environment and Social Stress). We measured concentrations of metals in blood and obtained measures of bone remodeling by quantitative ultrasound (QUS) at the radius in the second and third trimester of pregnancy. To account for chronic lead exposure, we measured lead in tibia and patella one-month postpartum with K-shell X-ray fluorescence. We assessed cross-sectional and longitudinal associations between multiple-metal concentrations and QUS z-scores using linear regression models and linear mixed models adjusted for potential confounders. Third trimester blood Cd concentrations were marginal associated with lower QUS z-scores [-0.16 (95% CI: −0.33, 0.007); P-Value = 0.06]. Mixed models showed that blood Cd was longitudinally and marginally associated with an average of −0.10 z-score (95% CI: −0.21, 0.002; P-Value = 0.06) over the course of pregnancy. Associations for Pb and As were all inverse however none reached significance. Additionally, bone Pb concentrations in patella, an index of cumulative exposure, were significantly associated with −0.06 z-score at radius (95% CI: −0.10, −0.01; P-Value = 0.03) during pregnancy. Pb and Cd blood levels are associated with lower QUS distal radius z-scores in pregnant women. Bone Pb concentrations in patella were negatively associated with z-score at radius showing the long-term effects of Pb on bone tissue. However, we cannot exclude the possibility of reverse causality for patella Pb and radius z-score associations. Our results support the importance of reducing women’s metal exposure during pregnancy, as metals exposure during pregnancy may have consequences for bone strength later in life.The main finding of our study is the association between Cd blood levels and radius z-score during pregnancy. Bone lead in patella was also negatively associated with radius z-scores.