小学生产前砷暴露与近视的关系：维生素 D 水平的改变作用

Associations of prenatal arsenic exposure with myopia in primary school children: modifying effects of vitamin D levels

小学生产前砷暴露与近视的关系：维生素 D 水平的改变作用

Authors: Juan Tong, Chunmei Liang, Shuman Tao, Xing Wang, Hong Gan, Jixing Zhou, Menglong Geng, Shuangqin Yan, Guopeng Gao, Liu Jiang, Xiaoyan Wu, Kun Huang, Fangbiao Tao.

Source: Environ Res. 2024 Nov 13:120366.doi: 10.1016/j.envres.2024.120366. 

Abstract

The increasing role of environmental pollutants and nutrients in the development of myopia. Further longitudinal evidence is needed to elucidate the effects of early-life environmental pollutants on myopia and nutrients to protect against pollutant-induced myopia. We used mother-child dyads from the Ma'anshan Birth Cohort (n = 2028) to explore the modifying effects of maternal vitamin D status of prenatal and childhood arsenic exposure with refractive parameters and myopia. We measured serum or plasma arsenic concentrations during three trimesters, in cord blood, in childhood (5-year-old), and performed cycloplegic refraction in children aged 7 to 9 years (n = 1616). Primary outcomes were myopia and refractive parameters including axial length (AL), corneal radius of curvature, and spherical equivalent refraction error. Linear regression, logistic regression, and multiple informant models were performed for the association of prenatal and childhood arsenic exposure with vision health. Sex- and vitamin D status stratification analyses were also conducted. Cord serum arsenic was positively associated with AL (β = 0.15, 95%CI: 0.01, 0.29) and the risk of developing myopia (OR = 1.72, 95%CI: 1.07, 2.75). Among boys, a 1 ng/L increase in cord serum log10-transformed arsenic resulted in larger AL and a higher risk of myopia. In the vitamin D deficient group (<20 ng/mL), cord serum arsenic showed positive associations with AL (0.26 [0.06, 0.46]) and the risk of myopia (1.99 [1.01, 3.90]). Late pregnancy arsenic exposure likely affects offspring development of myopia, especially in boys. Maternal sufficient vitamin D may confer protective effects against the development of myopia.

Keywords: Arsenic; Cohort; Myopia; Prenatal; Vitamin D.

摘要

环境污染物和营养物质在近视发展中的作用越来越大。需要进一步的纵向证据来阐明早期环境污染物对近视和营养物质的影响，以防止污染物引起的近视。我们使用来自马鞍山出生队列（n = 2028）的母子二元组来探讨产前和儿童砷暴露对母体维生素 D 状态对屈光参数和近视的改变影响。我们测量了孕早期三个时期、脐带血、儿童期（5 岁）的血清或血浆砷浓度，并对 7 至 9 岁儿童进行了睫状肌麻痹屈光术（n = 1616）。主要结局是近视和屈光参数，包括眼轴长度（AL）、角膜曲率半径和球面等效屈光不正。对产前和儿童期砷暴露与视力健康的关联进行线性回归、logistic 回归和多线人模型。还进行了性别和维生素 D 状态分层分析。脊髓血清砷与 AL （β = 0.15， 95%CI： 0.01， 0.29）和发生近视的风险（OR = 1.72， 95%CI： 1.07， 2.75）呈正相关。在男孩中，脊髓血清对数增加 1 ng/L10-转化的砷导致更大的 AL 和更高的近视风险。在维生素 D 缺乏组（<20 ng/mL）中，脊髓血清砷与 AL （0.26 [0.06， 0.46]）和近视风险（1.99 [1.01， 3.90]）呈正相关。怀孕晚期接触砷可能会影响后代近视的发展，尤其是男孩。母亲足够的维生素 D 可能具有防止近视发展的保护作用。

关键字： 砷;队列;近视;产前;維生素D。