[논문]Relationships of Lead, Mercury and Cadmium Levels with the Timing of Menarche among Korean Girls

Choi, Hye Seon

doi:10.4094/chnr.2020.26.1.98

Relationships of Lead, Mercury and Cadmium Levels with the Timing of Menarche among Korean Girls 원문보기

CHNR : Child health nursing research, v.26 no.1, 2020년, pp.98 - 106

Choi, Hye Seon (College of Nursing, Woosuk University)

Abstract ▼ AI-Helper

Purpose: This study utilized data from the Korean National Health and Nutrition Examination Survey (KNHANES) to explore differences in the timing of menarche in Korean girls according to blood heavy metal concentrations. Methods: This study performed a secondary analysis of cross-sectional data from the sixth KNHANES. Data from 179 female children and adolescents aged 10~18 were included in this study. The relationships of blood heavy metal concentrations (lead, mercury, and cadmium) with age of menarche were analyzed using complex sample multiple logistic regression. Results: In the participants of this study, the geometric mean values of blood lead, mercury, and cadmium concentrations were 1.15±0.04 ㎍/dL, 1.80±0.08 ㎍/L, and 0.30±0.03 ㎍/L, respectively. Mercury poisoning (>5 ㎍/L) was found in 1.5% of participants. Furthermore, significant relationships were found between blood lead and mercury concentrations and age at menarche (p for trend: p<.001 and p=.015, respectively). Conclusion: Through an analysis of national big data, this study found evidence that Korean girls showed a younger age at menarche in response to higher blood lead and mercury concentrations. To prevent and manage precocious puberty in Korean children and adolescents, a systematic policy that monitors both exposure to environmental hazards and blood heavy metal concentrations is needed.

주제어

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문제 정의

This study performed a secondary analysis of the sixth KNHANES to investigate the correlation between age at menarche and blood heavy metal concentrations in Korean girls [22].
This study revealed that higher blood concentrations of lead and mercury were associated with lower ages at menarche. Exposure to endocrine-disrupting chemicals (EDCs) such as lead, cadmium, mercury, and polychlorinated biphenyls, among others [29], during the developmental stages of the central nervous system and sexual differentiation can alter the course of puberty [5,7].

제안 방법

The KNHANES health survey items were used to analyze subjects’ general characteristics including, age, economic status (household income quartile), residential area, housing type, height, body weight, and BMI.
Age at menarche was categorized as 10, 11, 12, 13 and ≥14 years to examine the relationships between blood concentrations of heavy metals and menarche. The blood concentrations of heavy metals were analyzed using a complex sample multiple logistic regression with lead, mercury, and cadmium levels as the dependent variables.
The variables analyzed in this study were gender, age, economic status, residential area, housing type, age at menarche, height, body weight, body mass index (BMI), and blood heavy metal concentrations (lead, mercury, and cadmium) [22]. Previous studies have identified differences in blood heavy metal concentration according to socioeconomic status, residential area, and life environment [11,23].
In particular, children living in areas with lower socioeconomic status and poor living conditions had significantly higher blood lead levels than children living in the opposite environment (lower socioeconomic status and good living conditions) [6,20,23]. Therefore, this study used the variables of economic status, residential area, and housing type.
This study also used the same ranges of age at menarche as the KNHANES data, in which participants were categorized into the early-maturing group (<11 years), the average-maturing group (11~13 years), and the late-maturing group (≥14 years) [14,22].

대상 데이터

The city of Sejong was added to the strata and cluster variables starting in 2016 [22]. For the purpose of this study, the dataset from the 2013~2015 KNHANES was used.
Age, economic status, housing type, age at menarche, height, body weight, and BMI were analyzed according to the raw data [22]. The residential areas of participants were reclassified from 16 cities into five regions: the capital area (Seoul, Incheon, and Gyeonggi Province); the Chungcheong area (Daejeon and North and South Chungcheong Provinces); the Daegu, Gyeongbuk, and Gangwon area (Daeju, North Gyeongsang Province, and Gangwon Province); the Busan, Ulsan, and Gyeongnam area (Busan, Ulsan, and South Gyeongsang Province); and the Honam and Jeju area (Gwangju, North and South Jeolla Provinces, and Jeju). This study used raw data with 1-year variation; the age at menarche was indicated using the international age [22].
The subjects of this study were all females, with a mean age of 14.4 years. Their economic status was distributed as follows: mid-high, 32.
The first-year data of the sixth KNHANES included an examination of heavy metal exposure (lead, mercury, and cadmium) among 2,355 subjects (female: 1,178 and male: 1,177) [22]. The subjects of this study were female children and adolescents aged between 10 and 18, and the final analysis included 179 girls who underwent tests of blood heavy metal concentrations (lead, mercury, and cadmium).
kr/). This study used a nationally representative sample from the sixth KNHANES, 2013~2015. This national survey has been conducted annually since 2005 by the KCDC.

데이터처리

Age at menarche according to participants’ demographic characteristics was analyzed with the x2 test and one-way ANOVA analysis of variance considering the complex sample design.

이론/모형

This study used the first-year data of the sixth KNHANES, which is being conducted with the approval of the Institutional Review Board of the Korea Centers for Disease Control and Prevention (KCDC) (Approval No. 2013-07CON-03-4C) [22]. Permission was also obtained from the Research Ethics Committee of W University (Approval No.

성능/효과

In the participants of this study, significant relationships were found between blood lead and mercury concentrations and age at menarche (p for trend: p<.001 and p=.015, respectively).
In the participants of this study, the geometric mean values of blood lead, mercury, and cadmium concentrations were 1.15±0.04 μg/dL, 1.80±0.08 μg/L, and 0.30±0.03 μg/L, respectively.
It was also not possible to analyze some other variables related to heavy metals and precocious puberty, such as diet, physical activity, and internal and external environmental factors (psychosocial status, living environment, and maternal age at menarche). Nevertheless, this study is significant in that it analyzed associations between blood heavy metal concentrations in Korean children and age at menarche, which had not been attempted previously, using representative national data, and it revealed that elevated lead and mercury levels increased the risk of precocious puberty.
There were no significant differences in economic status, residential area, housing type, body weight, or BMI among the participants whose age at menarche was 10 years, 11 years, 12 years, 13 years, or ≥14 years, but height showed a significant difference across these groups (F=3.54, p=.008) [Table 2].

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