early life exposure

生命早期暴露
  • 文章类型: Case Reports
    空间生命过程流行病学方法为前瞻性检查空气污染暴露对长期健康结果的影响提供了希望。但现有的研究是有限的。一个重要方面,经常被忽视的是暴露数据在整个生命周期中的全面性。主要目标是精心重建空气污染暴露的历史估计,以包括每个队列成员的产前暴露以及从出生到10年(1977-1987年)的年度暴露。我们将这些来自1265个人的出生队列的数据联系起来,1977年年中生于新西兰奥特罗阿,研究到40岁,研究了历史空气污染数据,以创建从出生到10年(1977-1987年)的暴露估计值。随着时间的推移,空气质量有所改善。然而,结果因人口和社会经济因素而异。未来的研究应该研究不公平的空气污染暴露如何与生命过程中的健康结果相关。
    Spatial life course epidemiological approaches offer promise for prospectively examining the impacts of air pollution exposure on longer-term health outcomes, but existing research is limited. An essential aspect, often overlooked is the comprehensiveness of exposure data across the lifecourse. The primary objective was to meticulously reconstruct historical estimates of air pollution exposure to include prenatal exposure as well as annual exposure from birth to 10 years (1977-1987) for each cohort member. We linked these data from a birth cohort of 1,265 individuals, born in Aotearoa/New Zealand in mid-1977 and studied to age 40, to historical air pollution data to create estimates of exposure from birth to 10 years (1977-1987). Improvements in air quality over time were found. However, outcomes varied by demographic and socioeconomic factors. Future research should examine how inequitable air pollution exposure is related to health outcomes over the life course.
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  • 文章类型: Journal Article
    目的:这项研究的目的是比较事件人群的差异,合并症,以及新诊断的早发性(T2DM)和晚发性T2DM患者之间的降糖药物处方,为临床实践提供现实世界的证据。
    方法:本研究基于上海医院链接数据库(SHLD)。本研究包括2013年至2021年的匿名电子病历(EHR)数据。新诊断的T2DM患者被定义为在过去三年中没有相关诊断记录或降糖药物处方的患者。早发性T2DM定义为在T2DM首次就诊时年龄为18-40岁的患者,代表1980年代以后出生的患者。晚发性T2DM被定义为65-80岁的人群,代表出生在相对不发达时期的人群。
    结果:本研究共纳入35457例新诊断的早发性T2DM患者和149108例新诊断的晚发性T2DM患者。与晚发型T2DM患者相比,更多的早发型T2DM患者在首次就诊时出现血脂异常(9.5%V.S.7.7%,P<0.01),尽管他们的年龄差异显着。早发型T2DM患者更有可能使用二甲双胍,DDP-4i,TZD,SGLT2-i,GLP-1RA在他们第一次访问医院。
    结论:早发性T2DM和晚发性T2DM患者的特征不同。与晚发型T2DM患者相比,早发型T2DM患者更容易出现血脂异常,并有新型的器官保护药物.
    UNASSIGNED: The aim of this study was to compare the differences in incident population, comorbidities, and glucose-lowering drug prescriptions between newly diagnosed patients with early-onset type 2 diabetes mellitus (T2DM) and those with late-onset T2DM to provide real-world evidence for clinical practice.
    UNASSIGNED: This study was based on the Shanghai Hospital Link Database (SHLD). Anonymized electronic medical record (EHR) data from 2013 to 2021 were included in this study. Newly diagnosed patients with T2DM were defined as those without related diagnostic records or glucose-lowering medicine prescriptions in the past 3 years. Early-onset T2DM was defined as patients who were aged 18-40 years old at the first visit for T2DM to represent those who were born after the 1980s. And late-onset T2DM was defined as those aged 65-80 years old to represent those who were born in a relatively undeveloped period. Descriptive statistical analyses were performed to describe their incidence number, glucose-lowering drug prescriptions, and comorbidities at the first visit to the hospital between two T2DM groups.
    UNASSIGNED: There were a total of 35,457 newly diagnosed patients with early-onset T2DM and 149,108 newly diagnosed patients with late-onset T2DM included in this study. Patients with late-onset T2DM constituted the majority and their number increased by 2.5% on average by years, while the number of patients with early-onset T2DM remained stable each year. Compared with late-onset T2DM patients, more early-onset T2DM patients had dyslipidemia at the first visit to hospitals (9.5% vs 7.7%, P < 0.01) despite their significant age differences. Patients with early-onset T2DM were more likely to use metformin (74.8% vs 46.5, P < 0.01), dipeptidyl peptidase-4 inhibitors (DDP-4i) (16.7% vs 11.2%, P < 0.01), thiazolidinediones (TZD) (14.9% vs 8.4%, P < 0.01), sodium glucose cotransporter 2 inhibitors (SGLT2-i) (0.8% vs 0.3%, P < 0.01), and glucagon-like peptide 1 receptor agonists (GLP-1 RA) (3.7% vs 0.5%, P < 0.01) at their first visit to the hospital.
    UNASSIGNED: Different characteristics were observed between patients with early-onset T2DM and those with late-onset T2DM. Compared with patients with late-onset T2DM, those with early-onset T2DM were more prone to dyslipidemia and had novel organ-protective drugs prescribed.
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  • 文章类型: Journal Article
    背景:空气污染暴露与心血管疾病发病率和死亡率相关。尽管生命早期暴露于空气污染可能是心血管疾病危险因素发展的关键窗口,很少有研究对年轻人长期暴露于空气污染与心血管和代谢健康标志物之间的关系进行研究.
    目的:通过将全国青少年与成人健康纵向研究(添加健康)的健康数据与使用降尺度(FAQSD)存档的融合空气质量表面的空气污染数据相结合,我们:(1)计算了AddHealth参与者暴露于臭氧(O3)和空气动力学直径≤2.5µm(PM2.5)的颗粒物的多年估计值;(2)估计了空气污染暴露与心脏代谢健康的多个标记之间的关联.
    方法:AddHealth是一项具有全国代表性的纵向队列研究,研究对象是1994-95年美国(US)超过20,000名12-19岁青少年(WaveI)。参与者在青春期和成年期进行了五次家庭访谈。从FAQSD档案中获得了人口普查区域中O3和PM2.5的每日估计浓度,并用于生成区域级O3和PM2.5浓度的年平均值。我们估计了2002年至2007年的平均O3和PM2.5暴露与第四波(2008-09)测量的心脏代谢健康标志物之间的关联,包括高血压,高脂血症,体重指数(BMI),糖尿病,C反应蛋白,和代谢综合征。
    结果:最终样本量为11,259名个体参与者。IV波参与者的平均年龄为28.4岁(范围:24-34岁)。在调整年龄的模型中,种族/民族,和性,长期的O3暴露(2002-07)与高血压的几率升高有关,比值比(OR)为1.015(95%置信区间[CI]:1.011,1.029);肥胖(1.022[1.004,1.040]);糖尿病(1.032[1.009,1.054]);代谢综合征(1.028[1.014,1.041]);PM2.5暴露(2002-07)与高血压的比值升高(1.022[1.001,1.045])相关。
    结论:研究结果表明,长期的环境空气污染暴露,特别是O3暴露,与成年早期的心脏代谢健康有关。
    Air pollution exposure is associated with cardiovascular morbidity and mortality. Although exposure to air pollution early in life may represent a critical window for development of cardiovascular disease risk factors, few studies have examined associations of long-term air pollution exposure with markers of cardiovascular and metabolic health in young adults.
    By combining health data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) with air pollution data from the Fused Air Quality Surface using Downscaling (FAQSD) archive, we: (1) calculated multi-year estimates of exposure to ozone (O3) and particulate matter with an aerodynamic diameter ≤ 2.5 µm (PM2.5) for Add Health participants; and (2) estimated associations between air pollution exposures and multiple markers of cardiometabolic health.
    Add Health is a nationally representative longitudinal cohort study of over 20,000 adolescents aged 12-19 in the United States (US) in 1994-95 (Wave I). Participants have been followed through adolescence and into adulthood with five in-home interviews. Estimated daily concentrations of O3 and PM2.5 at census tracts were obtained from the FAQSD archive and used to generate tract-level annual averages of O3 and PM2.5 concentrations. We estimated associations between average O3 and PM2.5 exposures from 2002 to 2007 and markers of cardiometabolic health measured at Wave IV (2008-09), including hypertension, hyperlipidemia, body mass index (BMI), diabetes, C-reactive protein, and metabolic syndrome.
    The final sample size was 11,259 individual participants. The average age of participants at Wave IV was 28.4 years (range: 24-34 years). In models adjusting for age, race/ethnicity, and sex, long-term O3 exposure (2002-07) was associated with elevated odds of hypertension, with an odds ratio (OR) of 1.015 (95% confidence interval [CI]: 1.011, 1.029); obesity (1.022 [1.004, 1.040]); diabetes (1.032 [1.009,1.054]); and metabolic syndrome (1.028 [1.014, 1.041]); PM2.5 exposure (2002-07) was associated with elevated odds of hypertension (1.022 [1.001, 1.045]).
    Findings suggest that long-term ambient air pollution exposure, particularly O3 exposure, is associated with cardiometabolic health in early adulthood.
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  • 文章类型: Journal Article
    The independent effect of lead exposure and parental education on children\'s neurocognition is well-documented. However, few studies have examined the combined effect of childhood lead exposure and parental education on adolescent neurocognition, especially in China.
    Examine both the combined and interactive effect of childhood blood lead levels (BLLs) and parental education on early adolescent neurocognition.
    417 children from a longitudinal cohort study in Jintan, China had BLLs measured at 3-5 years and 12 years, parental education levels assessed at 3-5 years, and neurocognitive outcomes tested at 12 years.
    BLLs at 3-5 years were inversely associated with adolescent IQ (β -0.55 95% CI: -0.97, -0.13) but not working memory (β -0.06 95% CI: -0.23, 0.11) and parental education was positively associated with adolescent IQ (β 0.68 95% CI: 0.19, 1.17) and working memory (β 0.24 95% CI: 0.04, 0.44). BLLs and parental education evidenced combined effects on neurocognition, where children with higher BLLs and lower fathers\' education had mean IQ scores 7.84 (95% CI: -13.15, -2.53) points lower than children with lower BLLs and higher fathers\' education. There were significant associations between parental education and working memory, however, not with BLLs. The interaction between mother and father high school education and BLLs was insignificant for effects on IQ and working memory.
    Childhood lead exposure and parental education levels have a combined and long-term impact on IQ, evidence that may partially explain disparities in lead exposure associated outcomes and highlight those children at greatest risk for neurocognitive deficits.
    Children continue to be exposed to low-levels of environmental lead in China and globally, warranting examination of the impact of such exposures. This paper demonstrates that even relatively low-level lead exposure in early childhood significantly influences adolescent neurocognitive functioning. Furthermore, co-existing social determinant of health-related variables, measured here as parental education, have a combined impact on neurocognition. These results highlight children at greater risk for neurocognitive deficits and demonstrate the need to examine the influence of lead exposure within the broader socio- ecological environment, as these factors work in tandem to influence longer-term neurocognitive outcomes.
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  • 文章类型: Journal Article
    现在越来越多的证据表明,在大脑发育的关键早期阶段暴露于环境污染物可能导致自闭症谱系障碍(ASD)的出现。本研究旨在比较六溴环十二烷(α-HBCDD)的α-异构体的发育神经毒性,持久性溴化阻燃剂,啮齿动物ASD的丙戊酸(VPA)模型。怀孕的Wistar大鼠分为三组:对照组,α-HBCDD(100ng/kg/天p.o.,GD0-PND21)和VPA(600mg/kg腹膜内注射,GD12)。从PND2-21测试雄性后代的神经运动发育。在PND21,通过测量细胞色素氧化酶活性(CO)来评估脑功能。在皮质中评估了神经胶质和突触可塑性的修饰。在两个治疗组中观察到与神经运动成熟和噪声反应相关的类似细微行为变化。在PND21时,仅在VPA组中测量到CO活性的降低,在包括听觉核在内的特定区域,视觉皮层,扣带和额叶皮质。在相同的年龄,α-HBCDD指出突触可塑性的皮质标记物显着过表达,而两个治疗组均显示星形胶质细胞蛋白(S100-β和GFAP)的显着表达不足。早期暴露于低剂量的α-HBCDD可能会引发与ASD一致的神经行为改变。
    Evidence is now growing that exposure to environmental pollutants during the critical early-life period of brain development may contribute to the emergence of Autism Spectrum Disorders (ASD). This study seeks to compare the developmental neurotoxicity of the α-isomer of hexabromocyclododecane (α-HBCDD), a persistent brominated flame retardant, to the valproic acid (VPA) model of ASD in rodents. Pregnant Wistar rats were divided into three groups: control, α-HBCDD (100 ng/kg/day p.o., GD0-PND21) and VPA (600 mg/kg i.p., GD12). Male offspring were tested for their neuromotor development from PND2-21. At PND21, brain functionality was assessed by measuring cytochrome oxidase activity (CO). Modifications in neuroglia and synaptic plasticity were evaluated in the cortex. Similar subtle behavioural changes related to neuromotor maturation and noise reaction were observed in both treated groups. At PND21, a reduction in CO activity was measured in the VPA group only, in specific areas including auditory nuclei, visual cortex, cingulate and frontal cortices. At the same age, α-HBCDD pointed out significant overexpression of cortical markers of synaptic plasticity while both treated groups showed a significant under expression of astrocyte proteins (S100-β and GFAP). Early-life exposure to a low dose of α-HBCDD may trigger neurobehavioural alterations in line with ASD.
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  • 文章类型: Journal Article
    背景:我们以前在Matlab中报道了7-17岁儿童的慢性呼吸影响,孟加拉国。一组儿童曾在子宫内和儿童早期接触过高浓度的饮用水砷(平均436微克/升),另一组儿童从未接触过>10µg/L。暴露的孩子,男性和女性,慢性呼吸道症状明显增加。
    方法:当前的研究涉及对这些年龄在14-26岁的463名儿童进行进一步的随访,并同意参加。他们接受了呼吸道症状的采访,并测量了肺功能。收集了关于吸烟的数据,体重指数(BMI),以及房子里房间的数量作为社会经济地位的衡量标准。
    结果:呼吸作用仍然存在于男性而非女性。在高暴露组(早年>400µg/L)中,男性参与者在过去12个月中干咳的比值比(OR)为2.36(95%置信区间[CI]=1.21,4.63,P=0.006),哮喘的OR=2.51(95%CI=1.19,5.29,P=0.008)。与从未接触过的男性相比,早期高暴露组的男性强迫肺活量(FVC)降低了(-95ml,P=0.04),但不是女性参与者。
    结论:在14-26岁的年龄范围内,女性中几乎没有慢性呼吸影响的剩余证据,但男性中仍然存在明显的影响。明显的男性女性差异的机制需要进一步调查以及进一步的随访,以了解男性的呼吸影响是否持续。
    BACKGROUND: We previously reported chronic respiratory effects in children who were then 7-17 years of age in Matlab, Bangladesh. One group of children had been exposed to high concentrations of arsenic in drinking water in utero and early childhood (average 436 µg/L), and the other group of children were never known to have been exposed to >10 µg/L. The exposed children, both males and females, had marked increases in chronic respiratory symptoms.
    METHODS: The current study involves a further follow-up of these children now 14-26 years of age with 463 located and agreeing to participate. They were interviewed for respiratory symptoms and lung function was measured. Data were collected on smoking, body mass index (BMI), and number of rooms in the house as a measure of socioeconomic status.
    RESULTS: Respiratory effects were still present in males but not females. In the high exposure group (>400 µg/L in early life) the odds ratio (OR) among male participants for dry cough in the last 12 months was 2.36 (95% confidence interval [CI] = 1.21, 4.63, P = 0.006) and for asthma OR = 2.51 (95% CI = 1.19, 5.29, P = 0.008). Forced vital capacity (FVC) was reduced in males in the early life high-exposure group compared with those never exposed (-95ml, P = 0.04), but not in female participants.
    CONCLUSIONS: By the age range 14-26, there was little remaining evidence of chronic respiratory effects in females but pronounced effects persisted in males. Mechanisms for the marked male female differences warrant further investigation along with further follow-up to see if respiratory effects continue in males.
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  • 文章类型: Journal Article
    OBJECTIVE: To explore the relation between famine exposure in early life and subsequent pregnancy loss, including stillbirth, and spontaneous abortion in adulthood.
    METHODS: A population-based, partly ecological study.
    METHODS: Individual data of 58 601 females born around the time of the Great Chinese Famine in 1959-1961.
    METHODS: Associations between the famine exposure in early life and pregnancy loss (stillbirth and spontaneous abortion) in adulthood were analysed using negative binomial regression, with the non-exposure group as reference, adjusting for region, highest education, monthly income, alcohol consumption, tobacco use, body mass index in 25-year-olds and metabolic equivalent. Further analyses were stratified by rural versus urban region.
    METHODS: Continuous variables of times of stillbirths and spontaneous abortions were used according to the individual self-reported reproductive history.
    RESULTS: No association was found between famine exposure and spontaneous abortion. In contrast, females experiencing the famine during their prenatal period (incidence rate ratio = 1.15, 95% CI 1.00-1.33) or infant period (incidence rate ratio = 1.27, 95% CI 1.12-1.44) were more likely to report stillbirth in later adult life. Such an association appeared stronger in women living in rural regions.
    CONCLUSIONS: Early life exposure of famine was associated with an increased risk of stillbirth but not spontaneous abortion in adulthood. The strength of such an association appeared stronger in rural areas. Given the high potential for unmeasured confounding, these associations must be interpreted with caution. Regarding the potential implication that undernutrition in the fetal period is related to reproductive outcome in adulthood, fetal nutritional supply may play an important role in human reproduction.
    UNASSIGNED: Exposure to famine in early life was associated with increased pregnancy loss in adulthood.
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  • 文章类型: Journal Article
    Prenatal exposure to endocrine disrupting chemicals may affect fetal development through disruption of hormonal actions and epigenetic modifications, potentially predisposing individuals to later on-set health risks, such as obesity. The objective of this study was to determine associations between biological exposure markers of various endocrine disrupting chemicals and birth weight in a newly established, prospective mother-child cohort in the Netherlands. Birth weight (n = 91) was obtained from birth records, and exposure to dichlorodiphenyldichloroethylene (DDE), three di-2-ethylhexyl phthalate (DEHP) metabolites, polychlorinated biphenyl-153, perfluorooctanesulfonic acid (PFOS), and perfluorooctanoic acid (PFOA) was determined in cord plasma. For DDE, exposure was also measured in breast milk. Linear regression analysis was used to determine associations between compounds and birth weight, which were stratified for gender and adjusted for a priori defined covariates. Increased exposure to DDE was associated with lower birth weight in boys (>95.89 ng L-1, -325.9 g, 95% CI -634.26 to -17.56), whereas in girls a tendency towards a higher birth weight was observed. Lower birth weights for boys were also observed for high exposure to MECPP, and to a certain extent also for PFOA. MEHHP and PFOS exposure on the other hand were associated with higher birth weights in boys. In girls no effects were observed for these compounds. It can be concluded that prenatal exposure to DDE, perfluorinated alkyl acids, and phthalates was associated with changes in birth weight in this population. Associations were gender specific, and appeared to be non-linear. Since the population was relatively small, results should be interpreted with caution.
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