Mobilization of lead from human bone tissue during pregnancy and lactation - a summary of long-term research
Mobilization of lead from human bone tissue during pregnancy and lactation - a summary of long-term research
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DOI：
10.1016/s0048-9697(02)00355-8
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发表时间：
2003-02-15
影响因子：
9.8
通讯作者：
Donnelly, JB
中科院分区：
文献类型：
--
作者：
Gulson, BL;Mizon, KJ;Donnelly, JB
骨骼是妊娠期和哺乳期铅的潜在内源性来源。我们进行了一项纵向调查，从人类母体骨骼的铅动员，以确定是否在怀孕和哺乳期间从母体骨骼铅动员，如果是这样，什么时候和有多少释放。在这项研究中的主题是移民到澳大利亚（n = 15）的骨骼铅同位素组成（内源性铅）是不同的，在澳大利亚的环境（外源性铅）。该移民队列与6个多代澳大利亚对照组进行了比较。在可能的情况下，在妊娠前、整个妊娠期和产后至少6个月采集生物和环境样本。对移民和澳大利亚母亲的新生儿进行了为期6个月的监测。移民母亲的血铅浓度范围为1.5至20 mug/dl（几何平均值为2.8），澳大利亚母亲的血铅浓度范围为1.9至4.3 mug/dl（几何平均值为2.9）。澳大利亚孕妇对照组的铅同位素组成变化很小，尽管产后期间6例中有3例的血铅浓度增加了约40%，其他3例的血铅浓度从0增加到12%。在移民妊娠受试者中，使用同位素组成，使用外源性铅的修订估计值，14例受试者的骨骼铅对血铅的几何平均贡献约为33%（范围10-88%）。产后期骨骼对血铅的贡献显著大于妊娠期（P < 0.001）。骨骼血铅的贡献更高，变化更一致的那些科目谁在100天内设想的抵达澳大利亚相比，那些谁设想超过100天。在流动人口中，妊娠期和产后血铅浓度的变化各不相同，总体增加20%;产后期间的增加大于妊娠期间（P < 0.001）。据估计，在怀孕期间动员的母体骨骼铅的量，并通过脐带血转移到婴儿平均约79%。骨骼对血铅的贡献增加归因于每日钙摄入量低（约500 mgCa/天），这种情况在移民和澳大利亚受试者中都存在。一项正在进行的临床试验正在为一个新的队列提供钙补充剂。该研究的其他方面的摘要包括并涵盖：怀孕期间和产后骨骼释放的额外通量; X射线荧光法骨铅结果;怀孕期间和产后铅的尿排泄;成年女性和儿童血铅的饮食贡献;新生儿和母亲血液中铅交换率的比较;母乳中的铅与婴儿和母亲的血液、尿液和饮食中的铅的关系;停止母乳喂养后血铅的变化;怀孕期间和产后的尿铅同位素表明内源性铅没有优先分配到血浆中;非人灵长类动物和人类妊娠研究的某些方面的比较。(C)2002 Elsevier Science B. V.保留所有权利。
The skeleton is potential endogenous source of lead during pregnancy and lactation. We have undertaken a longitudinal investigation into the mobilization of lead from the human maternal skeleton to determine whether lead is mobilized from the maternal skeleton during pregnancy and lactation, and if so, when and how much is released. Subjects in the study were migrants to Australia (n = 15) whose skeletal lead isotopic composition (endogenous lead) was different to that prevailing in the Australian environment (exogenous lead). This migrant cohort was compared with 6 multi-generational Australian controls. Biological and environmental samples were taken pre-pregnancy where possible, throughout pregnancy and postpartum for at least 6 months. Newly-born infants of the migrant and Australian mothers were monitored for 6 months. Blood lead concentrations for the migrant mothers ranged from 1.5 to 20 mug/dl (geometric mean 2.8) and for Australian mothers ranged from 1.9 to 4.3 mug/dl (geometric mean 2.9). There was minimal change in lead isotopic composition of the Australian pregnant controls although there were increases of approximately 40% in blood lead concentration in 3 of 6 cases during the postpartum period and from 0 to 12% in the other 3. In the migrant pregnant subjects, the geometric mean skeletal lead contribution to blood lead using the isotopic composition was approximately 33% (range 10-88%) for 14 subjects using a revised estimate for exogenous lead. Skeletal contribution to blood lead during the postpartum period was significantly greater than during pregnancy (P < 0.001). The skeletal contributions to blood lead are higher and the changes are more consistent in those subjects who conceived within 100 days of arrival in Australia compared with those who conceived longer than 100 days. In the migrant subjects, changes in blood lead concentration during pregnancy and postpartum varied from subject to subject with an overall 20% increase; the increases during the postpartum period were greater than during pregnancy (P < 0.001). It was estimated that the amount of maternal skeletal lead mobilized during pregnancy and transferred to the infant via cord blood averaged approximately 79%. The increased skeletal contribution to blood lead is attributed to a low daily calcium intake of approximately 500 mgCa/day, a condition which was present in both migrant and Australian subjects. An ongoing clinical trial is providing a new cohort with calcium supplements. A summary of other aspects of the study is included and covers: additional flux released from the skeleton during pregnancy and postpartum; XRF bone lead results; urinary excretion of lead during pregnancy and postpartum; dietary contribution to blood lead in female adults and children; comparison of rates of exchange of lead in blood of newlyborn infants and mothers; relationships of lead in breast milk to lead in blood, urine and diet of the infant and mother; changes in blood lead after cessation of breastfeeding; urinary lead isotopes during pregnancy and postpartum indicate no preferential partitioning of endogenous lead into plasma; a comparison of some aspects of the nonhuman primate and human pregnancy studies. (C) 2002 Elsevier Science B.V. All rights reserved.