上海地区学龄前儿童对羟基苯甲酸酯类物质暴露与肺功能的相关性研究

Associations between paraben exposure and pulmonary function in preschool children in Shanghai

目的·探讨食品、药品和个人护理品中常用防腐剂对羟基苯甲酸酯类物质暴露与儿童肺功能指标的相关性。方法·以2019年8月—2020年1月于上海交通大学医学院附属儿童医院招募的136名5~7岁学龄前儿童为研究对象,收集儿童年龄、身高、体质量指数(body mass index,BMI)、家庭年收入等基线信息。留取尿液样本,采用高效液相色谱串联质谱法(high performance liquid chromatography-tandem mass spectrometry,HPLC-MS/MS)检测5种对羟基苯甲酸酯类物质的浓度,包括对羟基苯甲酸甲酯(methyl 4-hydroxybenzoate,MeP)、对羟基苯甲酸乙酯(ethyl 4-hydroxybenzoate,EtP)、对羟基苯甲酸丙酯(propyl 4-hydroxybenzoate,PrP)、对羟基苯甲酸丁酯(butyl 4-hydroxybenzoate,BuP)和对羟基苯甲酸苄酯(benzyl 4-hydroxybenzoate,BzP)。使用肺功能仪检测儿童用力肺活量(forced vital capacity,FVC)、1 s用力呼气容积(forced expiratory volume in one second,FEV_(1))、FEV_(1)/FVC、最大呼气流量(peak expiratory flow,PEF)和呼气中段流速(forced expiratory flow between the 25th and 75th percentile of forced vital capacity,FEF_(25-75))指标。通过多元线性回归评估儿童尿液中对羟基苯甲酸酯类物质暴露与儿童肺功能指标的相关性。结果·136名学龄前儿童的平均年龄和BMI分别为(5.76±0.84)岁和(15.78±2.86)kg/m2,男性59名(占43.4%),肥胖儿童13名(占9.6%)。学龄前儿童尿液MeP、EtP、PrP、BuP和BzP的检出率分别为97.8%、86.8%、99.3%、77.9%和11.8%;肌酐校正后MeP、EtP、PrP和BuP的中位数水平分别为36.12、3.88、1.50和0.06μg/g。经校正年龄、性别、身高、BMI、早产和家庭年收入等混杂因素后,多元线性回归结果提示,儿童尿液MeP与FVC(β=−0.018,95%CI−0.035~−0.001,P=0.044)、PrP与FEV_(1)(β=−0.032,95%CI−0.051~−0.013,P=0.013)、BuP与FVC(β=−0.018,95%CI−0.034~−0.002,P=0.038)以及BuP与FEV_(1)(β=−0.021,95%CI−0.041~−0.001,P=0.047)均呈显著负相关。结论·上海地区学龄前儿童可能普遍暴露于对羟基苯甲酸酯类物质,对羟基苯甲酸酯类物质暴露与儿童肺功能呈负相关。

Objective·To investigate the association of exposure to parabens,a class of common used preservatives in food,drugs and personal care products,with pulmonary function in preschool children.Methods·A total of 136 preschool children aged 5‒7 years old were recruited from Shanghai children's Hospital,Shanghai Jiao Tong University School of Medicine from August 2019 to January 2020.Baseline information such as children's age,height,body mass index(BMI),and annual family income were collected.Urine samples were taken,and the concentrations of five kinds of urinary paraben were detected by high performance liquid chromatography tandem mass spectrometry(HPLC-MS/MS),including methyl 4-hydroxybenzoate(MeP),ethyl 4-hydroxybenzoate(EtP),propyl 4-hydroxybenzoate(PrP),butyl 4-hydroxybenzoate(BuP)and benzyl 4-hydroxybenzoate(BzP).The forced vital capacity(FVC),forced expiratory volume in one second(FEV_(1)),FEV_(1)/FVC,peak expiratory flow(PEF),forced expiratory flow between the 25th and 75th percentile of forced vital capacity(FEF_(25-75))were measured by using pulmonary function instrument.Multiple linear regressions were conducted to examine the associations between paraben exposure and pulmonary function indexes in children.Results·In the 136 preschool children,the average age and BMI were(5.76±0.84)years and(15.78±2.96)kg/m2 respectively,59(43.4%)were males,and 13(9.6%)were obese children.The detection rates of MeP,EtP,PrP,BuP and BzP were 97.8%,86.8%,99.3%,77.9%and 11.8%,respectively;the median creatinine-adjusted levels of MeP,EtP,PrP,and BuP were 36.12,3.88,1.50 and 0.06μg/g,respectively.After adjusting age,sex,height,BMI,preterm birth,and annual family income,the results of multiple linear regressions suggested significantly negative associations between MeP and FVC(β=−0.018,95%CI−0.035‒−0.001,P=0.044),PrP and FEV_(1)(β=−0.032,95%CI−0.051‒−0.013,P=0.013),BuP and FVC(β=−0.018,95%CI−0.034‒−0.002,P=0.038),as well as BuP and FEV_(1)(β=−0.021,95%CI−0.041‒−0.001,P=0.047).Conclusion·Preschool children in Shanghai may be widely exposed to parabens,and exposure to parabens is negatively associated with child pulmonary function.