Peripubertal blood lead levels and growth among Russian boys

Background: Childhood blood lead levels (BLL) have been associated with growth impairment. Objectives: We assessed associations of peripubertal BLL with adolescent growth and near adult height in a longitudinal cohort of Russian boys. Methods: 481 boys were enrolled at ages 8-9 years and followed annually to age 18. At enrollment, BLL was measured, and height, weight, and pubertal staging were obtained annually during 10 years of follow-up. Mixed effects models were used to assess the associations of BLL with longitudinal age-adjusted World Health Organization Z-scores for height (HT-Z) and body mass index (BMI-Z), and annual height velocity (HV). Interactions between boys' age and BLL on growth outcomes were evaluated. Results: The median (range) BLL was 3.0 (0.5-31.0) mu g/dL. At age 18 years, 79% of boys had achieved near adult height (HV < 1.0 cm/year), and means (SD) for HT-Z and BMI-Z were 0.15 (0.92) and -0.32 (1.24). Over 10 years of follow-up, after covariate adjustment, boys with higher ( >= 5 mu g/dL) BLL compared with lower BLL were shorter (adjusted mean difference in HT-Z = -0.43, 95% CI -0.60, -0.25, p-value < 0.001), translating to a 2.5 cm lower height at age 18 years. The decrement in height for boys with higher BLL was most pronounced at 12 to 15 years of age (interaction p = 0.03). Boys with higher BLL were leaner (adjusted mean difference in BMI-Z = -0.22, 95% CI: -0.45, 0.01, p = 0.06). Conclusions: Higher peripubertal BLLs were associated with shorter height through age 18 years, suggesting a persistent effect of lead on linear growth.