Jane S Burns1, Paige L Williams2, Mary M Lee3, Boris Revich4, Oleg Sergeyev5, Russ Hauser6, Susan A Korrick7. 1. Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA. Electronic address: jburns@hsph.harvard.edu. 2. Department of Biostatistics, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA. 3. Pediatric Endocrine Division, Department of Pediatrics, University of Massachusetts Medical School, 55 N Lake Avenue, Worcester, MA 01655, USA. 4. Institute for Forecasting, Russian Academy of Sciences, 47 Nakhimovsky Prosp, Moscow 117418, Russia. 5. Department of Genomics and Human Genetics, Vavilov Institute of General Genetics, Russian Academy of Sciences, Gubkina Str. 3, Moscow 119333, Russia; Chapaevsk Medical Association, Meditsinskaya Str., 3a, Chapaevsk, Samara Region 446100, Russia. 6. Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA. 7. Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA.
Abstract
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 8-9years and followed annually to age 18. At enrollment, BLL was measured, and height, weight, and pubertal staging were obtained annually during 10years of follow-up. Mixed effects models were used to assess the associations of BLL with longitudinal age-adjusted World Health OrganizationZ-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) μg/dL. At age 18years, 79% of boys had achieved near adult height (HV <1.0cm/year), and means (SD) for HT-Z and BMI-Z were 0.15 (0.92) and -0.32 (1.24). Over 10years of follow-up, after covariate adjustment, boys with higher (≥5μg/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 2.5cm lower height at age 18years. The decrement in height for boys with higher BLL was most pronounced at 12 to 15years 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 18years, suggesting a persistent effect of lead on linear growth.
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 8-9years and followed annually to age 18. At enrollment, BLL was measured, and height, weight, and pubertal staging were obtained annually during 10years of follow-up. Mixed effects models were used to assess the associations of BLL with longitudinal age-adjusted World Health OrganizationZ-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) μg/dL. At age 18years, 79% of boys had achieved near adult height (HV <1.0cm/year), and means (SD) for HT-Z and BMI-Z were 0.15 (0.92) and -0.32 (1.24). Over 10years of follow-up, after covariate adjustment, boys with higher (≥5μg/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 2.5cm lower height at age 18years. The decrement in height for boys with higher BLL was most pronounced at 12 to 15years 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 18years, suggesting a persistent effect of lead on linear growth.
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