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In recent decades, the prevalence of allergic diseases has increased sharply.In many countries including China, allergic diseases have become the most common chronic diseases.According to reports, various risk factors such as genetic, diet and infection can affect the occurrence of allergic diseases.However, the incidence of allergic diseases rose rapidly in a short period of time, indicating environmental factors, not genetic factor, and the main driving force behind its increasing incidence.Compared with adults, fetal and babies are more sensitive to exposing environmental pollutants.According to research, the exposure of environmental compounds during pregnancy may be caused by affecting the development of the fetal immune system, which leads to the occurrence of subsequent allergic diseases.Therefore, in recent years, more and more research has begun to pay attention to the impact of environmental compound exposure on the development of allergic diseases in infants and young children, including metal exposure.In daily life, people can be exposed to various metals through air, water, food, etc.
Studies have shown that metals such as 钒 (V), chromium (CR), nickel (Ni), arsenic (AS), cadmium (CD), 铊 (TL), and lead (PB) can be accumulated in the fetal tissue through the placenta barrier.It has adverse effects on the growth and development of the fetus.Studies have found that the exposure of arsenic during pregnancy is related to the changes in the number of T -cell sub -groups in umbilical cord blood, indicating that the exposure of arsenic during pregnancy may affect the development of the fetal immune system and may lead to fetal immune dysfunction.At present, some epidemiological studies have explored the correlation between metal exposure during pregnancy and allergic diseases in infants and young children. However, most of these studies only pay attention to a small number of metals such as arsenic, cadmium, and lead, and the results of the research are not consistent.In addition, several epidemiological studies have shown that several types of metals, including 钒, chromium, nickel, and crickets, are also embryonic toxicity.However, the current research on the risks related to the risks of allergic diseases such as tadpoles, chromium, nickel and nickels during pregnancy is very limited.
In addition, the study of previously exploring the impact of metal exposure during pregnancy on infants and young children pays attention to the exposure of a single metal, or only the traditional regression model is used to incorporate all metals into the model to analyze multiple metal exposure.This method ignores multiple common linearity and potential interactions that may exist between metals, and cannot analyze the combined effect of multi -metal exposure at the same time.In recent years, as a new type of statistical method, BKMR can be used to evaluate the health effect of the combined exposure of multiple environmental compounds, and can identify important components in the mixture, more and more applications, increasingly applicationsIn the field of environmental health research.Research reports that due to the differences in metabolism during pregnancy, there is a significant difference in metal exposure levels (arsenic, nickel, lead, and crickets) during pregnancy during pregnancy.Reliable biomarkers exposed during pregnancy.Therefore, it is necessary to accurately evaluate the level of metal exposure during pregnancy by detecting metal concentration during different pregnancy.
The population statistical data of pregnant women (including age, annual income and education, etc.), living habits (including active and passive smoking during pregnancy, drinking during pregnancy, etc.) are used to be pregnant women who have received unified training within three days before or after giving birth.The face -to -face questionnaire survey was obtained.Information such as the secondary of pregnant women, the gender of the gestational week and the newborn are obtained from the electronic medical records.Passive smoking during pregnancy is defined as a woman who does not smoke at home or workplace during pregnancy.The body quality index (BMI) before pregnancy is calculated by the pre -pregnancy weight and height of the pregnant woman’s self -reporting.In this study, no pregnant women have active smoking or drinking, so these two variables have not been included in model analysis.When children were 4 years old, they distributed structural questionnaires to parents through kindergarten health teachers to collect information about children’s basic information (age of children), children’s living environmental factors (whether residential pets), and children’s disease status.The informed consent letter, together with the questionnaire, was distributed to the parents by the kindergarten health teacher.
The problems used to define allergic rhinitis, asthma, and eczema are based on International StudyofastHmaandallergieSInthood (ISAAC).Because the Isaac questionnaire is only for the symptoms of allergic diseases, in order to increase the reliability of the cases of allergic diseases and reduce false positiveness, we also set the question of whether the child was diagnosed by a doctor as an allergic disease in the questionnaire.According to the answers to the following questions in the interview volume, it is determined whether children have some allergic diseases.For "your child has an allergic rhinitis (without a cold, but repeated sneezing, runny nose, nasal congestion, nose itching)" and "Do you have a diagnosis of your child with allergic rhinitis?" At the same time, these two questions at the same timeChildren who are answered as "yes" are defined as allergic rhinitis.
Also on the following two questions: "Do your children have a high -sound tone whistle when they have suffering from breathing or when they are in a gasping attack?" And "Have a doctor diagnosed your child with asthma, capillary bronchitis, asthma, asthma, asthmaBronchitis and asthma pneumonia? "Children who answered" yes "at the same time are defined as a breathing.For "your child has at least half a year of recurrent skin itchy rash, and these rashes affect any part of the following parts: elbow folds, rear, ankle, hip or neck, ears, eyes, and eyes?"And "Do you have a diagnosis of your child with eczema?" The two questions answered at the same time as "yes" as defined as eczema.Among the 628 analysis objects, 609 people have information about allergic rhinitis, 614 people have information about gasp, and 611 people are about eczema.
For the distribution characteristics of the basic information data of the crowd, we describe different statistical indicators based on the data type.Continuous variables are represented by mean number and standard deviation, and classification variables are expressed by frequency and percentage.For the comparison of the original crowd and the basic characteristics of the crowd, and the basic characteristics of the research crowd group, the continuous variables use student T test, and the classification variables are tested by the deck.The value of the metal concentration in the primitive urine sample is replaced by LOD/√2 with the value of the detection limit.Calculate the correlation coefficient (ICCS) with a hybrid linear model to calculate the three pregnancy urine metal concentrations (ICCS) for the early pregnancy and late pregnancy.The whole pregnancy has medium and highly variant.
In addition, the problem of error classification may occur because the measurement of the metal exposure level when using a single -point urine sample is used only.Therefore, in order to better estimate the level of metal exposure of individual pregnant women throughout pregnancy, we take the average urine concentration of the urine metal after the early three -time period of pregnancy, middle, and late.Because the metal concentration after creatinine correction is distributed, it naturally converts the number of numbers in subsequent analysis.Adopt the correlation coefficient between the seven metal concentrations transformed by the Pearson related calculation.The differences in the concentration of urine metal between the crowd group are analyzed by Wilcoxon rank and inspection.
The corrected Poson regression model is used to calculate the relative risk (RR) and 95%confident interval (CI) to evaluate the connection between single metal and multi -metal exposure to the connection between the single metal and multi -metal exposure during pregnancy, and the preschool children’s allergic rhinitis, breathing and eczema.EssenceThe choice of mixed factor is based on the analysis of metal exposure or allergic diseases (P <0.1) in a dual variable association analysis, or in previous literature reports to expose or allergic diseases in metal.The mixed factors in the final model include the education level of mothers, pre -pregnancy BMI, production, passive smoking during pregnancy, gender of children, and pets for houses.A single metal model is analyzed in the models of seven metals into the model, and the corresponding mixed factor is correct in the model of the model.Multi -metal models analyze the seven metals into the model at the same time, and evaluate that the seven metals are exposed to the correlation with allergic diseases at the same time.
Considering the repeated measurement of the metal concentration of the third stage of pregnancy, this study also uses a broader estimation equation (Gee) model to estimate the early pregnancy, neutralization metal concentration and preschool children’s allergic rhinitis, breathing and eczemaRelated.
After that, we further used the BKMR model to analyze seven metals at the same time to expose the combination of allergic diseases in preschool children, and identify important components of seven metals.The average metal concentration of early pregnancy, medium, and late is included in the analysis of the metal exposure of the entire pregnancy of pregnant women into the BKMR model.The BKMR model is fitted through the Markov ChainchainMontecarlo (MCMC) algorithm, which can create a relationship model between multiple exposure compounds and health endings.The number of iterations in this study is set to 10,000 times.During the model fitting process, it is estimated that the posteriorinclusionProbabilities (PIPS) will be estimated, which can be used as a measure of the importance of each exposure variable.The range of the PIPS value is 0 to 1, and its size represents the relatively important level of different components in the mixture.If the probability of incorporation in a certain component is high, it indicates that the component is more likely to be related to the ending.According to previous literature suggestions, using 0.5 as a PIP threshold to determine whether a certain metal is important.
The mixed factor of BKMR model correction is consistent with the aforementioned.By fitting the BKMR model, an estimate of the exposure of the joint exposure of multi-pollutants-response function can be obtained.
BKMR can explore the relationship between one or two exposure variables and the ending, and at the same time fix the remaining exposure variables at a specific level (for example, medium number) to visualize the exposure-reaction function of different section.In this study, we will mainly explore the following issues: fix all seven metals at a level level (25 % − 75 %), and all metals are at the median level levelCompared with the combined effect of all metals on allergic diseases; 2) the risk when a certain metal is at 75 % is compared with the risk of the metal at the 25th percentage. At the same time, the remaining six metals areFixed at the 25th percentage, 50 % or 75 %, respectively.In the context of joint exposure, the effect of single metal exposure on allergic diseases; 3) Exploring the exposure of each metal and allergic disease-reaction function, and at the same time fix the remaining six metals at the median level; 4)
Fix other metals at the level of digits. Metal 1 is exposed to the exposure of allergic diseases when metal 2 is at the 25th, 50th, and 75 percentage levels, and explores whether there is an interaction between metal 1 and metal 2.
Based on the forward -looking birth queue, this study collects urine in the early, middle and late period of pregnancy in pregnant women, and detects seven metal concentrations in urine.When children were 4 years old, information about children’s health diseases and respiratory diseases were collected through kindergarten health teachers.Using these data, this study explores the impact of metal exposure during pregnancy on preschool children’s allergic diseases and respiratory infection diseases.The conclusions of the research are mainly as follows: Seven metal exposure of seven metal metal exposure to seven metals of chromium, chromium, nickel, arsenic, cadmium, cadmium, and lead are significantly positively correlated with allergic rhinitis in preschool children.Increase the risk of allergic rhinitis in preschool children, and arsenic and 铊 are the main risk factor.
During pregnancy, exposure to preschool children is negatively related to allergic rhinitis, breathing, and eczema, suggesting that exposure during pregnancy may reduce the risk of preschool children’s allergic diseases, but more epidemiological research is required to verify this result.The higher level of metal mixture is related to the increase in the risk of colds in preschool children, increased risk of otitis media and bronchitis, and suggesting that multi -metal exposure during pregnancy may increase the risk of respiratory infection diseases in preschool children.