孕期（尤其是第二和第三孕期）接触钡可能会增加学龄前儿童的心脏代谢风险

Gestational and Early Childhood Exposure to Barium and Cardiometabolic Risk in Preschoolers: Findings From the Ma'anshan Birth Cohort Study in China

妊娠期和儿童早期钡暴露与学龄前儿童的心脏代谢风险：中国马鞍山出生队列研究的发现

Authors：Juan Tong, Xing Wang, Hong Gan, Hui Gao, Mengjuan Lu, Jixing Zhou, Chunmei Liang, Shuman Tao, Menglong Geng, Shuangqin Yan, Guopeng Gao, Xueqing Wang, Kun Huang, Xiaoyan Wu, Fangbiao Tao

Source：Journal of The American Heart Association

DOI: 10.1161/JAHA.124.037887

Abstract

Background: Animal studies suggest cardiovascular systems may be primary targets for barium toxicity. This study aims to examine longitudinal associations of prenatal and early childhood barium exposure with cardiometabolic risk (CMR) in preschoolers.

Methods: and results: We determined serum or plasma barium concentrations during 3 trimesters, delivery, and early childhood (5 years) from 2291 mother-child dyads within the Ma'anshan Birth Cohort. CMR scores were calculated by summing standardized z scores for glucose, insulin, triglycerides, waist circumference, mean of blood pressure, and high-density lipoprotein cholesterol among 5-year-old children. We employed multiple linear regression and multiple informant models to investigate whole pregnancy and stage-specific associations of barium exposure with CMR scores and individual components and the modifying effects of sex. The ranges of log10-transformed barium from the first trimester to early childhood were 3.39 to 4.61 ng/L. Barium during the whole pregnancy showed positive associations with CMR scores, glucose, and triglycerides and negative association with high-density lipoprotein cholesterol. These significant relationships of barium with CMR scores were mainly manifested in the second and third trimesters. Positive associations were observed between barium during the second and third trimesters and CMR scores, glucose, triglycerides, and negatively associated with high-density lipoprotein cholesterol among boys. In girls, positive associations of barium during the third trimester with CMR scores, glucose, and triglycerides and a negative association with high-density lipoprotein cholesterol were detected.

Conclusions: Barium exposure during pregnancy, especially during the second and third trimesters, may increase CMR in preschoolers. Boys are more vulnerable than girls. These findings support the need for reductions in barium exposure during pregnancy.

Keywords: barium; cardiometabolic risk; cohort; early‐childhood; prenatal.

摘要：

背景：动物实验表明，心血管系统可能是钡毒性的主要靶标。本研究旨在探讨产前和幼儿期钡暴露与学龄前儿童心脏代谢风险（CMR）之间的纵向联系。

方法和结果：我们测定了马鞍山出生队列中 2291 个母子二人在三个孕期、分娩和幼儿期（5 年）的血清或血浆钡浓度。通过对 5 岁儿童的葡萄糖、胰岛素、甘油三酯、腰围、血压平均值和高密度脂蛋白胆固醇的标准化 z 值求和，计算 CMR 分数。我们采用多元线性回归和多信息模型来研究整个妊娠期和特定阶段钡暴露与 CMR 评分和各个组成部分的关系以及性别的调节作用。从怀孕头三个月到幼儿期，钡的对数 10 转换范围为 3.39 至 4.61 纳克/升。整个孕期的钡与 CMR 评分、血糖和甘油三酯呈正相关，而与高密度脂蛋白胆固醇呈负相关。钡餐与 CMR 评分的这些重要关系主要体现在第二和第三个孕期。在男孩中，钡餐与 CMR 评分、血糖、甘油三酯呈正相关，而与高密度脂蛋白胆固醇呈负相关。在女孩中，妊娠三个月的钡餐与 CMR 评分、葡萄糖和甘油三酯呈正相关，与高密度脂蛋白胆固醇呈负相关。

结论：孕期（尤其是第二和第三孕期）接触钡可能会增加学龄前儿童的 CMR。男孩比女孩更容易受到影响。这些研究结果支持在孕期减少钡暴露的必要性。

关键词：钡；心脏代谢风险；队列；幼儿期；产前。