期刊
JAMA NETWORK OPEN
卷 3, 期 3, 页码 -出版社
AMER MEDICAL ASSOC
DOI: 10.1001/jamanetworkopen.2020.1007
关键词
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资金
- European Community Seventh Framework Programme [308333]
- European Union Horizon 2020 Research and Innovation Programme [874583]
- Centro de Excelencia Severo Ochoa 2013-2017, Spanish Ministry of Science, Innovation and Universities [SEV-2012-0208]
- Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement de la Generalitat de Catalunya [2017SGR595]
- Consorcio de Investigacion Biomedica en Red de Epidemiologia y Salud Publica [CB06/021/0041]
- Comissio Interdepartamental de Recerca i Innovacio Tecnologica, Generalitat de Catalunya [1999SGR00241]
- Lithuanian Agency for Science Innovation and Technology [31V-66]
- Plan Estatal de I+D+I 2013-2016 project from the Instituto de Salud Carlos III [PT17/0019]
- European Regional Development Fund [PT17/0019]
- National Institute for Health Sciences [R21 ES029681, P30 ES007048-23, P01CA196569, R01CA140561, R01 ES016813, P01 ES022845, R01 ES029944, R21 ES028903]
- National Institute of Diabetes and Digestive and Kidney Diseases [P30 DK048522-24]
- Ministry of Economy and Competitiveness at the Instituto de Salud Carlos III [MS16/00128]
- Environmental Protection Agency [RD-83544101]
This cohort study used data from the Human Early Life Exposome (HELIX) project, a collaboration of 5 European birth cohort studies, to examine the associations of maternal fish consumption and mercury exposure during pregnancy with metabolic health and inflammatory biomarkers in children. Importance The balance of mercury risk and nutritional benefit from fish intake during pregnancy for the metabolic health of offspring to date is unknown. Objective To assess the associations of fish intake and mercury exposure during pregnancy with metabolic syndrome in children and alterations in biomarkers of inflammation in children. Design, Setting, and Participants This population-based prospective birth cohort study used data from studies performed in 5 European countries (France, Greece, Norway, Spain, and the UK) between April 1, 2003, and February 26, 2016, as part of the Human Early Life Exposome (HELIX) project. Mothers and their singleton offspring were followed up until the children were aged 6 to 12 years. Data were analyzed between March 1 and August 2, 2019. Exposures Maternal fish intake during pregnancy (measured in times per week) was assessed using validated food frequency questionnaires, and maternal mercury concentration (measured in micrograms per liter) was assessed using maternal whole blood and cord blood samples. Main Outcomes and Measures An aggregate metabolic syndrome score for children was calculated using the z scores of waist circumference, systolic and diastolic blood pressures, and levels of triglyceride, high-density lipoprotein cholesterol, and insulin. A higher metabolic syndrome score (score range, -4.9 to 7.5) indicated a poorer metabolic profile. Three protein panels were used to measure several cytokines and adipokines in the plasma of children. Results The study included 805 mothers and their singleton children. Among mothers, the mean (SD) age at cohort inclusion or delivery of their infant was 31.3 (4.6) years. A total of 400 women (49.7%) had a high educational level, and 432 women (53.7%) were multiparous. Among children, the mean (SD) age was 8.4 (1.5) years (age range, 6-12 years). A total of 453 children (56.3%) were boys, and 734 children (91.2%) were of white race/ethnicity. Fish intake consistent with health recommendations (1 to 3 times per week) during pregnancy was associated with a 1-U decrease in metabolic syndrome score in children (beta = -0.96; 95% CI, -1.49 to -0.42) compared with low fish consumption (<1 time per week) after adjusting for maternal mercury levels and other covariates. No further benefit was observed with fish intake of more than 3 times per week. A higher maternal mercury concentration was independently associated with an increase in the metabolic syndrome score of their offspring (beta per 2-fold increase in mercury concentration = 0.18; 95% CI, 0.01-0.34). Compared with low fish intake, moderate and high fish intake during pregnancy were associated with reduced levels of proinflammatory cytokines and adipokines in children. An integrated analysis identified a cluster of children with increased susceptibility to metabolic disease, which was characterized by low fish consumption during pregnancy, high maternal mercury levels, decreased levels of adiponectin in children, and increased levels of leptin, tumor necrosis factor alpha, and the cytokines interleukin 6 and interleukin 1 beta in children. Conclusions and Relevance Results of this study suggest that moderate fish intake consistent with current health recommendations during pregnancy was associated with improvements in the metabolic health of children, while high maternal mercury exposure was associated with an unfavorable metabolic profile in children. Question Is fish consumption during pregnancy associated with benefits for the metabolic health of children? Findings In this cohort study of 805 mothers and their singleton offspring, moderate fish consumption during pregnancy was associated with the downregulation of inflammation and improvements in the metabolic profile of children; high mercury exposure during pregnancy had the opposite associations. Meaning The results of this study suggest that fish consumption consistent with current recommendations during pregnancy was associated with improvements in the metabolic health of children.
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