生命早期细颗粒物暴露与学龄期儿童孤独症谱系障碍患病风险的关联

詹晓玲; 陈宇靖; 欧晓璇; 王馨; 李秀红; 林力孜; 静进

doi:10.16835/j.cnki.1000-9817.2023.02.008

生命早期细颗粒物暴露与学龄期儿童孤独症谱系障碍患病风险的关联

doi: 10.16835/j.cnki.1000-9817.2023.02.008

1.
中山大学公共卫生学院妇幼卫生学系，广东广州 510080
2.
中山大学公共卫生学院劳动卫生与环境卫生学系/广州市环境污染与健康风险评价重点实验室

基金项目:

国家社会科学基金重大项目 20&ZD296

国家自然科学基金项目 82103794

详细信息

作者简介:
詹晓玲(1997-)，女，广东省人，在读硕士，主要研究方向为孤独症的环境危险因素

通讯作者:
林力孜，E-mail：linlz@mail.sysu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R748 R122 R179
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出版历程
- 收稿日期: 2022-05-26
- 修回日期: 2022-09-13
- 网络出版日期: 2023-03-02
- 刊出日期: 2023-02-25

Correlation between early-life exposure to PM_2.5 and risk of autism spectrum disorder among school-aged children

1.
Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou(510080)

摘要

摘要: 目的探索生命早期细颗粒物(PM_2.5)暴露与学龄期孤独症谱系障碍(ASD)患病风险的关联，为ASD的早期防控提供依据。方法采用病例对照设计，于中山大学儿童青少年心理行为发育研究中心招募ASD儿童165名，同期于广州市部分小学招募性别年龄匹配的典型发育(TD)儿童165名。采用问卷收集基本资料，采用社交反应量表(SRS)评估儿童ASD的相关症状表现；采用中国大气成分近实时追踪数据集(TAP)估算生命早期PM_2.5暴露(母亲孕前、孕期及儿童出生后2年)。采用条件Logistic回归分析PM_2.5暴露与ASD患病风险的关联，广义线性回归模型分析PM_2.5暴露与ASD相关症状的关联。结果 ASD儿童母亲孕前1年(55.08±9.34)μg/m³，孕期(50.44±8.71)μg/m³以及ASD儿童出生后1年(45.04±8.25)μg/m³、出生后2年(40.19±7.12)μg/m³的PM_2.5暴露均高于TD组儿童(47.66±7.63，44.19±7.16，38.95±6.07，35.76±5.65)，差异均有统计学意义(t值分别为7.94，7.13，7.70，6.32，P值均 < 0.05)。校正混杂因素后，母亲孕前、孕期，儿童出生后1年、出生后2年的PM_2.5暴露每升高1 μg/m³，儿童ASD患病风险分别为1.21(95%CI=1.13~1.29)、1.18(95%CI=1.11~1.26)、1.30(95%CI=1.18~1.43)和1.29倍(95%CI=1.17~1.42)。两组儿童均未发现生命早期PM_2.5暴露与SRS总分或分量表得分存在关联(P值均>0.05)。结论生命早期不同阶段的PM_2.5暴露均与ASD患病风险有关，在ASD生命早期的防控工作中应对大气颗粒物污染予以重视。
- 生命周期各时期 /
- 颗粒物 /
- 孤独性障碍 /
- 回归分析 /
- 儿童
Abstract: Objective To investigate the associations between early-life exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM_2.5) and the risk of autism spectrum disorder (ASD) among school-aged children. Methods A total of 165 children with ASD and 165 age-and gender-matched typical development (TD) children were recruited. Children's basic information were obtained via questionnaires, and the severity of ASD symptoms was assessed with Social Responsiveness Scale (SRS). Early-life PM_2.5 exposure (preconception, entire pregnancy, and the first two years after birth) were extracted from the Tracking Air Pollution in China (TAP) datasets. Conditional Logistic regression and generalized linear model were used to evaluate the associations of early-life exposure to PM_2.5 with the risk and the ASD severity symptoms, respectively. Results The PM_2.5 exposure of ASD group during preconception[(55.08±9.34)μg/m³], entire pregnancy[(50.44±8.71)μg/m³], the first year after birth [(45.04±8.25)μg/m³] and the second year after birth [(40.19±7.12)μg/m³] were significant higher than those in TD children [(47.66±7.63, 44.19±7.16, 38.95±6.07, 35.76±5.65)μg/m³](t=7.94, 7.13, 7.70, 6.32, P < 0.05). After adjusting for potential confounding, each increase of 1 μg/m³ in PM_2.5 was associated with higher risk of ASD during preconception (OR=1.21, 95%CI=1.13-1.29), entire pregnancy(OR=1.18, 95%CI=1.11-1.26), the first year after birth (OR=1.30, 95%CI=1.18-1.43) and the second year after birth (OR=1.29, 95%CI=1.17-1.42). No similar results were observed regarding the analyses of SRS total and sub-scale scores(P>0.05). Conclusion Early-life exposure to PM_2.5 is relate to the risk of ASD, these findings indicated that more attention should be paid to ambient PM pollution in the early-life prevention and control of ASD.
- Life cycle stages /
- Particulate matter /
- Autistic disorder /
- Regression analysis /
- Child
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 PM_2.5暴露(连续变量，每升高1 μg/m³)与儿童孤独症患病风险的关联[OR值(OR值95%CI), n=330]

Table 1. Associations of early life exposure to per 1 μg/m³ PM_2.5 higher with the risk of ASD[OR(OR 95%CI), n=330]

自变量	模型1	模型2
母亲孕前1年PM_2.5暴露	1.21(1.14~1.28)	1.21(1.13~1.29)
母亲全孕期PM_2.5暴露	1.19(1.13~1.25)	1.18(1.11~1.26)
儿童出生后1年PM_2.5暴露	1.31(1.21~1.42)	1.30(1.18~1.43)
儿童出生后2年PM_2.5暴露	1.31(1.20~1.42)	1.29(1.17~1.42)
注：模型1仅纳入对应自变量(空模型)，模型2校正变量：父母亲年龄、父母亲受教育水平、家庭人均月收入、是否独生子女、体力活动水平。P值均 < 0.01。

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表 2 PM_2.5暴露(分类变量)与儿童孤独症患病风险的关联[OR值(OR值95%CI)]

Table 2. Associations of early life exposure to PM_2.5 in categories with the risk of ASD[OR(OR 95%CI)]

自变量	选项	模型1	模型2
母亲孕前1年PM_2.5暴露	高	5.21(2.94~9.24)	6.17(2.95~12.91)
母亲全孕期PM_2.5暴露	高	6.73(3.57~12.67)	6.90(3.15~15.10)
儿童出生后1年PM_2.5暴露	高	5.27(2.77~10.05)	5.28(2.41~11.58)
儿童出生后2年PM_2.5暴露	高	2.84(1.68~4.79)	3.01(1.54~5.91)
注：模型1仅纳入对应自变量(空模型)，模型2校正变量：父母亲年龄、父母亲受教育水平、家庭人均月收入、是否独生子女、体力活动水平。P值均 < 0.01。

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表 3 典型发育与孤独症儿童PM_2.5暴露(连续变量，每升高1 μg/m³)与社交反应量表的关联分析[OR值(OR值95%CI)]

Table 3. Associations of early life exposure to per 1 μg/m³ PM_2.5 higher with SRS total and scales scores in TD and ASD children[OR(OR 95%CI)]

因变量	自变量	典型发育儿童(n=165)		孤独症儿童(n=165)
因变量	自变量	模型1	模型2	模型1	模型2
SRS总分	母亲孕前1年PM_2.5暴露	0.11(-0.23~0.45)	0.06(-0.39~0.50)	-0.02(-0.53~0.49)	-0.04(-0.77~0.69)
	母亲全孕期PM_2.5暴露	0.03(-0.33~0.40)	-0.09(-0.58~0.39)	-0.03(-0.57~0.51)	-0.04(-0.79~0.72)
	儿童出生后1年PM_2.5暴露	-0.10(-0.52~0.33)	-0.23(-0.83~0.36)	0.18(-0.40~0.76)	0.42(-0.48~1.32)
	儿童出生后2年PM_2.5暴露	-0.09(-0.55~0.37)	-0.21(-0.89~0.47)	0.20(-0.48~0.87)	0.70(-0.33~1.73)
社交知觉	母亲孕前1年PM_2.5暴露	0.02(-0.04~0.07)	0.02(-0.05~0.10)	-0.02(-0.06~0.03)	-0.03(-0.10~0.04)
	母亲全孕期PM_2.5暴露	0.01(-0.05~0.07)	0.01(-0.08~0.09)	-0.03(-0.08~0.01)	-0.06(-0.14~0.01)
	儿童出生后1年PM_2.5暴露	-0.04(-0.11~0.04)	-0.05(-0.15~0.05)	-0.00(-0.05~0.05)	-0.00(-0.09~0.09)
	儿童出生后2年PM_2.5暴露	-0.03(-0.11~0.04)	-0.04(-0.16~0.07)	0.01(-0.05~0.07)	0.04(-0.07~0.14)
社交认知	母亲孕前1年PM_2.5暴露	0.02(-0.06~0.10)	0.03(-0.08~0.13)	0.01(-0.08~0.11)	-0.01(-0.15~0.13)
	母亲全孕期PM_2.5暴露	-0.00(-0.09~0.08)	-0.02(-0.14~0.10)	0.02(-0.08~0.12)	0.02(-0.12~0.16)
	儿童出生后1年PM_2.5暴露	-0.04(-0.14~0.07)	-0.06(-0.21~0.08)	0.05(-0.05~0.16)	0.09(-0.08~0.26)
	儿童出生后2年PM_2.5暴露	-0.01(-0.12~0.10)	-0.01(-0.17~0.16)	0.06(-0.06~0.19)	0.10(-0.10~0.29)
社交沟通	母亲孕前1年PM_2.5暴露	0.03(-0.09~0.16)	-0.00(-0.17~0.16)	-0.03(-0.22~0.16)	-0.02(-0.30~0.25)
	母亲全孕期PM_2.5暴露	0.02(-0.11~0.16)	-0.03(-0.21~0.15)	-0.04(-0.24~0.17)	-0.03(-0.31~0.26)
	儿童出生后1年PM_2.5暴露	-0.01(-0.17~0.15)	-0.07(-0.30~0.16)	0.03(-0.18~0.25)	0.13(-0.21~0.47)
	儿童出生后2年PM_2.5暴露	0.01(-0.16~0.18)	-0.03(-0.29~0.22)	0.04(-0.21~0.29)	0.26(-0.13~0.65)
社交动机	母亲孕前1年PM_2.5暴露	0.01(-0.07~0.08)	-0.01(-0.10~0.09)	-0.02(-0.13~0.08)	-0.01(-0.16~0.15)
	母亲全孕期PM_2.5暴露	-0.01(-0.09~0.07)	-0.03(-0.14~0.08)	-0.02(-0.14~0.09)	-0.01(-0.17~0.15)
	儿童出生后1年PM_2.5暴露	-0.01(-0.10~0.09)	-0.01(-0.14~0.12)	0.01(-0.11~0.13)	0.06(-0.13~0.25)
	儿童出生后2年PM_2.5暴露	-0.05(-0.15~0.05)	-0.10(-0.24~0.05)	0.03(-0.11~0.17)	0.16(-0.06~0.38)
孤独症行为方式	母亲孕前1年PM_2.5暴露	0.03(-0.05~0.12)	0.02(-0.09~0.12)	0.03(-0.11~0.17)	0.03(-0.17~0.23)
	母亲全孕期PM_2.5暴露	0.02(-0.07~0.11)	-0.01(-0.13~0.10)	0.05(-0.11~0.20)	0.05(-0.16~0.25)
	儿童出生后1年PM_2.5暴露	-0.01(-0.11~0.10)	-0.04(-0.18~0.10)	0.08(-0.08~0.25)	0.15(-0.10~0.40)
	儿童出生后2年PM_2.5暴露	-0.01(-0.12~0.10)	-0.04(-0.20~0.13)	0.05(-0.14~0.24)	0.15(-0.14~0.44)
注：模型1仅纳入对应自变量(空模型)，模型2校正变量：父母亲年龄、父母亲受教育水平、家庭人均月收入、是否独生子女、体力活动水平；P值均>0.05。

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