北京学龄儿童有机磷酸酯暴露与血压的纵向关联  

Longitudinal associations between organophosphate esters exposure and blood pressure among school-aged children in Beijing

作　　者：肖惠迪 李梦龙 叶尔林·阿斯哈尔 关梦颖 邹雨辰 吐尔逊阿依·阿不都米吉提 赵瑞兰[2] 胡翼飞 XIAO Huidi;LI Menglong;ASIHAER Yeerlin;GUAN Mengying;ZOU Yuchen;ABUDUMIJITI Tuerxunayi;ZHAO Ruilan;HU Yifei(Department of Child,Adolescent Health and Maternal Care,School of Public Health,Capital Medical University,Beijing(100069),China;不详)

机构地区：[1]首都医科大学公共卫生学院儿少卫生与妇幼保健学系,北京100069 [2]北京市顺义区疾病预防控制中心学校卫生科

出　　处：《中国学校卫生》2024年第4期560-564,569,共6页Chinese Journal of School Health

基　　金：首都卫生发展科研专项项目(首发2022-1G-4262);国家自然科学基金项目(82073574)。

摘　　要：目的分析儿童有机磷酸酯(OPEs)暴露与血压的纵向关联,为识别OPEs暴露对儿童健康影响提供参考依据。方法采用病例队列研究设计,纳入404名来自北京儿童生长与健康队列(PROC)的儿童,于2018年进行基线体格检查、尿液收集、问卷调查,并于2019—2020年和2023年开展随访,根据随访期间是否新发血压偏高分为病例组(n=140)和对照组(n=264)。采用高效液相色谱-质谱联用法检测尿液中二乙基磷酸酯(DEP)、双(2-氯乙基)磷酸酯(BCEP)、双(1-氯-2-丙基)磷酸酯(BCIPP)、二苯基磷酸酯(DPHP)、二丁基磷酸酯(DnBP)、双(1,3-二氯-2-丙基)磷酸酯(BDCIPP)、双(2-丁氧基乙基)磷酸酯(BBOEP)、双(2-丁氧基乙基)-2-羟基乙基磷酸酯(BBOEHEP)和4-羟基苯基二苯基磷酸酯(4-OH-TPHP)9种OPEs代谢物质量体积浓度;建立广义线性混合模型和Quantile g-computation模型分析OPEs单独及混合暴露与儿童血压的纵向关联。结果3个时点(基线、第1次随访、第2次随访)DEP、BCEP、BCIPP、DPHP、DnBP、BDCIPP、BBOEP、BBOEHEP、4-OH-TPHP检出率范围分别为27.7%~92.1%,24.0%~99.3%,39.2%~90.9%。未调整儿童性别、年龄、体质量指数、Tanner分期、父母受教育程度、家庭月收入、高血压家族史等协变量前,BDCIPP质量体积浓度增加和OPEs混合暴露均可能降低儿童收缩压(β值分别为-0.85,-2.40,95%CI分别为-1.69~-0.01,-3.30~-1.50,P值均<0.05);而调整协变量后,OPEs单独或混合暴露与儿童血压的纵向关联均无统计学意义(P值均>0.05)。结论北京学龄儿童普遍暴露于OPEs,虽未发现OPEs暴露与儿童血压之间存在纵向关联,仍建议应尽可能减少儿童暴露。Objective To explore the longitudinal association between organophosphate esters(OPEs)exposure and blood pressure in children,so as to provide a reference for identifying the effects of OPEs exposure on child health.Methods A total of 404 children from the Beijing Child Growth and Health Cohort(PROC)were enrolled using a case cohort study design,baseline physical examination,urine collection,questionnaires survey were administered in 2018 and follow-up surveys in 2019-2020 and 2023.Participants were divided into case group(n=140)and control group(n=264)according to the observation of new onset of high blood pressure during the follow-up period.High performance liquid chromatography-tandem mass spectrometry was used to detect diethyl phosphate(DEP),bis(2-chloroethyl)phosphate(BCEP),bis(1-chloro-2-propyl)phosphate,(BCIPP),diphenyl phosphate(DPHP),dibutyl phosphate(DnBP),bis(1,3-dichloro-2-propyl)phosphate(BDCIPP),bis(2-butoxyethyl)phosphate(BBOEP),bis(2-butoxyethyl)2-hydroxyethyl phosphate(BBOEHEP),4-hydroxyphenyl diphenyl phosphate(4-OH-TPHP).Generalized linear mixed models and Quantile g-computation models were developed to analyze the longitudinal associations between OPEs individual/mixed exposure and blood pressure in children.Results The detection range of 9 OPEs metabolites,including DEP,BCEP,BCIPP,DPHP,DnBP,BDCIPP,BBOEP,BBOEHEP and 4-OH-TPHP at three time points(baseline,first follow-up and second follow-up)were 27.7%-92.1%,24.0%-99.3% and 39.2%-90.9%respectively.Without adjustment for covariates such as gender,age,body mass index,Tanner stage,parental education,and monthly household income,and family history of hypertension,the increase of BDCIPP concentration and mixed exposure of OPEs may reduce children's systolic blood pressure(β=-0.85,-2.40,95%CI=-1.69-0.01,-3.30-1.50,P<0.05).After adjusting for the covariates,the longitudinal association of individual OPEs or mixed exposure with pediatric BP was not statistically significant(P>0.05).Conclusion Children are commonly exposed to OPEs,and although no si

关 键 词：有机磷酸酯 血压 纵向研究 儿童 

分 类 号：R179[医药卫生—妇幼卫生保健] TQ453.22[医药卫生—公共卫生与预防医学] R544[化学工程—农药化工]