中国青少年队列中金属与血红蛋白和贫血的关系

Associations of metals with hemoglobin and anemia in a Chinese early adolescent cohort

中国青少年队列中金属与血红蛋白和贫血的关系

Authors: Mengyuan Yuan, Ting Tang, Yonghan Li, Xinhui Wang, Cong Wang, Xueying Zhang, Yichao Huang, Fangbiao Tao, Gengfu Wang, Daomin Zhu, Feng Geng, Puyu Su

Source: Ecotoxicology And Environmental Safety

DOI: 10.1016/j.ecoenv.2025.118122.

PMID: 40203704

Abstract

Background: The relationship between exposure to metals with hemoglobin levels and anemia in children and adolescents has shown inconsistency. This study aimed to evaluate the associations of individual metals and metal mixtures with hemoglobin levels and anemia risk, as well as potential sex differences, in a Chinese early adolescent cohort.

Methods: Data was obtained from a Chinese early adolescent cohort with two-year follow-up periods. Serum concentrations of 12 metals were measured using inductively coupled plasma mass spectrometry (ICP-MS). To examine the individual associations of metals with hemoglobin levels and anemia risk, a series of single-metal and multi-metal adjusted generalized linear mixed models (GLMMs) were applied. Additionally, quantile g-computation (qgcomp) and Bayesian kernel machine regression (BKMR) were used to analyze the effects of metal mixture. Furthermore, all analyses were stratified by sex.

Results: The multi-metal adjusted GLMMs identified significant associations of As (β=2.31; 95 % CI: 0.15, 4.47), Cd (β=-2.11; 95 % CI: -4.11, -0.11), Cr (β=-10.19; 95 % CI: -19.09, -1.30), Cu (β=-7.27; 95 % CI: -14.27, 0.26), Fe (β=13.71; 95 % CI: 10.03, 17.38), Pb (β=7.87; 95 % CI: 4.21, 11.5), V(β=-13.60; 95 % CI: -21.32, -5.88), and Zn (β=14.77; 95 % CI: 4.38, 25.15) with hemoglobin concentration, as well as As (OR=0.26; 95 % CI: 0.11, 0.60), Co(OR=4.27; 95 % CI: 1.25, 14.6), Cr (OR=10.49; 95 % CI: 1.61, 68.39), Fe (OR=0.03; 95 % CI: 0.01, 0.12) and Pb (OR=0.18; 95 % CI: 0.04, 0.80) with anemia risk. Moreover, the qgcomp revealed no association of metal mixture with hemoglobin concentration (β=0.94; 95 % CI=-0.45, 2.33) or anemia risk (OR=0.81; 95 % CI: 0.51, 1.27). After stratification by sex, the qgcomp demonstrated no significant overall effect of the metal mixture on hemoglobin concentration or anemia risk in either boys (β=0.93; 95 % CI: -0.84, 2.71 for hemoglobin, and OR=0.64; 95 % CI: 0.27, 1.52 for anemia) or girls (β=0.93, 95 % CI: -1.16, 3.01 for hemoglobin, and OR=0.72; 95 % CI: 0.40, 1.32 for anemia). Similarly, sex-stratified BKMR models also revealed no significant association between the metal mixture and hemoglobin concentration or anemia risk in either boys or girls.

Conclusions: This study highlights the individual and collective impacts of 12 metals on hemoglobin and anemia during early adolescence, underscoring the need for experimental and larger cohort studies to further corroborate these findings.

Keywords: Anemia; Cohort; Early adolescent; Hemoglobin; Metals.

摘要：

背景：儿童和青少年暴露于金属与血红蛋白水平和贫血之间的关系并不一致。本研究旨在评估中国青少年队列中个别金属和金属混合物与血红蛋白水平和贫血风险的关系，以及潜在的性别差异。

研究方法：数据来自一个中国青少年队列，随访期为两年。使用电感耦合等离子体质谱法测量了血清中 12 种金属的浓度。为了研究金属与血红蛋白水平和贫血风险的个体关联，应用了一系列单金属和多金属调整的广义线性混合模型（GLMM）。此外，还使用了分位数g计算（qgcomp）和贝叶斯核机器回归（BKMR）来分析金属混合物的影响。此外，所有分析都按性别进行了分层。

结果 经多金属调整的 GLMMs 发现，As（β=2.31；95 % CI：0.15，4.47）、Cd（β=-2.11；95 % CI：-4.11，-0.11）、Cr（β=-10. 19; 95 % CI: -19.09, -1.30), Cu (β=-7.27; 95 % CI: -14.27, 0.26), Fe (β=13.71; 95 % CI: 10.03, 17.38), Pb (β=7.87; 95 % CI: 4.21, 11.5), V(β=-13. 60；95 % CI：-21.32，-5.88）和 Zn（β=14.77；95 % CI：4.38，25.15）与血红蛋白浓度的关系，以及 As（OR=0.26；95 % CI：0.11，0.60）、Co（OR=4. 27；95 % CI：1.25，14.6）、铬（OR=10.49；95 % CI：1.61，68.39）、铁（OR=0.03；95 % CI：0.01，0.12）和铅（OR=0.18；95 % CI：0.04，0.80）与贫血风险有关。此外，qgcomp 显示金属混合物与血红蛋白浓度（β=0.94；95 % CI=-0.45，2.33）或贫血风险（OR=0.81；95 % CI：0.51，1.27）没有关联。按性别分层后，qgcomp 显示金属混合物对男孩（β=0.93；95 % CI：血红蛋白为-0.84，2.71；OR=0.64；95 % CI：贫血为 0.27，1.52）或女孩（β=0.93；95 % CI：血红蛋白为-1.16，3.01；OR=0.72；95 % CI：贫血为 0.40，1.32）的血红蛋白浓度或贫血风险没有显著的总体影响。同样，性别分层 BKMR 模型也显示，金属混合物与男孩或女孩的血红蛋白浓度或贫血风险之间均无显著关联。

结论：本研究强调了 12 种金属对青春期早期血红蛋白和贫血的个体和集体影响，强调需要进行实验和更大规模的队列研究来进一步证实这些发现。

关键词：贫血；队列；青春期早期；血红蛋白；金属