生命早期细颗粒物暴露与学龄期儿童孤独症谱系障碍患病风险的关联  

Correlation between early-life exposure to PM2.5 and risk of autism spectrum disorder among school-aged children

作　　者：詹晓玲 陈宇靖 欧晓璇 王馨[1] 李秀红[1] 林力孜 静进[1] ZHAN Xiaoling;CHEN Yujing;OU Xiaoxuan;WANG Xin;LI Xiuhong;LIN Lizi;JING Jin(Department of Maternal and Child Health,School of Public Health,Sun Yat-sen University,Guangzhou(510080);不详)

机构地区：[1]中山大学公共卫生学院妇幼卫生学系,广东广州510080 [2]中山大学公共卫生学院劳动卫生与环境卫生学系/广州市环境污染与健康风险评价重点实验室

出　　处：《中国学校卫生》2023年第2期195-199,共5页Chinese Journal of School Health

基　　金：国家社会科学基金重大项目(20&ZD296);国家自然科学基金项目(82103794)。

摘　　要：目的 探索生命早期细颗粒物(PM_(2.5))暴露与学龄期孤独症谱系障碍(ASD)患病风险的关联,为ASD的早期防控提供依据。方法 采用病例对照设计,于中山大学儿童青少年心理行为发育研究中心招募ASD儿童165名,同期于广州市部分小学招募性别年龄匹配的典型发育(TD)儿童165名。采用问卷收集基本资料,采用社交反应量表(SRS)评估儿童ASD的相关症状表现;采用中国大气成分近实时追踪数据集(TAP)估算生命早期PM_(2.5)暴露(母亲孕前、孕期及儿童出生后2年)。采用条件Logistic回归分析PM_(2.5)暴露与ASD患病风险的关联,广义线性回归模型分析PM_(2.5)暴露与ASD相关症状的关联。结果 ASD儿童母亲孕前1年(55.08±9.34)μg/m^(3),孕期(50.44±8.71)μg/m^(3)以及ASD儿童出生后1年(45.04±8.25)μg/m^(3)、出生后2年(40.19±7.12)μg/m^(3)的PM_(2.5)暴露均高于TD组儿童(47.66±7.63,44.19±7.16,38.95±6.07,35.76±5.65),差异均有统计学意义(t值分别为7.94,7.13,7.70,6.32,P值均<0.05)。校正混杂因素后,母亲孕前、孕期,儿童出生后1年、出生后2年的PM_(2.5)暴露每升高1μg/m^(3),儿童ASD患病风险分别为1.21(95%CI=1.13~1.29)、1.18(95%CI=1.11~1.26)、1.30(95%CI=1.18~1.43)和1.29倍(95%CI=1.17~1.42)。两组儿童均未发现生命早期PM_(2.5)暴露与SRS总分或分量表得分存在关联(P值均>0.05)。结论 生命早期不同阶段的PM_(2.5)暴露均与ASD患病风险有关,在ASD生命早期的防控工作中应对大气颗粒物污染予以重视。Objective To investigate the associations between early-life exposure to particulate matter with an aerodynamic diameter less than 2.5 μm(PM_(2.5)) and the risk of autism spectrum disorder(ASD) among school-aged children.Methods A total of 165 children with ASD and 165 age-and gender-matched typical development(TD) children were recruited. Children’s basic information were obtained via questionnaires, and the severity of ASD symptoms was assessed with Social Responsiveness Scale(SRS). Early-life PM_(2.5)exposure(preconception, entire pregnancy, and the first two years after birth) were extracted from the Tracking Air Pollution in China(TAP) datasets. Conditional Logistic regression and generalized linear model were used to evaluate the associations of early-life exposure to PM_(2.5)with the risk and the ASD severity symptoms, respectively.Results The PM_(2.5)exposure of ASD group during preconception[(55.08±9.34)μg/m^(3)], entire pregnancy[(50.44±8.71)μg/m^(3)], the first year after birth [(45.04±8.25)μg/m^(3)] and the second year after birth [(40.19±7.12)μg/m^(3)] were significant higher than those in TD children [(47.66±7.63, 44.19±7.16, 38.95±6.07, 35.76±5.65)μg/m^(3)](t=7.94, 7.13, 7.70, 6.32, P<0.05). After adjusting for potential confounding, each increase of 1 μg/m^(3) in PM_(2.5)was associated with higher risk of ASD during preconception(OR=1.21, 95%CI=1.13-1.29), entire pregnancy(OR=1.18, 95%CI=1.11-1.26), the first year after birth(OR=1.30, 95%CI=1.18-1.43) and the second year after birth(OR=1.29, 95%CI=1.17-1.42). No similar results were observed regarding the analyses of SRS total and sub-scale scores(P>0.05).Conclusion Early-life exposure to PM_(2.5)is relate to the risk of ASD, these findings indicated that more attention should be paid to ambient PM pollution in the early-life prevention and control of ASD.

关 键 词：生命周期各时期 颗粒物 孤独性障碍 回归分析 儿童 

分 类 号：R748[医药卫生—神经病学与精神病学] R122[医药卫生—临床医学] R179