Critical windows of exposure for arsenic-associated impairment of cognitive function in pre-school girls and boys: a population-based cohort study
Critical windows of exposure for arsenic-associated impairment of cognitive function in pre-school girls and boys: a population-based cohort study
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DOI：
10.1093/ije/dyr176
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发表时间：
2011-12-01
影响因子：
7.7
通讯作者：
Vahter, M.
中科院分区：
文献类型：
--
作者：
Hamadani, J. D.;Tofail, F.;Vahter, M.
背景在一些横断面研究中，通过饮用水接触砷与学龄儿童的认知功能受损有关；然而，关于暴露的关键窗口的信息很少。方法我们在孟加拉国农村进行了一项以人群为基础的纵向研究。我们采用韦氏学前和初级智力量表[智商(IQ)]对1700名5岁儿童进行了尿砷暴露(U-As；孕期两次，儿童期两次)与发育的相关性评估。结果孕妇孕期U-As中位数为80微克/L(10-90百分位数：25-400微克/L)。1.5岁和5岁时儿童尿量分别为35(12~155)微克/L和51(20~238)微克/L。采用多变量调整回归分析，控制所有可能的混杂因素和失访，我们发现女孩的言语智商(VIQ)和全量表智商(FSIQ)与(LOG)U-AS呈负相关。与1.5年前相比(VIQ：B=-0.85，95%CI=-2.1~0.4；FSIQ：B=-1.4，95%CI=-2.7~-0.1，n=817)，这些相关性是一致的，但与并发砷暴露的相关性更强[VIQ：B=-2.4，95%CI=-3.8~-1.1；FSIQ：B=-1.4，95%CI=-2.7~-0.1，n=817]；FSIQ：B=-0.74，95%CI=-1.9~0.4，n=902)；妊娠晚期(VIQ：B=-1.52，95%CI=-2.6~-0.4；FSIQ：B=-1.35，95%CI=-2.4~-0.3，n=874)；FSIQ：B=-0.92，95%CI=-2.0~-0.2，n=833)。在男孩中，U-AS与所有智商指标都显示出低而不显著的相关性。效应量计算表明，100ug/L的U-AS可使女孩的VIQ和FSIQ降低1~3分。结论5岁时砷暴露对女孩的智商有不良影响，但对男孩的影响不明显。
Background Exposure to arsenic through drinking water has been associated with impaired cognitive function in school-aged children in a few cross-sectional studies; however, there is little information on critical windows of exposure.Methods We conducted a population-based longitudinal study in rural Bangladesh. We assessed the association of arsenic exposure, based on urinary arsenic (U-As; twice during pregnancy and twice in childhood), with the development of about 1700 children at 5 years of age using Wechsler Pre-school and Primary Scale of Intelligence [intelligence quotient (IQ)].Results Median maternal U-As in pregnancy was 80 mu g/l (10-90 percentiles: 25-400 mu g/l). Children's urine contained 35 (12-155) mu g/l and 51 (20-238) mu g/l at 1.5 and 5 years, respectively. Using multivariable-adjusted regression analyses, controlling for all potential confounders and loss to follow-up, we found that verbal IQ (VIQ) and full scale IQ (FSIQ) were negatively associated with (log) U-As in girls. The associations were consistent, but somewhat stronger with concurrent arsenic exposure [VIQ: B = -2.4, 95% confidence interval (CI) = -3.8 to -1.1; FSIQ: B = -1.4, 95% CI = -2.7 to -0.1, n = 817), compared with that at 1.5 years (VIQ: B = -0.85, 95% CI = -2.1 to 0.4; FSIQ: B = -0.74, 95% CI = -1.9 to 0.4, n = 902), late gestation (VIQ: B = -1.52, 95% CI = -2.6 to -0.4; FSIQ: B = -1.35, 95% CI = -2.4 to -0.3, n = 874) and early gestation (VIQ: B = -1.23, 95% CI = -2.4 to -0.06; FSIQ: B = -0.92, 95% CI = -2.0 to -0.2, n = 833). In boys, U-As showed consistently low and non-significant associations with all IQ measures. An effect size calculation indicated that 100 mu g/l U-As was associated with a decrement of 1-3 points in both VIQ and FSIQ in girls.Conclusion We found adverse effects of arsenic exposure on IQ in girls, but not boys, at 5 years of age.