The association between prenatal perfluoroalkyl substance exposure and symptoms of attention-deficit/hyperactivity disorder in 8-year-old children and the mediating role of thyroid hormones in the Hokkaido study
The association between prenatal perfluoroalkyl substance exposure and symptoms of attention-deficit/hyperactivity disorder in 8-year-old children and the mediating role of thyroid hormones in the Hokkaido study
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北海道研究中产前全氟烷基物质暴露与8岁儿童注意力缺陷/多动障碍症状的关联以及甲状腺激素的中介作用
DOI：
10.1016/j.envint.2021.107026
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发表时间：
2022
影响因子：
11.8
通讯作者：
Kishi Reiko
中科院分区：
文献类型：
--
作者：
Itoh Sachiko;Yamazaki Keiko;Suyama Satoshi;Ikeda-Araki Atsuko;Miyashita Chihiro;Ait Bamai Yu;Kobayashi Sumitaka;Masuda Hideyuki;Yamaguchi Takeshi;Goudarzi Houman;Okada Emiko;Kashino Ikuko;Saito Takuya;Kishi Reiko
研究背景妊娠期甲状腺激素（TH）水平的紊乱与注意缺陷多动障碍（ADHD）的发生有关.妊娠期暴露于全氟烷基物质（PFAS）可能会影响母体和新生儿TH水平;然而，关于TH介导的PFAS对ADHD的影响知之甚少。目的我们研究了母亲PFAS暴露对儿童ADHD症状的影响，以及TH的介导作用。（北海道研究），我们纳入了770对母亲和儿童在2002年和2005年之间招募的产前母亲和脐带血样本。采用超高效液相色谱-三重四极杆串联质谱法测定了孕28-32周孕妇血清中11种PFAS。在妊娠早期（中位11孕周）和出生时的脐带血中测定TH和甲状腺抗体，包括促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT 3）、游离甲状腺素（FT 4）、甲状腺过氧化物酶抗体（TPOAb）和甲状腺球蛋白抗体（TgAb）。父母使用ADHD评定量表（ADHD-RS）对8岁儿童的ADHD症状进行评定。截断值被设置在第80百分位为每个sex. Results显着的逆协会之间的一些PFAS在母亲的血清和ADHD症状的第一个出生的孩子。假设因果关系，我们发现只有一个显着的关联：产妇FT 4介导的估计影响perfluoroundecanoic酸暴露于多动-冲动之间的第一个出生的children.DiscussionHigher PFAS水平在孕妇血清在怀孕期间与ADHD症状的风险较低，在8岁。这种关联在第一个出生的孩子中与多动冲动的关系比与注意力不集中的关系更强。在母亲暴露于PFAS和8岁时ADHD症状减少之间的关联中，妊娠期间TH的介导作用很小。
BackgroundDisruption of thyroid hormone (TH) levels during pregnancy contributes to attention deficit hyperactivity disorder (ADHD). Exposure to perfluoroalkyl substances (PFAS) during gestation may affect levels of maternal and neonatal TH; however, little is known about the effect of PFAS on ADHD mediated by TH.ObjectivesWe investigated the impact of maternal PFAS exposure on children’s ADHD symptoms with the mediating effect of TH.MethodsIn a prospective birth cohort (the Hokkaido study), we included 770 mother–child pairs recruited between 2002 and 2005 for whom both prenatal maternal and cord blood samples were available. Eleven PFAS were measured in maternal serum obtained at 28–32 weeks of gestation using ultra-performance liquid chromatography coupled with triple quadrupole tandem mass spectrometry. TH and thyroid antibody, including thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb) were measured in maternal blood during early pregnancy (median 11 gestational weeks) and in cord blood at birth. ADHD symptoms in the children at 8 years of age were rated by their parents using the ADHD-Rating Scale (ADHD-RS). The cut-off value was set at the 80th percentile for each sex.ResultsSignificant inverse associations were found between some PFAS in maternal serum and ADHD symptoms among first-born children. Assuming causality, we found only one significant association: maternal FT4 mediated 17.6% of the estimated effect of perfluoroundecanoic acid exposure on hyperactivity–impulsivity among first-born children.DiscussionHigher PFAS levels in maternal serum during pregnancy were associated with lower risks of ADHD symptoms at 8 years of age. The association was stronger among first-born children in relation to hyperactivity–impulsivity than with regard to inattention. There was little mediating role of TH during pregnancy in the association between maternal exposure to PFAS and reduced ADHD symptoms at 8 years of age.