Abstract：
BACKGROUND: The cardiotoxicity of prenatal exposure to mercury has been suggested in populations having regular contaminated seafood intake, though replications in the literature are inconsistent.
METHODS: The Timoun Mother-Child Cohort Study was set up in Guadeloupe, an island in the Caribbean Sea where seafood consumption is regular. At seven years of age, 592 children underwent a medical examination, including cardiac function assessment. Blood pressure (BP) was taken using an automated blood pressure monitor, heart rate variability (HRV, 9 parameters) and electrocardiogram (ECG) characteristics (QT, T-wave parameters) were measured using Holter cardiac monitoring during the examination. Total mercury concentrations were measured in cord blood at birth (median = 6.6 μg/L, N = 399) and in the children\'s blood at age 7 (median = 1.7 μg/L, N = 310). Adjusted linear and non-linear modelling was used to study the association of each cardiac parameter with prenatal and childhood exposures. Sensitivity analyses included co-exposures to lead and cadmium, adjustment for maternal seafood consumption, selenium and polyunsaturated fatty acids (n3-PUFAs), and for sporting activity.
RESULTS: Higher prenatal mercury was associated with higher systolic BP at 7 years of age (βlog2 = 1.02; 95% Confidence Interval (CI) = 0.10, 1.19). In boys, intermediate prenatal exposure was associated with reduced overall HRV and parasympathetic activity, and longer QT was observed with increasing prenatal mercury (βlog2 = 4.02; CI = 0.48, 7.56). In girls, HRV tended to increase linearly with prenatal exposure, and no association was observed with QT-wave related parameters. Mercury exposure at 7 years was associated with decreased BP in girls (βlog2 = -1.13; CI = -2.22, -0.004 for diastolic BP). In boys, the low/high-frequency (LF/HF) ratio increased for intermediate levels of exposure.
CONCLUSIONS: Our study suggests sex-specific and non-monotonic modifications in some cardiac health parameters following prenatal exposure to mercury in pre-pubertal children from an insular fish-consuming population.
METHODS: The Timoun Mother-Child Cohort Study was set up in Guadeloupe, an island in the Caribbean Sea where seafood consumption is regular. At seven years of age, 592 children underwent a medical examination, including cardiac function assessment. Blood pressure (BP) was taken using an automated blood pressure monitor, heart rate variability (HRV, 9 parameters) and electrocardiogram (ECG) characteristics (QT, T-wave parameters) were measured using Holter cardiac monitoring during the examination. Total mercury concentrations were measured in cord blood at birth (median = 6.6 μg/L, N = 399) and in the children\'s blood at age 7 (median = 1.7 μg/L, N = 310). Adjusted linear and non-linear modelling was used to study the association of each cardiac parameter with prenatal and childhood exposures. Sensitivity analyses included co-exposures to lead and cadmium, adjustment for maternal seafood consumption, selenium and polyunsaturated fatty acids (n3-PUFAs), and for sporting activity.
RESULTS: Higher prenatal mercury was associated with higher systolic BP at 7 years of age (βlog2 = 1.02; 95% Confidence Interval (CI) = 0.10, 1.19). In boys, intermediate prenatal exposure was associated with reduced overall HRV and parasympathetic activity, and longer QT was observed with increasing prenatal mercury (βlog2 = 4.02; CI = 0.48, 7.56). In girls, HRV tended to increase linearly with prenatal exposure, and no association was observed with QT-wave related parameters. Mercury exposure at 7 years was associated with decreased BP in girls (βlog2 = -1.13; CI = -2.22, -0.004 for diastolic BP). In boys, the low/high-frequency (LF/HF) ratio increased for intermediate levels of exposure.
CONCLUSIONS: Our study suggests sex-specific and non-monotonic modifications in some cardiac health parameters following prenatal exposure to mercury in pre-pubertal children from an insular fish-consuming population.
摘要：
背景：在经常摄入被污染的海鲜的人群中，产前接触汞的心脏毒性已被提出，尽管文献中的复制是不一致的。
方法：在瓜德罗普岛建立了Timoun母婴队列研究，加勒比海的一个岛屿，经常食用海鲜。七岁时，592名儿童接受了体检，包括心功能评估。使用自动血压监测仪测量血压（BP），心率变异性(HRV，9参数）和心电图（ECG）特征（QT，T波参数）在检查过程中使用Holter心脏监测进行测量。在出生时测量脐带血中的总汞浓度（中位数=6.6μg/L，N=399）和7岁儿童血液（中位数=1.7μg/L，N=310）。使用调整的线性和非线性模型来研究每个心脏参数与产前和儿童暴露的关联。敏感性分析包括铅和镉的共同暴露，调整孕妇的海鲜消费，硒和多不饱和脂肪酸（n3-PUFA），和体育活动。
结果：在7岁时，较高的产前汞与较高的收缩压相关（βlog2=1.02；95％置信区间（CI）=0.10，1.19））。在男孩中，中间产前暴露与整体HRV和副交感神经活性降低有关，随着产前汞的增加，观察到QT更长（βlog2=4.02；CI=0.48，7.56）。在女孩中，HRV随着产前暴露呈线性增加趋势，并且没有观察到与QT波相关参数的关联。7年时汞暴露与女孩血压下降相关（舒张压血压βlog2=-1.13，CI=-2.22，-0.004）。在男孩中，对于中等水平的暴露，低/高频（LF/HF）比率增加。
结论：我们的研究表明，产前接触汞后，某些心脏健康参数会发生性别特异性和非单调性改变，来自岛屿鱼类消费群体的青春期前儿童。
方法：在瓜德罗普岛建立了Timoun母婴队列研究，加勒比海的一个岛屿，经常食用海鲜。七岁时，592名儿童接受了体检，包括心功能评估。使用自动血压监测仪测量血压（BP），心率变异性(HRV，9参数）和心电图（ECG）特征（QT，T波参数）在检查过程中使用Holter心脏监测进行测量。在出生时测量脐带血中的总汞浓度（中位数=6.6μg/L，N=399）和7岁儿童血液（中位数=1.7μg/L，N=310）。使用调整的线性和非线性模型来研究每个心脏参数与产前和儿童暴露的关联。敏感性分析包括铅和镉的共同暴露，调整孕妇的海鲜消费，硒和多不饱和脂肪酸（n3-PUFA），和体育活动。
结果：在7岁时，较高的产前汞与较高的收缩压相关（βlog2=1.02；95％置信区间（CI）=0.10，1.19））。在男孩中，中间产前暴露与整体HRV和副交感神经活性降低有关，随着产前汞的增加，观察到QT更长（βlog2=4.02；CI=0.48，7.56）。在女孩中，HRV随着产前暴露呈线性增加趋势，并且没有观察到与QT波相关参数的关联。7年时汞暴露与女孩血压下降相关（舒张压血压βlog2=-1.13，CI=-2.22，-0.004）。在男孩中，对于中等水平的暴露，低/高频（LF/HF）比率增加。
结论：我们的研究表明，产前接触汞后，某些心脏健康参数会发生性别特异性和非单调性改变，来自岛屿鱼类消费群体的青春期前儿童。
