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Dai Y, Ding J, Wang Z, Zhang B, Guo Q, Guo J, Qi X, Chang X, Wu C, Zhang J, Zhou Z. Sex-specific associations of per- and polyfluoroalkyl substances with brain-derived neurotrophic factors (BDNF) in cord serum. ENVIRONMENTAL RESEARCH 2024; 262:119922. [PMID: 39237020 DOI: 10.1016/j.envres.2024.119922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 09/01/2024] [Accepted: 09/02/2024] [Indexed: 09/07/2024]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) is perceived as an emerging environmental endocrine disruptor, which have been linked to children neurodevelopment. However, the potential mechanisms are not clear. Brain-derived neurotrophic factor (BDNF) is a vital protein in neurodevelopment, and the associations between PFAS exposure and BDNF require exploration. OBJECTIVE We aimed to explore the relationships between PFAS exposure and the levels of BDNF in cord serum. METHODS A total of 1,189 mother-infant dyads from the Sheyang Mini Birth Cohort Study (SMBCS) were enrolled. The levels of 12 PFAS and BDNF were measured in cord serum. We utilized generalized linear models (GLMs), quantile-based g-computation (QGC) models, and Bayesian Kernel Machine Regression (BKMR) models to explore the relationships between single and mixed PFAS exposure and BDNF concentration. Additionally, the potential sex differences were explored by sex-stratified analysis. RESULTS Median concentrations of the included 10 PFAS ranged from 0.04 to 3.97 μg/L. In the single chemical models, four PFAS congeners, namely perfluorononanoic acid (PFNA), perfluorooctane sulfonic acid (PFOS), perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA), were negatively associated with BDNF levels in cord serum among females only (β: -0.116 to -0.062, p < 0.05). In the BKMR models of total mother-infant dyads and female fetuses, the significant negative relationships between PFAS mixtures and BDNF were observed, and PFUnDA was identified as an important contributor (Posterior inclusion probability, PIP = 0.8584 for the total subjects; PIP = 0.8488 for the females). PFOS was another important driver based on the mixture approaches. CONCLUSIONS We found that PFNA, PFOS, PFDA, and PFUnDA were associated with decreased BDNF concentration in the females, although the causal inference might be limited. PFAS mixtures were also negatively linked with BDNF levels in the total mother-infant pairs and female fetuses. The adverse effect of PFAS exposure on fetal BDNF levels might be sex-specific.
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Affiliation(s)
- Yiming Dai
- Key Laboratory of Public Health Safety of Ministry of Education, Key Laboratory of Health Technology Assessment of National Health Commission, School of Public Health, Fudan University, No.130 Dong'an Road, Shanghai, 200032, China
| | - Jiayun Ding
- Key Laboratory of Public Health Safety of Ministry of Education, Key Laboratory of Health Technology Assessment of National Health Commission, School of Public Health, Fudan University, No.130 Dong'an Road, Shanghai, 200032, China
| | - Zheng Wang
- Key Laboratory of Public Health Safety of Ministry of Education, Key Laboratory of Health Technology Assessment of National Health Commission, School of Public Health, Fudan University, No.130 Dong'an Road, Shanghai, 200032, China
| | - Boya Zhang
- Key Laboratory of Public Health Safety of Ministry of Education, Key Laboratory of Health Technology Assessment of National Health Commission, School of Public Health, Fudan University, No.130 Dong'an Road, Shanghai, 200032, China
| | - Qin Guo
- Key Laboratory of Public Health Safety of Ministry of Education, Key Laboratory of Health Technology Assessment of National Health Commission, School of Public Health, Fudan University, No.130 Dong'an Road, Shanghai, 200032, China
| | - Jianqiu Guo
- Key Laboratory of Public Health Safety of Ministry of Education, Key Laboratory of Health Technology Assessment of National Health Commission, School of Public Health, Fudan University, No.130 Dong'an Road, Shanghai, 200032, China
| | - Xiaojuan Qi
- Zhejiang Provincial Center for Disease Control and Prevention, No. 3399 Binsheng Road, Hangzhou, 310051, China
| | - Xiuli Chang
- Key Laboratory of Public Health Safety of Ministry of Education, Key Laboratory of Health Technology Assessment of National Health Commission, School of Public Health, Fudan University, No.130 Dong'an Road, Shanghai, 200032, China
| | - Chunhua Wu
- Key Laboratory of Public Health Safety of Ministry of Education, Key Laboratory of Health Technology Assessment of National Health Commission, School of Public Health, Fudan University, No.130 Dong'an Road, Shanghai, 200032, China
| | - Jiming Zhang
- Key Laboratory of Public Health Safety of Ministry of Education, Key Laboratory of Health Technology Assessment of National Health Commission, School of Public Health, Fudan University, No.130 Dong'an Road, Shanghai, 200032, China.
| | - Zhijun Zhou
- Key Laboratory of Public Health Safety of Ministry of Education, Key Laboratory of Health Technology Assessment of National Health Commission, School of Public Health, Fudan University, No.130 Dong'an Road, Shanghai, 200032, China.
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Feng Y, Wan Y, Wang H, Jiang Q, Zhu K, Xiang Z, Liu R, Zhao S, Zhu Y, Song R. Dyslexia is associated with urinary polycyclic aromatic hydrocarbon metabolite concentrations of children from China: Data from the READ program. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 346:123538. [PMID: 38341065 DOI: 10.1016/j.envpol.2024.123538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/24/2024] [Accepted: 02/07/2024] [Indexed: 02/12/2024]
Abstract
It has been found that exposure to polycyclic aromatic hydrocarbons (PAHs) is associated with the risk of certain childhood neurodevelopmental disorders. However, no research has investigated the relationship between exposure to PAHs and children's dyslexia odds. The objective of this research was to investigate whether urinary mono-hydroxylated polycyclic aromatic hydrocarbons (OH-PAHs) are associated with increased dyslexia odds in Chinese children. We recruited 1,089 children (542 dyslexic children and 547 non-dyslexic children) for this case-control study. Ten OH-PAHs were measured in the participants' urine samples, which were collected between November 2017 and March 2023. Odds ratios (ORs) of the associations between the OH-PAHs and dyslexia were calculated using logistic regression models, after adjustment for the potential confounding factors. A significant association was found between urinary concentrations of 2-hydroxynaphthalene (2-OHNap) and the elevated odds of dyslexia. The children in the highest quartile of 2-OHNap had a higher OR of dyslexia (1.87, 95% CI: 1.07-3.27) than those in the lowest quartile (P-trend = 0.02) after adjustment for the covariates. After excluding children with maternal disorders during pregnancy, logistic regression analyses showed similar results. Our results suggested a possible association between PAH exposure and the elevated odds of dyslexia.
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Affiliation(s)
- Yanan Feng
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China; Department of Nursing, Medical School, Shihezi University, Shihezi, 832003, China
| | - Yanjian Wan
- Center for Public Health Laboratory Service, Institute of Environmental Health, Wuhan Centers for Disease Control & Prevention, Wuhan, Hubei, 430024, China
| | - Haoxue Wang
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qi Jiang
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Kaiheng Zhu
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zhen Xiang
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Rundong Liu
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Shuai Zhao
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ying Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, 430072, China
| | - Ranran Song
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Rodríguez-Carrillo A, Verheyen VJ, Van Nuijs ALN, Fernández MF, Remy S. Brain-derived neurotrophic factor (BDNF): an effect biomarker of neurodevelopment in human biomonitoring programs. FRONTIERS IN TOXICOLOGY 2024; 5:1319788. [PMID: 38268968 PMCID: PMC10806109 DOI: 10.3389/ftox.2023.1319788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/13/2023] [Indexed: 01/26/2024] Open
Abstract
The present narrative review summarizes recent findings focusing on the role of brain-derived neurotrophic factor (BDNF) as a biomarker of effect for neurodevelopmental alterations during adolescence, based on health effects of exposure to environmental chemical pollutants. To this end, information was gathered from the PubMed database and the results obtained in the European project Human Biomonitoring for Europe (HBM4EU), in which BDNF was measured at two levels of biological organization: total BDNF protein (serum) and BDNF gene DNA methylation (whole blood) levels. The obtained information is organized as follows. First, human biomonitoring, biomarkers of effect and the current state of the art on neurodevelopmental alterations in the population are presented. Second, BDNF secretion and mechanisms of action are briefly explained. Third, previous studies using BDNF as an effect biomarker were consulted in PubMed database and summarized. Finally, the impact of bisphenol A (BPA), metals, and non-persistent pesticide metabolites on BDNF secretion patterns and its mediation role with behavioral outcomes are addressed and discussed. These findings were obtained from three pilot studies conducted in HBM4EU project. Published findings suggested that exposure to some chemical pollutants such as fine particle matter (PM), PFAS, heavy metals, bisphenols, and non-persistent pesticides may alter circulating BDNF levels in healthy population. Therefore, BDNF could be used as a valuable effect biomarker to investigate developmental neurotoxicity of some chemical pollutants.
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Affiliation(s)
- Andrea Rodríguez-Carrillo
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
- Toxicological Centre, University of Antwerp, Universiteitsplein, Wilrijk, Belgium
| | - Veerle J. Verheyen
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | | | - Mariana F. Fernández
- Biomedical Research Center and School of Medicine, Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), University of Granada, Granada, Spain
| | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
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Crespo-Lopez ME, Barthelemy JL, Lopes-Araújo A, Santos-Sacramento L, Leal-Nazaré CG, Soares-Silva I, Macchi BM, do Nascimento JLM, Arrifano GDP, Augusto-Oliveira M. Revisiting Genetic Influence on Mercury Exposure and Intoxication in Humans: A Scoping Review. TOXICS 2023; 11:967. [PMID: 38133368 PMCID: PMC10747380 DOI: 10.3390/toxics11120967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/21/2023] [Accepted: 11/26/2023] [Indexed: 12/23/2023]
Abstract
Human intoxication to mercury is a worldwide health problem. In addition to the type and length of exposure, the genetic background plays an important role in mercury poisoning. However, reviews on the genetic influence in mercury toxicity are scarce and not systematic. Therefore, this review aimed to systematically overview the most recent evidence on the genetic influence (using single nucleotide polymorphisms, SNPs) on human mercury poisoning. Three different databases (PubMed/Medline, Web of Science and Scopus) were searched, and 380 studies were found that were published from 2015 to 2022. After applying inclusion/exclusion criteria, 29 studies were selected and data on characteristics (year, country, profile of participants) and results (mercury biomarkers and quantitation, SNPs, main findings) were extracted and analyzed. The largest number of studies was performed in Brazil, mainly involving traditional populations of the Tapajós River basin. Most studies evaluated the influence of the SNPs related to genes of the glutathione system (GST, GPx, etc.), the ATP-binding cassette transporters and the metallothionein proteins. The recent findings regarding other SNPs, such as those of apolipoprotein E and brain-derived neurotrophic factor genes, are also highlighted. The importance of the exposure level is discussed considering the possible biphasic behavior of the genetic modulation phenomena that could explain some SNP associations. Overall, recommendations are provided for future studies based on the analysis obtained in this scoping review.
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Affiliation(s)
- Maria Elena Crespo-Lopez
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, PA, Brazil (L.S.-S.); (C.G.L.-N.)
| | - Jean Ludger Barthelemy
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, PA, Brazil (L.S.-S.); (C.G.L.-N.)
| | - Amanda Lopes-Araújo
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, PA, Brazil (L.S.-S.); (C.G.L.-N.)
| | - Leticia Santos-Sacramento
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, PA, Brazil (L.S.-S.); (C.G.L.-N.)
| | - Caio Gustavo Leal-Nazaré
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, PA, Brazil (L.S.-S.); (C.G.L.-N.)
| | - Isabela Soares-Silva
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, PA, Brazil (L.S.-S.); (C.G.L.-N.)
| | - Barbarella M. Macchi
- Laboratório de Neuroquímica Molecular e Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, PA, Brazil (J.L.M.d.N.)
| | - José Luiz M. do Nascimento
- Laboratório de Neuroquímica Molecular e Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, PA, Brazil (J.L.M.d.N.)
| | - Gabriela de Paula Arrifano
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, PA, Brazil (L.S.-S.); (C.G.L.-N.)
| | - Marcus Augusto-Oliveira
- Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, PA, Brazil (L.S.-S.); (C.G.L.-N.)
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Wang H, Wan Y, Liu Q, Xie X, Zhu K, Jiang Q, Feng Y, Xiao P, Xiang Z, Zhang Q, Fan Y, Wu X, Zhu Y, Song R. Association between urinary 2-hydroxyethyl mercapturic acid and dyslexia among school-aged children. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:101091-101098. [PMID: 37646928 DOI: 10.1007/s11356-023-29418-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/17/2023] [Indexed: 09/01/2023]
Abstract
Ethylene oxide is commonly used in industrial synthesis and medical disinfection. It is a known human carcinogen and has neurotoxicity. However, the association between ethylene oxide exposure and neurodevelopmental disorders remains unclear. This study aimed to evaluate the association between urinary concentrations of 2-hydroxyethyl mercapturic acid (HEMA; metabolite of ethylene oxide) and dyslexia among school-aged children. A total of 355 dyslexic children and 390 controls from three cities in China were enrolled in this case-control study from November 2017 to December 2020. Urinary HEMA was detected in 100% of the urine samples, suggesting widespread exposure to ethylene oxide in the children. Notably, the children with dyslexia had higher concentrations of urinary HEMA compared to the controls (geometric mean: 2.92 vs. 2.47 ng/mL) (P = 0.004). In the multivariable-adjusted model, urinary concentrations of HEMA were significantly associated with dyslexia risk. The individuals within the highest HEMA concentration demonstrated a 1.97-fold increased odds of dyslexia compared to those within the lowest quartile (95% confidence interval: 1.20-3.23). Thus, these findings suggested the possible link between HEMA levels and the risk of dyslexia. Further studies are warranted to validate this finding and illustrate the underlying mechanism.
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Affiliation(s)
- Haoxue Wang
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Yanjian Wan
- Institute of Environmental Health, Wuhan Centers for Disease Control & Prevention, Wuhan, 430024, Hubei, China
| | - Qi Liu
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Xinyan Xie
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Kaiheng Zhu
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Qi Jiang
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Yanan Feng
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Pei Xiao
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Zhen Xiang
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Quan Zhang
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Yixi Fan
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Xvfang Wu
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Ying Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, 430072, Hubei, China
| | - Ranran Song
- Department of Maternal and Child Health and MOE (Ministry of Education) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China.
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Zhu K, Wan Y, Zhu B, Wang H, Liu Q, Xie X, Jiang Q, Feng Y, Xiao P, Xiang Z, Song R. Association of perchlorate, thiocyanate, and nitrate with dyslexic risk. CHEMOSPHERE 2023; 325:138349. [PMID: 36898444 DOI: 10.1016/j.chemosphere.2023.138349] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 02/28/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
Perchlorate, thiocyanate, and nitrate are sodium iodide symporter (NIS) inhibitors that disturb iodide uptake into the thyroid and have been implicated in child development. However, no data are available on the association between exposure to/related with them and dyslexia. Here, we examined the association of exposure to/related with the three NIS inhibitors with the risk of dyslexia in a case-control study. The three chemicals were detected in urine samples of 355 children with dyslexia and 390 children without dyslexia from three cities in China. The adjusted odds ratios for dyslexia were examined using logistic regression models. The detection frequencies of all the targeted compounds were 100%. After adjusting for multiple covariates, urinary thiocyanate was significantly associated with the risk of dyslexia (P-trend = 0.02). Compared with the lowest quartile, children within the highest quartile had a 2.66-fold risk of dyslexia (95% confidence interval: 1.32, 5.36]. Stratified analyses showed that the association between urinary thiocyanate level and the risk of dyslexia was more pronounced among boys, children with fixed reading time, and those without maternal depression or anxiety during pregnancy. Urinary perchlorate and nitrate levels were not associated with the risk of dyslexia. This study suggests the possible neurotoxicity of thiocyanate or its parent compounds in dyslexia. Further investigation is warranted to confirm our findings and clarify the potential mechanisms.
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Affiliation(s)
- Kaiheng Zhu
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yanjian Wan
- Laboratory Center for Public Health Service, Institute of Environmental Health, Wuhan Centers for Disease Control & Prevention, Wuhan, Hubei, 430024, China.
| | - Bing Zhu
- Hangzhou Center for Disease Control and Prevention, Hangzhou, 310021, China
| | - Haoxue Wang
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qi Liu
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xinyan Xie
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qi Jiang
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yanan Feng
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Pei Xiao
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zhen Xiang
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ranran Song
- Department of Maternal and Child Health and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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