充足的维生素D水平可能对砷影响近视的发生风险存在保护作用

Associations of prenatal arsenic exposure with myopia in primary school children: modifying effects of vitamin D levels

产前砷暴露与小学生近视的关联：维生素D的修饰作用

Authors: Juan Tong, Chunmei Liang, Shuman Tao, Xing Wang, Hong Gan, Jixing Zhou, Menglong Geng, Shuangqin Yan, Guopeng Gao, Liu Jiang, Xiaoyan Wu, Kun Huang, Fangbiao Tao.

Source: Environmental Research

DOI: 10.1016/j.envres.2024.120366.

Abstract

The increasing role of environmental pollutants and nutrients in the development of myopia. Further longitudinal evidence is needed to elucidate the effects of early-life environmental pollutants on myopia and nutrients to protect against pollutant-induced myopia. We used mother-child dyads from the Ma'anshan Birth Cohort (n = 2028) to explore the modifying effects of maternal vitamin D status of prenatal and childhood arsenic exposure with refractive parameters and myopia. We measured serum or plasma arsenic concentrations during three trimesters, in cord blood, in childhood (5-year-old), and performed cycloplegic refraction in children aged 7 to 9 years (n = 1616). Primary outcomes were myopia and refractive parameters including axial length (AL), corneal radius of curvature, and spherical equivalent refraction error. Linear regression, logistic regression, and multiple informant models were performed for the association of prenatal and childhood arsenic exposure with vision health. Sex- and vitamin D status stratification analyses were also conducted. Cord serum arsenic was positively associated with AL (β = 0.15, 95%CI: 0.01, 0.29) and the risk of developing myopia (OR = 1.72, 95%CI: 1.07, 2.75). Among boys, a 1 ng/L increase in cord serum log10-transformed arsenic resulted in larger AL and a higher risk of myopia. In the vitamin D deficient group (<20 ng/mL), cord serum arsenic showed positive associations with AL (0.26 [0.06, 0.46]) and the risk of myopia (1.99 [1.01, 3.90]). Late pregnancy arsenic exposure likely affects offspring development of myopia, especially in boys. Maternal sufficient vitamin D may confer protective effects against the development of myopia.

Keywords: Arsenic; Cohort; Myopia; Prenatal; Vitamin D.

 摘要

环境污染物和营养素在近视进展中的作用愈加显著。需要进一步的纵向证据来阐明生命早期环境污染物对近视的影响，以及营养素对环境污染物诱发近视的保护作用。利用马鞍山优生优育队列（n = 2028）中的母子对来探讨母亲维生素D状态在产前和儿童期砷暴露与屈光参数和近视关联中的调节作用。我们测量了三个孕期、脐带血和儿童期（5岁）的血清或血浆砷浓度，并对7～9岁儿童（n = 1616）进行了睫状肌麻痹验光检查。主要结局是近视和屈光参数，包括眼轴长度、角膜曲率半径和等效球镜度。采用线性回归、逻辑回归和多信息模型分析产前和儿童期砷暴露与视力健康的关联。此外，还进行了性别和维生素D状态分层分析。脐带血清砷与眼轴长度（β = 0.15，95%CI：0.01，0.29）和近视发生风险（OR = 1.72，95%CI：1.07，2.75）呈正相关。在男孩中，脐带血清中经log₁₀转换的砷含量每增加1 ng/L，眼轴长度和近视发生风险随之增加。在维生素D缺乏组（<20 ng/mL），脐带血清砷与眼轴长度（0.26 [0.06, 0.46]）和近视发生风险（1.99 [1.01, 3.00]）呈正相关。妊娠后期接触砷可能会影响后代的近视发展，尤其是在男孩中。母体充足的维生素D可能对近视的发生有保护作用。