钒暴露与儿童注意缺陷多动障碍症状关联的出生队列研究

Association between vanadium exposure and children’s attention deficit hyperactivity disorder symptoms: A birth cohort study

[背景]钒是一种有毒金属元素,用途广泛,人群可普遍暴露于钒。目前尚缺乏钒暴露与子代神经发育的研究。[目的]了解马鞍山市孕妇和新生儿钒暴露水平,探讨钒暴露与儿童注意缺陷多动障碍(ADHD)症状发生风险之间的关联。[方法]依托马鞍山市优生优育队列,该队列招募2013年5月—2014年9月在马鞍山市妇幼保健院建档立卡的3 474名孕妇,最终纳入2 922对母婴对作为本研究对象。收集孕妇孕早期和孕中期外周血以及新生儿脐带血样本,使用NexION350X电感耦合等离子质谱仪测量孕妇外周血和新生儿脐带血血清钒质量浓度(浓度)。于2016年10月—2018年4月随访36月龄儿童,采用Conners简明症状问卷中文版评估其ADHD症状得分。将血清钒浓度经自然对数转换,并根据血清钒分布水平划分为低( 0.05)。性别分层分析表明,孕早期血清钒浓度自然对数值每增加1个单位,男童和女童ADHD症状发生风险分别增加至3.66(95%CI:1.31~10.25)倍和6.73(95%CI:1.65~27.40)倍;与血清钒低水平组相比,孕早期血清钒高水平组男童、女童ADHD症状发生风险增加(OR=2.03,95%CI:1.14~3.61;OR=2.44,95%CI:1.04~5.73);孕中期和脐带血血清钒水平与男童和女童ADHD症状发生风险之间的关联均无统计学意义(均P> 0.05)。[结论]马鞍山市孕妇普遍暴露于钒;孕早期高水平血清钒会增加儿童ADHD症状发生风险。

[Background] Vanadium is a toxic metal element with a wide range of applications and people can be generally exposed to vanadium. At present, studies investigating the effect of vanadium exposure on offspring’s neurodevelopment are scarce.[Objective] This study aims to determine vanadium exposure levels of pregnant women and newborns in Ma’anshan city and to explore the association of vanadium exposure with the risk of attention deficit hyperactivity disorder(ADHD) symptoms among children.[Methods] The recruitment to the Ma’anshan Birth Cohort was between May 2013 and September 2014. A total of 3 474 women from Ma’anshan Maternal and Child Health Care Center, and 2 922 mother-newborn pairs were finally enrolled in this study. We collected maternal peripheral blood samples during the first and second trimesters and neonatal umbilical cord blood samples. The concentrations of serum vanadium in maternal peripheral blood and neonatal umbilical cord blood were determined by inductively coupled plasma mass spectrometry. Children’s ADHD symptom scores were assessed by the Chinese version of the Conners Abbreviated Symptom Questionnaire at follow-up visits of 36-month-old children between October 2016 and April 2018. We converted serum vanadium concentrations by natural logarithm and divided serum vanadium concentrations into low( 0.05). By sex stratification, for each unit increase of natural logarithm of serum vanadium in the first trimester, the risk of ADHD symptoms among boys and girls increased to 3.66(95% CI: 1.31-10.25) times and 6.73(95% CI: 1.65-27.40) times, respectively;compared with the low level group, the high level group of serum vanadium in the first trimester had an increased risk of ADHD symptoms in both boys and girls(OR=2.03, 95% CI: 1.14-3.61;OR=2.44, 95% CI: 1.04-5.73);there were no significant correlations between vanadium level in the second trimester and umbilical cord blood and the risk of ADHD symptoms in boys and girls(all Ps > 0.05).[Conclusion] The selected pregnant women in Ma’anshan are generally exposed to vanadium;high levels of serum vanadium exposure during the first trimester could increase the risk of ADHD symptoms among children.