Abstract：
BACKGROUND: Exposure to metals during pregnancy can potentially influence blood pressure (BP) in children, but few studies have examined the mixed effects of prenatal metal exposure on childhood BP. We aimed to assess the individual and combined effects of prenatal metal and metalloid exposure on BP in preschool children.
METHODS: A total of 217 mother-child pairs were selected from the Zhuang Birth Cohort in Guangxi, China. The maternal plasma concentrations of 20 metals [e.g. lead (Pb), rubidium (Rb), cesium (Cs), and zinc (Zn)] in early pregnancy were measured by inductively coupled plasmamass spectrometry. Childhood BP was measured in August 2021. The effects of prenatal metal exposure on childhood BP were explored by generalized linear models, restricted cubic spline and Bayesian kernel machine regression (BKMR) models.
RESULTS: In total children, each unit increase in the log10-transformed maternal Rb concentration was associated with a 10.82-mmHg decrease (95% CI: -19.40, -2.24) in childhood diastolic BP (DBP), and each unit increase in the log10-transformed maternal Cs and Zn concentrations was associated with a 9.67-mmHg (95% CI: -16.72, -2.61) and 4.37-mmHg (95% CI: -8.68, -0.062) decrease in childhood pulse pressure (PP), respectively. The log10-transformed Rb and Cs concentrations were linearly related to DBP (P nonlinear=0.603) and PP (P nonlinear=0.962), respectively. Furthermore, an inverse association was observed between the log10-transformed Cs concentration and PP (β =-12.18; 95% CI: -22.82, -1.54) in girls, and between the log10-transformed Rb concentration and DBP (β =-12.54; 95% CI: -23.87, -1.21) in boys, while there was an increasing association between the log10-transformed Pb concentration and DBP there was an increasing in boys (β =6.06; 95% CI: 0.36, 11.77). Additionally, a U-shaped relationship was observed between the log10-transformed Pb concentration and SBP (P nonlinear=0.015) and DBP (P nonlinear=0.041) in boys. Although there was no statistically signiffcant difference, there was an inverse trend in the combined effect of maternal metal mixture exposure on childhood BP among both the total children and girls in BKMR.
CONCLUSIONS: Prenatal exposure to both individual and mixtures of metals and metalloids influences BP in preschool children, potentially leading to nonlinear and sex-specific effects.
METHODS: A total of 217 mother-child pairs were selected from the Zhuang Birth Cohort in Guangxi, China. The maternal plasma concentrations of 20 metals [e.g. lead (Pb), rubidium (Rb), cesium (Cs), and zinc (Zn)] in early pregnancy were measured by inductively coupled plasmamass spectrometry. Childhood BP was measured in August 2021. The effects of prenatal metal exposure on childhood BP were explored by generalized linear models, restricted cubic spline and Bayesian kernel machine regression (BKMR) models.
RESULTS: In total children, each unit increase in the log10-transformed maternal Rb concentration was associated with a 10.82-mmHg decrease (95% CI: -19.40, -2.24) in childhood diastolic BP (DBP), and each unit increase in the log10-transformed maternal Cs and Zn concentrations was associated with a 9.67-mmHg (95% CI: -16.72, -2.61) and 4.37-mmHg (95% CI: -8.68, -0.062) decrease in childhood pulse pressure (PP), respectively. The log10-transformed Rb and Cs concentrations were linearly related to DBP (P nonlinear=0.603) and PP (P nonlinear=0.962), respectively. Furthermore, an inverse association was observed between the log10-transformed Cs concentration and PP (β =-12.18; 95% CI: -22.82, -1.54) in girls, and between the log10-transformed Rb concentration and DBP (β =-12.54; 95% CI: -23.87, -1.21) in boys, while there was an increasing association between the log10-transformed Pb concentration and DBP there was an increasing in boys (β =6.06; 95% CI: 0.36, 11.77). Additionally, a U-shaped relationship was observed between the log10-transformed Pb concentration and SBP (P nonlinear=0.015) and DBP (P nonlinear=0.041) in boys. Although there was no statistically signiffcant difference, there was an inverse trend in the combined effect of maternal metal mixture exposure on childhood BP among both the total children and girls in BKMR.
CONCLUSIONS: Prenatal exposure to both individual and mixtures of metals and metalloids influences BP in preschool children, potentially leading to nonlinear and sex-specific effects.
摘要：
背景：怀孕期间接触金属可能会影响儿童的血压（BP），但是很少有研究检查产前金属暴露对儿童血压的混合影响。我们旨在评估产前金属和类金属暴露对学龄前儿童BP的个体和综合影响。
方法:从广西壮族出生队列中选取217对母子,中国。母体血浆中20种金属的浓度[例如铅（Pb），铷(Rb),铯（Cs），通过电感耦合等离子体光谱法测量妊娠早期的锌（Zn）]。童年BP于2021年8月测量。通过广义线性模型探讨了产前金属暴露对儿童血压的影响，约束三次样条和贝叶斯核机回归(BKMR)模型。
结果：在所有儿童中，log10转化的母体Rb浓度每增加一个单位与儿童舒张压血压(DBP)下降10.82-mmHg(95%CI:-19.40,-2.24)相关,log10转化的母体Cs和Zn浓度的每一个单位增加都与9.67-mmHg（95％CI：-16.72，-2.61）和4.37-mmHg（95％CI：-8.68，-0.062）相关儿童脉压（PP）下降，分别。log10变换的Rb和Cs浓度与DBP（P非线性=0.603）和PP（P非线性=0.962）线性相关，分别。此外，在女孩中观察到log10转化的Cs浓度与PP（β=-12.18；95％CI：-22.82，-1.54）之间呈负相关，在男孩的log10转化的Rb浓度和DBP之间（β=-12.54；95％CI：-23.87，-1.21），虽然log10转化的Pb浓度与DBP之间的相关性增加，但男孩的相关性增加（β=6.06；95％CI：0.36，11.77）。此外,在男孩中，log10转换的Pb浓度与SBP（P非线性=0.015）和DBP（P非线性=0.041）之间观察到U形关系。虽然没有统计学上的显著差异，在BKMR的所有儿童和女孩中,母体金属混合物暴露对儿童血压的综合影响呈相反趋势.
结论：产前暴露于金属和类金属的个体和混合物会影响学龄前儿童的血压，可能导致非线性和特定性别的影响。
方法:从广西壮族出生队列中选取217对母子,中国。母体血浆中20种金属的浓度[例如铅（Pb），铷(Rb),铯（Cs），通过电感耦合等离子体光谱法测量妊娠早期的锌（Zn）]。童年BP于2021年8月测量。通过广义线性模型探讨了产前金属暴露对儿童血压的影响，约束三次样条和贝叶斯核机回归(BKMR)模型。
结果：在所有儿童中，log10转化的母体Rb浓度每增加一个单位与儿童舒张压血压(DBP)下降10.82-mmHg(95%CI:-19.40,-2.24)相关,log10转化的母体Cs和Zn浓度的每一个单位增加都与9.67-mmHg（95％CI：-16.72，-2.61）和4.37-mmHg（95％CI：-8.68，-0.062）相关儿童脉压（PP）下降，分别。log10变换的Rb和Cs浓度与DBP（P非线性=0.603）和PP（P非线性=0.962）线性相关，分别。此外，在女孩中观察到log10转化的Cs浓度与PP（β=-12.18；95％CI：-22.82，-1.54）之间呈负相关，在男孩的log10转化的Rb浓度和DBP之间（β=-12.54；95％CI：-23.87，-1.21），虽然log10转化的Pb浓度与DBP之间的相关性增加，但男孩的相关性增加（β=6.06；95％CI：0.36，11.77）。此外,在男孩中，log10转换的Pb浓度与SBP（P非线性=0.015）和DBP（P非线性=0.041）之间观察到U形关系。虽然没有统计学上的显著差异，在BKMR的所有儿童和女孩中,母体金属混合物暴露对儿童血压的综合影响呈相反趋势.
结论：产前暴露于金属和类金属的个体和混合物会影响学龄前儿童的血压，可能导致非线性和特定性别的影响。
