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研究生:簡美茹
研究生(外文):Mei-Ju Chien
論文名稱:產前暴露環境重金屬與幼兒語言發展相關性
論文名稱(外文):Prenatal exposure to environmental heavy metals and language development in toddlers
指導教授:陳保中陳保中引用關係
指導教授(外文):Pau-Chung Chen
口試委員:何文照陳美惠楊曜旭
口試委員(外文):Wen-Chao HoMei-Huei ChenYao-Hsu Yang
口試日期:2021-07-28
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:環境與職業健康科學研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2021
畢業學年度:109
語文別:英文
論文頁數:52
中文關鍵詞:重金屬神經發展語言發展幼童
外文關鍵詞:languagelanguage developmentchild languageenvironmental metalsarseniccadmiummanganesemercuryleadtoddlersyoung children
DOI:10.6342/NTU202103142
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背景/目的
在當前的研究中,已知暴露於環境重金屬會對於出生後孩童的神經行為有相當的負面影響,並且,在文獻中提到,這些重金屬對於認知行為發展有著顯著的負相關性,語言溝通為認知發展的一種主要層面,然而目前並沒有針對母親孕程中環境重金屬暴露與孩童語言溝通發展之影響的相關研究。本研究目的即是希望透過問卷評估以及生物檢體,了解懷孕期間重金屬暴露對孩童語言發展的影響。
方法
本研究族群來自台灣出生世代追蹤研究,於2004至2005年間招募個案,在母親生產過後進行結構性問卷訪談,同時於生產時收取臍帶血作為生物檢體指標,以電感耦合電漿體質譜法分析砷、鎘、錳、汞及鉛等環境重金屬濃度。在孩童在兩至三歲期間的語言溝通發展情形,則以華語嬰幼兒溝通發展量表作為評估工具。
結果
在排除干擾因子及遺失資料篩選後,選取147組於北台灣出生之兒童及母親配對,在多變項線性迴歸模型當中,暴露於鎘金屬的幼兒在華語嬰幼兒溝通發展量表的總分(β=-29.95, p<0.05)及子項目字彙的產生(β=-28.37, p<0.05)分數顯著的負相關性。
在錳分成三組與語言發展分數分析後,雖無顯著的相關性但可在結果中觀察到中間的參考組比起其他兩組有正向相關的趨勢。而在不同的基因型組別分析後,尚無觀察到顯著的差異。
討論
本研究結果指出,在母親孕程中暴露環境重金屬與孩童早期語言發展的負面影響有關連性。然而在人們所存在的環境當中,重金屬持續地暴露,故在臍帶血中的重金屬濃度與孩童語言發展之間的因果關係及其機轉,則有待進一步的研究釐清。
Background/Aim
Language development is an essential basic achievement of child development, and it is also the most common development problem in early childhood development. With the rapid advancement of science and technology, the heavy metals issue is becoming more and more sophisticated. In the current research, it is known that exposure to heavy metals will have a considerable negative impact on the neurobehavior of children after birth, and it is mentioned in the literature that these heavy metals have a significant negative correlation with the development of cognitive behavior. In cognitive development, language development is particularly important. However, there is no convincing evidence that supports the theory that exposure to environmental heavy metals will affect children’s language development. The objective of this study is to find the relation between maternal exposure to multiple heavy metals and children’s language development at 2 years of age.
Methods
We analyzed the data from the Taiwan Birth Panel Study I (TBPS I), which was conducted at one medical center, one local hospital, and two obstetric clinics in north Taiwan, and a total of four hundred and eighty-six parent-infant pairs participated from April 2004 to January 2005. We measured the levels of lead, manganese, mercury, arsenic, and cadmium by using inductively coupled plasma mass spectrometry and evaluated the language developmental status of each child at two years of age by using the Mandarin-Chinese Communicative Developmental Inventory (MCDI).
Results
In total, 147 subjects were included in the final analysis. After adjusting for potential confounders, we found that cadmium levels were significantly negatively associated with the total score and word produced score. When categorized into three groups of manganese, there was a positive trend in the middle group. There was no significant difference in the classification of different APOE genotypes.
Conclusions
Maternal exposure during pregnancy to cadmium may have adverse effects on language development at 2 years of age. The issue should be more concerning because pregnancy is a period of rapid growth and cell differentiation of the fetal brain, so during this period, the fetal brain is more susceptible to these metals. Since frequent human exposure to environmental heavy metals is very common in the environment, it is very urgent to understand the mechanism of multiple exposures to metals in order to protect the descendants of humans.
CONTENTS
口試委員會審定書 I
Thesis Verification Form II
誌謝 i
中文摘要 ii
ABSTRACT iii
CONTENTS v
LIST OF TABLES vi
LIST OF SUPPLEMENTARY TABLES vii
LIST OF FIGURES viii
Chapter 1 Introduction 1
Chapter 2 Materials and Methods 5
2.1 Study design and population 5
2.2 Measurement of heavy metals 7
2.3 APOE genotyping 8
2.4 The Mandarin-Chinese Communicative Developmental Inventory 9
2.5 The Home Observation for Measurement of the Environment inventory 11
2.6 Statistical analysis 12
Chapter 3 Results 13
Chapter 4 Discussion 15
Chapter 5 Conclusion 19
REFERENCE 20
APPENDIX 31
LIST OF TABLES
TABLE 1. THE CHARACTERISTICS OF THE SUBJECTS. 25
TABLE 2. MEASUREMENTS OF LEVELS OF HEAVY METAL IN CORD BLOOD. 26
TABLE 3. CORRELATION MATRIX OF THE SUBJECTS' CORD BLOOD METAL LEVELS. 26
TABLE 4. THE DISTRIBUTION OF MCDI SCORE. 27
TABLE 5. MULTIPLE LINEAR REGRESSION MODEL OF MCDI SCORE AND HEAVY METALS. 28
TABLE 6. MULTIPLE LINEAR REGRESSION MODEL OF THE MCDI SCORE AND CATEGORIZE MANGANESE LEVELS. 29
TABLE 7. HEAVY METALS ON LANGUAGE DEVELOPMENT WITH DIFFERENT GENOTYPES OF APOE. 30
LIST OF SUPPLEMENTARY TABLES
SUPPLEMENTARY TABLE 1. THE CHARACTERISTICS OF THE SUBJECTS. 31
SUPPLEMENTARY TABLE 2. THE DISTRIBUTION OF HEAVY METAL LEVELS BETWEEN TWO GROUPS. 32
SUPPLEMENTARY TABLE 3. MULTIPLE LINEAR REGRESSION MODEL OF MCDI SCORE AND HEAVY METALS. 33
SUPPLEMENTARY TABLE 4. MULTIPLE LINEAR REGRESSION MODEL OF THE MCDI SCORE AND CATEGORIZE MANGANESE LEVELS. 34
SUPPLEMENTARY TABLE 5. COMPARISON OF HEAVY METALS MEDIAN LEVELS IN DIFFERENT STUDIES. 35
LIST OF FIGURES
FIGURE 1. THE FLOW CHART IN THIS STUDY. 24
FIGURE 2. COMPARISON OF ARSENIC MEDIAN LEVELS IN DIFFERENT STUDIES. 36
FIGURE 3. COMPARISON THE MEDIAN LEVELS OF CADMIUM IN DIFFERENT STUDIES. 37
FIGURE 4. COMPARISON THE MEDIAN LEVELS OF MANGANESE IN DIFFERENT STUDIES. 38
FIGURE 5. COMPARISON THE MEDIAN LEVELS OF MERCURY IN DIFFERENT STUDIES. 39
FIGURE 6. COMPARISON THE MEDIAN LEVELS OF LEAD IN DIFFERENT STUDIES. 40
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