Confirmation and extension of association of blood lead with attention-deficit/hyperactivity disorder (ADHD) and ADHD symptom domains at population-typical exposure levels.
Confirmation and extension of association of blood lead with attention-deficit/hyperactivity disorder (ADHD) and ADHD symptom domains at population-typical exposure levels.
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DOI：
10.1111/j.1469-7610.2009.02135.x
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发表时间：
2010-01
期刊：
影响因子：
--
通讯作者：
Friderici K
中科院分区：
文献类型：
--
作者：
Nigg JT;Nikolas M;Mark Knottnerus G;Cavanagh K;Friderici K
最近的研究表明，儿童ADHD及其症状范围与血铅水平有关，即使在西方国家典型的背景暴露水平下也是如此。然而，关于铅是否与注意力不集中或ADHD领域内的多动-冲动有关，最近的研究存在分歧。有人寻求对这些问题作出更明确的评价。236名6~17岁儿童(ADHD合并型61例，ADHD以注意力不集中型为主47例，非ADHD对照组99例，未分类交界型、情境型或NOS型29例)。正式的诊断是通过基于半结构化临床访谈和家长和教师评级的最佳评估程序可靠地建立的。采用电感耦合等离子体质谱仪测定全血中铅，方法检出限为0.3μg/dL。血铅水平略低于美国和西欧人口暴露的平均值，平均值为0.73，最高为2.2μg/dL。这是迄今为止研究过的与ADHD有关的最低血铅水平。在对包括智商和产前吸烟暴露在内的协变量进行统计控制后，血铅与ADHD合并型有关，但与注意力不集中型无关。家长和老师的报告表明血铅与Conners认知问题有关，但只有老师的报告显示了对DSM-IV注意力不集中症状的影响。无论测量方法如何，家长报告中的血铅与多动-冲动相关，而教师报告的效果则取决于儿童治疗史。这些发现证实，在典型的美国人群铅暴露的儿童中，仔细识别患有ADHD的儿童也可以发现血铅略有升高的儿童。
Recent studies have suggested that child ADHD and its symptom domains are related to blood lead level, even at background exposure levels typical in western countries. However, recent studies disagreed as to whether lead was related to inattention or hyperactivity-impulsivity within the ADHD domain. More definitive evaluation of these questions was sought. 236 children aged 6–17 years participated (61 ADHD-Combined type, 47 ADHD Predominantly Inattentive type, 99 non-ADHD control, 29 unclassified borderline, situational, or NOS cases). Formal diagnosis was reliably established by a best estimate procedure based on a semi-structured clinical interview and parent and teacher ratings. Lead was assayed from whole blood using inductively coupled plasma mass spectrometry with a method detection limit of 0.3 μg/dL. Blood lead levels were slightly below United States and Western Europe population exposure averages, with a mean of 0.73 and a maximum of 2.2 μg/dL. This is the lowest level of blood lead ever studied in relation to ADHD. After statistical control for covariates including IQ and prenatal smoking exposure, blood lead was associated with ADHD-combined type but not inattentive type. Parent and teacher report indicated association of blood lead with Conners cognitive problems, but only teacher report showed effects on DSM-IV inattention symptoms. Blood lead was associated with hyperactivity-impulsivity in parent report regardless of measurement method, whereas teacher report effects depended on child treatment history. These findings confirm that in children with typical U.S. population lead exposure, careful identification of children with ADHD also identifies children with slightly elevated blood lead.
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影响因子：
5
作者：
Burns, JM;Baghurst, PA;Tong, SL
通讯作者：
Tong, SL
DOI：
10.1375/136905202762342035
发表时间：
2002-12-01
期刊：
TWIN RESEARCH
影响因子：
--
作者：
Purcell, S
通讯作者：
Purcell, S
DOI：
10.1111/j.1469-7610.1988.tb00687.x
发表时间：
1988-01-01
影响因子：
7.6
作者：
SILVA, PA;HUGHES, P;FAED, JM
通讯作者：
FAED, JM
美国儿童的环境有毒物质和注意力缺陷多动障碍的暴露。
影响因子：
10.4
作者：
Braun, Joe M;Kahn, Robert S;Froehlich, Tanya;Auinger, Peggy;Lanphear, Bruce P
通讯作者：
Lanphear, Bruce P
影响因子：
8.3
作者：
Stromberg, Ulf;Lundh, Thomas;Skerfving, Staffan
通讯作者：
Skerfving, Staffan