Lead exposure in utero may worsen kidney health in overweight children
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Children who were overweight and had low-level prenatal lead exposure may have worsened kidney function later in life, according to research published in Environment International.
“We must continue to biomonitor pregnant women and children for toxic exposures, and reduce exposure when levels are elevated,” Alison Sanders, PhD, assistant professor of environmental medicine, public health and pediatrics at Icahn Mount Sinai, told Healio Primary Care. “However, while blood lead levels are monitored at the U.S. Centers for Disease Control and Prevention guideline value of 5 ug/dL, there is no safe level of lead for children.”
In their study, Sanders and colleagues assessed 453 mother-child pairs who were participating in the PROGRESS birth cohort, a prospective, ongoing birth cohort study in Mexico City. Pregnant women were enrolled from July 2007 to February 2011 and were receiving care from the Mexican Social Security System.
The researchers evaluated blood samples collected during the second trimester, third trimester and delivery to assess blood lead levels, along with tibial and patellar bone lead measures at 1 month after birth.
To determine eGFR in children, the researchers evaluated serum levels of creatinine or cystatin C in participants aged 8 to 12 years.
Among children included in the study, 24% were considered overweight, and 23% were considered obese.
According to the researchers, nearly 20% of maternal blood lead levels in the second trimester were above the CDC’s level of concern threshold, 5 g/dL.
Sanders and colleagues identified null associations between lead exposure during pregnancy and eGFR in children.
However, they found that among overweight children, there was an association between blood lead levels and eGFR. They determined that a one ln-unit increase in blood lead level was associated with a 10.5-unit decrease in cystatin C-based eGFR (95% CI, 18.1 to 2.8) in the second trimester, a 10-unit decrease in cystatin C-based eGFR (95% CI, 17.6 to 2.4) in the third trimester, and an 8.9-unit decrease in cystatin C-based eGFR (95% CI, 16.8 to 0.9) at delivery.
They also found that there was a null relationship between BMI z-score and eGFR overall, but among children who were obese, there was a significant 5.9-unit increase in eGFR (95% CI. 11 to 0.8).
The researchers said the findings suggest that children who were overweight and had low-level prenatal lead exposure may have worsened kidney function later in life.
“My research investigates how the environment and mixtures of environmental chemicals/toxicants interact with traditional risk factors such as obesity, preterm birth and nutritional status to hasten or prevent chronic kidney disease,” Sanders said. “More studies are needed to identify early life environmental risk factors, as well as the timing of when exposure prevention may be most critical in combination with traditional well-established risk factors.”
References:
Newswise. Overweight Children Exposed to Lead in Utero Have Poor Future Kidney Function. https://www.newswise.com/articles/overweight-children-exposed-to-lead-in-utero-may-have-poor-future-kidney-function. Accessed March 5, 2021.
Saylor C, et al. Environ Int. 2021;doi:10.1016/j.envint.2021.106414.