邻苯二甲酸酯暴露与2岁幼儿神经发育的关联  

Association between phthalates exposure and neurodevelopment of infants aged two years

作　　者：许思楠 郭剑秋 张济明[1] 朱效宁[1] 刘萍[1] 王彦娜 常秀丽[1] 邬春华[1] 周志俊[1] XU Sinan;GUO Jianqiu;ZHANG Jiming;ZHU Xiaoning;LIU Ping;WANG Yanna;CHANG Xiuli;WU Chunhua;ZHOU Zhijun(School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学公共卫生学院/公共卫生安全教育部重点实验室,上海200032

出　　处：《环境与职业医学》2021年第9期972-978,共7页Journal of Environmental and Occupational Medicine

基　　金：上海市公共卫生三年行动计划重点学科建设项目(GWV-10.1-XK11)。

摘　　要：[背景]邻苯二甲酸酯(PAEs)是一类环境内分泌干扰物,对儿童神经发育、认知功能存在潜在影响。因此研究PAEs暴露对幼儿神经发育影响可为制定儿童卫生保健措施提供科学依据。[目的]评估江苏某农村地区2岁幼儿尿中PAEs暴露水平,并探究其与儿童早期神经发育的关系。[方法]本研究基于"射阳小型出生队列",以2岁时参与随访的331名儿童为研究对象,使用问卷收集幼儿的基本信息并采集尿样;使用"Gesell量表0~3岁智力发育诊断量表"评估儿童神经发育情况。采用高效液相色谱串联质谱法(HPLC-MS/MS)检测幼儿尿中10种PAEs代谢物水平,采用广义线性模型分析PAEs暴露与幼儿神经发育的关联。[结果]2岁幼儿尿中10种PAEs代谢产物检出率范围为93.05%~100.00%。PAEs代谢物浓度几何均值范围为0.25~50.13μg·L-1。2岁幼儿总发育商的均值±标准差为97.58±8.11。幼儿尿中邻苯二甲酸单甲酯(MMP)浓度分别与幼儿应物能区(b=-1.53,95%CI:-2.77~-0.30,P=0.015)、应人能区评分(b=-1.58,95%CI:-2.86~-0.30,P=0.015)和总发育商平均分(b=-1.34,95%CI:-2.53~-0.15,P=0.027)呈负相关;而幼儿尿中邻苯二甲酸单(2-乙基己基)酯(MEHP)浓度与幼儿动作能区评分(b=2.03,95%CI:0.35~3.71,P=0.018)和总发育商平均分(b=1.51,95%CI:0.04~2.96,P=0.045)呈正相关。性别分层分析发现,女童尿中MMP分别与应物能区(b=-1.94,95%CI:-3.81~-0.06,P=0.043)、应人能区(b=-2.80,95%CI:-4.73~-0.87,P=0.004)以及总发育商平均分(b=-1.88,95%CI:-3.69~-0.07,P=0.042)呈负相关;男童中观察到尿MEHP分别与动作能区评分(b=3.17,95%CI:1.01~5.33,P=0.004)及总发育商平均分(b=2.15,95%CI:0.24~4.07,P=0.027)呈正相关。[结论]本研究发现PAEs在该农村地区2岁幼儿体内暴露普遍,PAEs暴露对2岁幼儿神经发育存在潜在影响并具有性别差异。[Background] Phthalates(PAEs), a class of endocrine disrupting chemicals(EDCs), have been linked to potential adverse effects on neurodevelopment and cognitive function of children. Therefore, it is critical to explore the effects of PAEs exposure on neurodevelopment in the earlier life stage and provide scientific evidence for making child health protection measures.[Objective] This study is conducted to assess urinary PAEs levels of two-year-old toddlers, and investigate its association with neurodevelopment during early childhood.[Methods] A total of 331 toddlers aged 2 years from the Sheyang Mini Birth Cohort were enrolled. A questionnaire survey was conducted to collect the socio-demographic information of the toddlers and spot urine samples were collected during the follow-up visits. Urinary concentrations of 10 PAEs metabolites were detected by high performance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS). Gesell Development Schedule (GDS) was administered to assess the neurodevelopment of children. A generalized linear regression model was employed to explore the association between PAEs exposure and infant neurodevelopment.[Results] The positive rates of selected 10 urinary PAEs metabolites were between 93.05% and 100.00%. The urinary PAEs metabolites concentrations(geometric mean) were in the range of 0.25-50.13 μg·L-1. The children’s total development quotient(mean±SD) evaluated by GDS was 97.58±8.11. The urinary mono-methyl phthalate(MMP) concentration was negatively associated with the adaptive domain scores(b=-1.53, 95% CI:-2.77--0.30, P=0.015), the personal-social domain scores(b=-1.58, 95% CI:-2.86--0.30, P=0.015), and the total development quotient(b=-1.34, 95% CI:-2.53--0.15, P=0.027). Conversely, the urinary mono-(2-ethylhexyl) phthalate(MEHP) concentration was positively associated with the motor domain scores(b=2.03, 95% CI: 0.35-3.71, P=0.018) and the total development quotient(b=1.51, 95% CI: 0.04-2.96, P=0.045). In sex-stratified analysis, the urinary concentration of M

关 键 词：邻苯二甲酸酯类 暴露评估 高效液相色谱-串联质谱 神经发育 Gesell量表 幼儿 

分 类 号：R12[医药卫生—环境卫生学]