Publications by authors named "Gengsheng He"

57 Publications

Bayesian toxicokinetic modeling of cadmium exposure in Chinese population.

J Hazard Mater 2021 Jul 19;413:125465. Epub 2021 Feb 19.

School of Public Health/Key Laboratory of Public Health Safety, Ministry of Education, Department of Nutrition and food science, Fudan University, Shanghai 200032, China. Electronic address:

Cadmium (Cd) is a toxic heavy metal widely present in the environment. Estimating its internal levels for a given external exposure using toxicokinetic (TK) models is key to the human health risk assessment of Cd. In this study, existing Cd TK models were adapted to develop a one-compartment TK model and a multi-compartment physiologically based toxicokinetic (PBTK) model by estimating the characteristics of Cd kinetics based on Cd exposure data from 814 Chinese residents. Both models not only considered the effect of gender difference on Cd kinetics, but also described the model parameters in terms of distributions to reflect individual variability. For both models, the posterior distributions of sensitive parameters were estimated using the Markov chain-Monte Carlo method (MCMC) and the approximate Bayesian computation-MCMC algorithm (ABC-MCMC). Validation with the test dataset showed 1.4-22.5% improvement in the root mean square error (RMSE) over the original models. After a systematic literature search, the optimized models showed acceptable prediction on other Chinese datasets. The study provides a method for parameter optimization of TK models under different exposure environment, and the validated models can serve as new quantitative assessment tools for the risk assessment of Cd in the Chinese population.
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http://dx.doi.org/10.1016/j.jhazmat.2021.125465DOI Listing
July 2021

Relationships between Maternal Dietary Patterns and Blood Lipid Levels during Pregnancy: A Prospective Cohort Study in Shanghai, China.

Int J Environ Res Public Health 2021 Apr 1;18(7). Epub 2021 Apr 1.

Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai 200032, China.

The relationships between maternal dietary patterns and blood lipid profile during pregnancy have not been well understood. We aimed to analyze the dietary patterns of pregnant women and their associations with blood lipid concentrations during pregnancy. A cohort of 1008 Chinese pregnant women were followed from 10-15 weeks of gestation to delivery. Their dietary patterns were identified using a principal component analysis. The relationships between dietary pattern score and maternal blood lipid concentrations were assessed using both multivariate linear regression models and generalized estimating equation (GEE) models. Five different dietary patterns were identified. GEE showed that a high score for the fish-shrimps pattern was associated with higher concentrations of total cholesterol (TC) (β = 0.11), low-density lipoprotein cholesterol (LDL-C) (β = 0.07), and high-density lipoprotein cholesterol (HDL-C) (β = 0.03), with all values < 0.001. In contrast, a high tubers-fruit-vegetables pattern score was associated with lower concentrations of TC (β = -0.12), LDL-C (β = -0.07), and HDL-C (β = -0.03), with all values < 0.001. In addition, dietary protein, carbohydrate, and cholesterol intake significantly contributed to the associations between the fish-shrimps dietary pattern and blood lipid concentrations. Predominant seafood consumption is associated with higher cholesterol concentrations, whereas predominant tuber, fruit, and vegetable consumptions are associated with lower cholesterol concentrations during pregnancy.
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http://dx.doi.org/10.3390/ijerph18073701DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8036959PMC
April 2021

Impact of a Fermented High-Fiber Rye Diet on and Cardio-Metabolic Risk Factors: A Randomized Controlled Trial Among -Positive Chinese Adults.

Front Nutr 2020 15;7:608623. Epub 2021 Jan 15.

Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden.

High dietary fiber intake has been associated with reduced risk of infection and co-morbidities such as gastric cancer but also with reduced risk of cardiovascular disease. It has been suggested that fermented rye could affect bacterial load and that high- fiber rye may be superior to wheat for improvement of several cardiometabolic risk factors, but few long-term interventions with high fiber rye foods have been conducted. To examine the effect of high-fiber wholegrain rye foods with added fermented rye bran vs. refined wheat on infection and cardiometabolic risk markers in a Chinese population with a low habitual consumption of high fiber cereal foods. A parallel dietary intervention was set up and 182 normal- or overweight men and women were randomized to consume wholegrain rye products containing fermented rye bran (FRB) or refined wheat (RW) for 12 weeks. Anthropometric measurements, fasting blood sample collection and C-urea breath test (C-UBT) were performed at baseline and after 6 and 12 weeks of intervention as well as 12 weeks after the end of the intervention. No difference between diets on bacterial load measured by C-UBT breath test or in virulence factors of in blood samples were found. Low density lipoprotein cholesterol (LDL-C) and high sensitivity C-reactive protein (hs-CRP) were significantly lower in the FRB group, compared to the RW group after 12 weeks of intervention. The intervention diets did not affect markers of glucose metabolism or insulin sensitivity. While the results of the present study did not support any effect of FRB on bacterial load, beneficial effects on LDL-C and hs-CRP were clearly shown. This suggest that consumption of high fiber rye foods instead of refined wheat could be one strategy for primary prevention of cardiovascular disease. The trial was registered at www.clinicaltrials.gov, Identifier: NCT03103386.
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http://dx.doi.org/10.3389/fnut.2020.608623DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7844128PMC
January 2021

Serum perfluoroalkyl substances in relation to lipid metabolism in Chinese pregnant women.

Chemosphere 2021 Jun 8;273:128566. Epub 2020 Oct 8.

School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200032, China. Electronic address:

Laboratory and epidemiologic studies suggested that exposure to perfluoroalkyl substances (PFASs) could affect lipid metabolisms, but data remain limited for pregnant women. A total of 436 pregnant women were selected in Tangshan City, North China. Serum levels of 11 PFASs were determined in the early term of pregnancy. Four lipids (total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL)) were measured in the late term of pregnancy. Of 11 PFASs, seven had a detection rate of greater than 70%. After adjusting for potential confounders, natural log-transformed perfluororohexanesulfonic acid (ln PFHxS) was positively associated with TC (β: 0.184, 95% CI: 0.045-0.321), HDL (β: 0.040, 95% CI: 0.001-0.083), and LDL (β: 0.091, 95% CI: 0.001-0.185). Ln perfluoroundecanoic acid (PFUdA) was positively associated with HDL (β: 0.021, 95% CI: 0.001-0.044), while Ln perfluorodecanoic acid (PFDA) was negatively associated with LDL (β: -0.053, 95% CI: -0.098∼-0.009) and ln perfluorootanoic acid (PFOA) was negatively associated with LDL/HDL (β: -0.042, 95% CI: -0.075∼-0.009). In principal component analysis, the component with a large loading of 31.3% for PFOA, perfluorononanoic acid (PFNA), PFDA and PFUdA showed a negative association with LDL/HDL. After serum concentrations of PFASs were categorized into quartiles, a higher level of TC was seen in the second quartile of PFOA or PFNA than the first quartile, but a lower LDL/HDL ratio was seen in the fourth quartile of PFOA, PFUdA or PFDA. These results suggested that exposure to PFASs has a potential to influence lipid metabolisms in pregnant women.
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http://dx.doi.org/10.1016/j.chemosphere.2020.128566DOI Listing
June 2021

Serum Bisphenol A, glucose homeostasis, and gestational diabetes mellitus in Chinese pregnant women: a prospective study.

Environ Sci Pollut Res Int 2021 Mar 20;28(10):12546-12554. Epub 2020 Oct 20.

School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, No. 130 Dong'an Road, Shanghai, 200032, China.

Lab studies have suggested that exposure to Bisphenol A (BPA) could disturb glucose homeostasis, but epidemiologic studies are limited and show inconsistent results for pregnant women. For this, 535 pregnant women were selected from a pregnant women cohort established in Tangshan City in North China between 2013 and 2014. Serum concentrations of BPA were measured in the early term of pregnancy, and fasting glucose and insulin levels were repeatedly measured in each of three terms of pregnancy (early, middle, and late). Gestational diabetes mellitus (GDM) were examined by Oral Glucose Tolerance Test (OGTT) in the middle and late terms of pregnancy. BPA was detected in 97.5% of pregnant women with a median of 6.50 ng/ml. Natural log-transformed BPA (Ln BPA) was positively associated with fasting glucose level (β (95% CI): 0.038 (0.015~0.061)), fasting insulin level (0.195 (0.069~0.321)), and homeostasis model insulin resistance index (HOMA-IR) (0.226 (0.087~0.364)) in the middle term of pregnancy by multiple linear regression model after adjusting for potential confounders. After serum BPA levels were divided into three groups (low, middle, and high), BPA showed a positive dose-response relationship with blood glucose, insulin, and HOMA-IR in the middle term of pregnancy. Increased BPA concentration tended to increase the RR of GDM although not statistically significant (risk ratio: 2.51 (95% CI: 0.68~9.30) for high vs low tertile of BPA concentrations). These findings suggested that exposure to BPA might affect glucose homeostasis and the middle term of pregnancy was a potentially sensitive period.
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http://dx.doi.org/10.1007/s11356-020-11263-4DOI Listing
March 2021

Serum phytosterols associate with T helper 1 cytokine concentration in pregnant women.

Food Sci Nutr 2020 Jul 10;8(7):3893-3899. Epub 2020 Jun 10.

School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education Fudan University Shanghai China.

The dietary phytosterols have been demonstrated to modulate CD4 T-cell polarization in cells, animals, and humans. However, T helper (Th)1/Th2 dichotomy has rarely been correlated with phytosterols during pregnancy. The present study investigated associations between the serum cytokines and serum phytosterols in 100 pregnant women at 34- to 37-week gestation and their offspring. The results showed that serum concentrations of interferon (IFN)-γ, tumor necrosis factor (TNF)-α, and total Th1 cytokines were positively associated with serum β-sitosterol level, adjusting for age, BMI, and serum cholesterol. Serum IFN-γ and total Th1 cytokine concentrations positively correlated with total phytosterol concentration, controlling age, BMI, and serum cholesterol. Moreover, none of the cytokines measured correlated with phytosterol concentration in the newborns. Our results show that serum Th1 cytokine concentrations, but not Th2 levels, are positively associated with serum phytosterols in pregnant women. These findings implicate that phytosterols modulate Th1/Th2 balance by inducing Th1 secretions in pregnant women.
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http://dx.doi.org/10.1002/fsn3.1697DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7382156PMC
July 2020

Cancer risk and disease burden of dietary cadmium exposure changes in Shanghai residents from 1988 to 2018.

Sci Total Environ 2020 Sep 13;734:139411. Epub 2020 May 13.

School of Public Health/Key Laboratory of Public Health Safety, Ministry of Education, Department of Nutrition and Food Hygiene, Fudan University, Shanghai 200032, China. Electronic address:

Cadmium (Cd) is a widely distributed toxic metal, which is mainly exposed to humans through diet. The impact of dietary guidelines on the Chinese diet structure has indirectly led to changes in dietary Cd exposure. The Chinese Dietary Guidelines were issued in 1997 and revised in 2007. Based on the time between issuance and revision, this study examined the Cd contamination levels in Shanghai foods from 1988 to 2018 and evaluated cancer risk and disease burden of dietary Cd exposure accordingly. Over the time periods of 1988-1997, 1998-2007, and 2008-2018, it was found that Cd dietary exposure of Shanghai residents showed a trend of increasing and then decreasing (39.7, 44.7, and 36.4 μg/day, respectively). In contrast to cereals, the contribution rates of meat and vegetables to Cd exposure have gradually increased over time, and aquatic foods have become the main source of Cd exposure (40.6%). Although the non-cancer risk hazard quotients of dietary Cd exposure and the excess lifetime cancer risks (ELCR) are relatively low (HQ < 1, ELCR < 10), 26.6% of Shanghai residents had a potential risk of kidney injury calculated by toxicokinetic model (TK model), and the disability adjusted life years (DALYs) have been rising (from 41.6 to 58.2). Results indicated that in the past three decades, changes of Cd contamination in food due to both limit standards and changes in dietary structure have influenced cancer risk and disease burden from Cd exposure in Shanghai residents. In summary, our study suggested that while regulating the contamination in foods, attention should also be paid to the potential impacts of dietary structure and guidelines on the exposure of pollutants.
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http://dx.doi.org/10.1016/j.scitotenv.2020.139411DOI Listing
September 2020

Multi-omics integrative analysis to access role of coiled-coil domain-containing 80 in lipid metabolism.

Biochem Biophys Res Commun 2020 06 7;526(3):813-819. Epub 2020 Apr 7.

School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200032, China. Electronic address:

Coiled-coil domain-containing 80 (Ccdc80) is closely linked to energy homeostasis. However, the molecular mechanism remains unclear. This study aims to uncover the potential mechanism of Ccdc80 in modulating lipid metabolism by accessing the metabolic and transcriptional consequences of removing Ccdc80. We established a Ccdc80 knockout model (Ccdc80) in C57BL/6 mouse. Serum and liver samples from Ccdc80 (n = 8) and Ccdc80 (n = 8) male mice were obtained at the age of week 10. The serum metabolites and lipids were analyzed by gas chromatography-mass spectrometry and ultra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry, respectively. RNA expression microarray was performed in the livers of the same mice. Results showed that a total of 58 metabolites and 30 lipids were altered between the Ccdc80 and Ccdc80 mice. A total of 873 hepatic differentially expressed genes (DEGs) were identified. The enrichment analysis of discriminant metabolites and lipids reflected alterations in α-linolenic acid and linoleic acid metabolism. Reactome pathway analysis of DEGs revealed a decreased hydroxylation of arachidonic acid in Ccdc80 mice. The Kyoto Encyclopedia of Genes and Genomes pathway result suggested a decrease of PPAR signaling and fatty acid degradation by Ccdc80-knockout. The joint pathway analysis integrating metabolomics, lipidomics and transcriptomics indicated that Ccdc80-knockout could down-regulate arachidonic acid and α-linolenic acid metabolism. These results provide new insights into the role of Ccdc80 in fatty acid metabolism.
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http://dx.doi.org/10.1016/j.bbrc.2020.03.121DOI Listing
June 2020

Nutrition Education Practices of Health Teachers from Shanghai K-12 Schools: The Current Status, Barriers and Willingness to Teach.

Int J Environ Res Public Health 2019 12 20;17(1). Epub 2019 Dec 20.

Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai 200433, China.

China is facing challenges in both undernutrition and overnutrition, resulting from unhealthy diets. Nutrition education early in life, especially in school settings, has been reported to be effective in addressing these challenges. However, little is known about how nutrition education is delivered in schools in China. This study aimed to investigate the current status of delivering nutrition education by health teachers in Shanghai and to determine the barriers and resources that influence the teachers' practices and their willingness to teach nutrition. In 2016-2017, a cross-sectional questionnaire survey was conducted on 904 health teachers from 823 K-12 schools in Shanghai, China. There were 722 (79.9%) teachers that had the experience of teaching nutrition, but only 137 (19.0% of 722) spent ≥1 h teaching nutrition courses in each school year. Only 18.6% of the teachers had received a formal education in nutrition in college. About 88.5% of teachers expressed their willingness to teach nutrition in the future. The three major reasons for never teaching nutrition were categorized as: nutrition being taught by other teachers (39.5%), willing to teach but lack of knowledge (37.9%), and the subject not being required by school administrators (31.3%). Teachers who spent more time or were more willing to teach nutrition courses were those who were female, from private schools, had a better background in receiving nutrition education, and were more concerned about nutrition. Our data show that nutrition education is at a formative stage in Shanghai, China.
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http://dx.doi.org/10.3390/ijerph17010086DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6982291PMC
December 2019

Authorship Correction: A Community-Based Short Message Service Intervention to Improve Mothers' Feeding Practices for Obesity Prevention: Quasi-Experimental Study.

JMIR Mhealth Uhealth 2019 Jul 18;7(7):e15046. Epub 2019 Jul 18.

School of Public Health, Global Health Institute, Fudan University, Shanghai, China.

[This corrects the article DOI: 10.2196/13828.].
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http://dx.doi.org/10.2196/15046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6670271PMC
July 2019

Understanding the Use of Smartphone Apps for Health Information Among Pregnant Chinese Women: Mixed Methods Study.

JMIR Mhealth Uhealth 2019 06 18;7(6):e12631. Epub 2019 Jun 18.

Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, China.

Background: Hospital-based health promotion resources to assist pregnant women in adopting a healthy lifestyle and optimizing gestational weight gain are important, but with limited effects. Increasingly, women are using mobile apps to access health information during the antenatal period.

Objective: The aims of the study were to investigate app-usage by Chinese women during pregnancy and to gain a better understanding of their views and attitudes toward apps containing health information.

Methods: A mixed methods study design was applied. Study participants were recruited from 2 maternity hospitals in Shanghai, China, between March and July 2018. A self-administered Web-based survey was conducted with 535 pregnant Chinese women on their sources of health information and reasons for using apps during pregnancy. A total of 4 semistructured focus groups were also conducted with the pregnant women (n=28).

Results: The use of pregnancy-related apps and the internet was common among the respondents. Almost half of the women had used pregnancy-related apps. Specifically, the use of apps for health information declined as pregnancy progressed from 70% (35/50) in the first trimester to 41.3% (143/346) in the third trimester. The main reason for using an app was to monitor fetal development (436/535, 81.5%), followed by learning about nutrition and recording diet in pregnancy (140/535, 26.2%). The women found that the apps were useful and convenient and can support lifestyle modifications during pregnancy. However, some apps also contained misinformation or incorrect information that could cause anxiety as reported by the participants. Many women expressed the need for developing an app containing evidence-based, well-informed, and tailored health information to support them during pregnancy.

Conclusions: The study suggests that apps were widely used by many Chinese women during pregnancy to monitor fetal development, to obtain diet and physical activity information, and to track their body changes. The women highly appreciated the evidence-based information, expert opinions, and tailored advice available on apps. Smartphone apps have the potential to deliver health information for pregnant women.
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http://dx.doi.org/10.2196/12631DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6604500PMC
June 2019

A Community-Based Short Message Service Intervention to Improve Mothers' Feeding Practices for Obesity Prevention: Quasi-Experimental Study.

JMIR Mhealth Uhealth 2019 06 3;7(6):e13828. Epub 2019 Jun 3.

School of Public Health, Global Health Institute, Fudan University, Shanghai, China.

Background: The prevalence of childhood obesity is increasing in China, and the effect of mobile phone short message service (SMS) interventions to prevent early childhood obesity needs to be evaluated.

Objective: The objective of this study was to assess the effect of an SMS intervention on the prevention of obesity in young children.

Methods: A quasi-experimental design SMS intervention was carried out in 4 community health centers (CHCs) in Shanghai, China. A total of 2 CHCs were assigned to the intervention group, and 2 CHCs were assigned to the control group. Mothers in the intervention group received weekly SMS messages on breastfeeding and infant feeding from the third trimester to 12 months postpartum. The primary outcomes were children's body mass index (BMI), BMI z-score, and weight-for-length z-score at 12 and 24 months. Factors associated with higher BMI and weight-for-length z-score at 24 months were also assessed.

Results: A total of 582 expectant mothers were recruited at the beginning of the third gestational trimester. 477 (82.0%) and 467 (80.2%) mothers and their children were followed up to 12 and 24 months postpartum, respectively. There were no significant differences in children's BMI, BMI z-score, and weight-for-length z-score at 12 and 24 months between the 2 groups. Factors associated with higher BMI, BMI z-score, and weight-for-length z-score at 24 months included higher birth weight, introduction of solid foods before 4 months, and taking a bottle to bed at 12 months.

Conclusions: The SMS intervention did not show a significant effect on children's BMI, BMI z-score, or weight-for-length z-score at 12 and 24 months. Introduction of solid foods before 4 months and taking a bottle to bed at 12 months were significantly and positively correlated with a higher BMI, BMI z-score, and weight-for-length z-score at 24 months. Further studies with more rigorous design are needed to evaluate the effect of SMS interventions on preventing early childhood obesity.
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http://dx.doi.org/10.2196/13828DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6638993PMC
June 2019

PFOS, PFOA, estrogen homeostasis, and birth size in Chinese infants.

Chemosphere 2019 Apr 9;221:349-355. Epub 2019 Jan 9.

School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200032, China. Electronic address:

Laboratory studies have suggested that perfluoroalkyl substances (PFASs) could affect fetal growth by disrupting estrogen homeostasis, but there are limited data for human. For this, 424 mother-infant pairs were selected from a cohort established in Hebei Province of North China in 2013. Two typical PFASs, perfluorooctyl sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA), and three typical estrogens, estrone (E), β-estradiol (E), and estriol (E), were measured in cord serum. After adjusted for important covariates, serum PFOS was positively related to E and E, but negatively related to E. Serum PFOA was positively related to serum E and negatively related to head circumference at birth. Serum E was negatively related to head circumference, body weight, and body length at birth and serum E was positively related to body weight. Serum E mediated the relationship between serum PFOS and body weight. There were sex-specific differences for the associations between PFOS/PFOA and estrogens/birth size. These findings suggested that exposure to PFASs could affect estrogen homeostasis and fetal growth during pregnancy and that estrogens might mediate the association between exposure to PFASs and fetal growth.
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http://dx.doi.org/10.1016/j.chemosphere.2019.01.061DOI Listing
April 2019

Factors associated with exposure of pregnant women to perfluoroalkyl acids in North China and health risk assessment.

Sci Total Environ 2019 Mar 5;655:356-362. Epub 2018 Nov 5.

School of Public Health/Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China. Electronic address:

Perfluoroalkyl acids (PFAAs) have been frequently found in blood of pregnant women, but the predictors and potential health risk have not been well studied in China. We recruited 534 pregnant women in Tangshan City of Hebei Province in North China between 2013 and 2014 and measured five PFAAs in serum during their early term of pregnancy, including perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), perfluoro‑n‑undecanoic acid (PFUdA), and perfluorononanoic acid (PFNA). We explored the factors associated with the levels of serum PFAAs and assessed associated health risks. Food consumption information was obtained by food frequency questionnaire covering 100 items. Multiple linear regression model was used to determine the associations of sociodemographic, anthropometric, and food factors with the concentrations of serum PFAAs. Some PFAAs in serum were positively associated with age and body mass index (BMI). Consumption of beans, aquatic products, and eggs was positively associated with the concentrations of several PFAAs after adjusting for important covariates. Pregnant women who ate more cereal, vegetables, mushrooms and alga tended to have lower levels of serum PFOA, PFOS and PFNA. The Hazard index (HI) for reproductive toxicity and developmental toxicity was below 0.8, and the HI for hepatotoxicity beyond 1 was found in 0.37% of pregnant women. These results suggested that age, BMI, and some food consumption were predictors for the exposure to PFAAs in Chinese pregnant women. More attention should be paid to the hepatotoxicity for these exposures.
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http://dx.doi.org/10.1016/j.scitotenv.2018.11.042DOI Listing
March 2019

Exposure of Adults to Antibiotics in a Shanghai Suburban Area and Health Risk Assessment: A Biomonitoring-Based Study.

Environ Sci Technol 2018 12 13;52(23):13942-13950. Epub 2018 Nov 13.

Key Laboratory of Public Health Safety of Ministry of Education/School of Public Health , Fudan University , Shanghai 200032 , China.

An extensive exposure to antibiotics has been demonstrated in children and pregnant women by biomonitoring, but data from general adults remain limited. In the current study, we studied 822 adults aged 21-75 years in Shanghai in 2017 and analyzed 18 common antibiotics (five veterinary antibiotics (VAs), four human antibiotics (HAs), and nine human/veterinary antibiotics (H/VAs)) in spot urine by liquid chromatography coupled to high-resolution mass spectrometry. All 18 antibiotics were detected in urine with an overall detection frequency of 45.9% and the detection frequency for each ranged from 0.1% to 15.2%. HAs, VAs, H/VAs, and VAs+H/VAs were detected in 4.4%, 11.6%, 38.0, and 44.5% of urine samples, respectively. Adults with the sum of estimated daily exposure dose of all the antibiotics below 1.55 μg/kg/day accounted for 89.1% of adults tested positive. A hazard index value beyond one was seen in 7.2% of adults based on microbiological effect. Ciprofloxacin was the biggest contributor to HI and its hazard quotient value more than one was seen in 5.6% of adults. These findings indicated an extensive exposure to low-dose multiple antibiotics in adults in Shanghai and some adults were at health risk related to the disturbance of gut microbiota.
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http://dx.doi.org/10.1021/acs.est.8b03979DOI Listing
December 2018

A Short Message Service Intervention for Improving Infant Feeding Practices in Shanghai, China: Planning, Implementation, and Process Evaluation.

JMIR Mhealth Uhealth 2018 Oct 29;6(10):e11039. Epub 2018 Oct 29.

Global Health Institute, School of Public Health, Fudan University, Shanghai, China.

Background: Although mobile health (mHealth) has been widely applied in health care services, few studies have reported the detailed process of the development and implementation of text messaging (short message service, SMS) interventions.

Objective: Our study aims to demonstrate the process and lessons learned from a community-based text messaging (SMS) intervention for improving infant feeding in Shanghai, China.

Methods: The intervention included planning and development, implementation, and process evaluation. A 3-phase process was adopted during planning and development: (1) a formative study with expectant and new mothers to explore the barriers of appropriate infant feeding practices; (2) a baseline questionnaire survey to understand potential intervention approaches; and (3) development of the text message bank. The text messaging intervention was delivered via a computer-based platform. A message bank was established before the start of the intervention containing information on the benefits of breastfeeding, preparing for breastfeeding, early initiation of breastfeeding, timely introduction of complementary foods, and establishing appropriate feeding practices, etc. An expert advisory committee oversaw the content and quality of the message bank. Process evaluation was conducted through field records and qualitative interviews with participating mothers.

Results: We found that the text messaging intervention was feasible and well received by mothers because of its easy and flexible access. The weekly based message frequency was thought to be appropriate, and the contents were anticipatory and trustworthy. Some mothers had high expectations for timely response to inquiries. Occasionally, the text messages were not delivered due to unstable telecommunication transmission. Mothers suggested that the messages could be more personalized.

Conclusions: This study demonstrates the feasibility and value of text messaging intervention in filling gaps in delivering health care services and promoting healthy infant feeding practices in settings where personal contact is limited.
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http://dx.doi.org/10.2196/11039DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234339PMC
October 2018

Predictors of urinary antibiotics in children of Shanghai and health risk assessment.

Environ Int 2018 12 3;121(Pt 1):507-514. Epub 2018 Oct 3.

Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China. Electronic address:

Background: An extensive exposure to antibiotics has been confirmed in children, but the predictors and potential health risk remain unclear.

Objective: To investigate the predictors of antibiotics in urine and potential health risk in children of Shanghai.

Methods: We selected 284 school children aged 8-11 years from a central area of Shanghai, China, in 2017. Ultra-performance liquid chromatography coupled with high-resolution mass spectrometry was used to measure 20 antibiotics, including four human antibiotics (HAs), six veterinary antibiotics (VAs), 10 human/veterinary antibiotics (H/VAs), and three metabolites in first morning urine. Logistic regression model was used to examine the associations of 17 variables related to demographic and socioeconomic factors, recent antibiotic use, drinking water intake, food consumption, and anthropometric measurements with the detection frequency of HAs, VAs, or H/VAs in urine. After daily intake was estimated, health risk was assessed for VAs and H/VAs by using hazard quotient (HQ) and hazard index (HI) based on microbiological or toxicological effects.

Results: The detection frequencies of 20 antibiotics and three metabolites ranged from 0 to 27.8% with an overall detection frequency being 56.0%. The detection frequency of HAs increased with age and screen time at weekend. Sex, age, family income and screen time were positively associated with the detection frequencies of VAs and H/VAs. Children reporting antibiotic use in the past three months had a higher detection frequency of HAs. Children with a higher consumption frequency of dairy products had a higher detection frequency of VAs + H/VAs, but a lower detection frequency of HAs. An increased overall detection frequency of all antibiotics was seen in children with higher consumption frequencies of aquatic products, livestock and poultry meat, or milk and dairy products. HQ >1 was only found for ciprofloxacin (5.6%) and ofloxacin (0.4%) based on microbiological effect. HI >1 was found in 6.0% of children for microbiological effect and none was found for toxicological effect.

Conclusions: Predictors for antibiotics in urine for children included sex, age, family income, screen time, clinical use, and animal-derived food consumption. There was potential health risk for children with exposure to antibiotics.
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http://dx.doi.org/10.1016/j.envint.2018.09.032DOI Listing
December 2018

Heavy Exposure of Waste Collectors to Polycyclic Aromatic Hydrocarbons in a Poor Rural Area of Middle China.

Environ Sci Technol 2018 08 18;52(15):8866-8875. Epub 2018 Jul 18.

Centers for Water and Health, Key Laboratory of the Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Department of Environmental Health, School of Public Health , Fudan University , Shanghai , 200032 , China.

Manual collection and open-air incineration of waste materials is a common practice in rural regions of China and beyond. Low-temperature combustion of rubber and plastic waste generates high levels of airborne polycyclic aromatic hydrocarbons (PAHs). We investigated ten urinary hydroxylated PAH metabolites (OH-PAHs), the oxidative damage biomarker (8-hydroxy-deoxyguanosine, 8-OHdG), and four serum biomarkers including gamma-glutamyl transferase (GGT) and alanine aminotransferase (ALT) in 41 waste collectors and 122 control subjects residing in the same or a distant rural village in Henan Province. The level of PAH metabolites in urine (median: 17.24 μg/g Cre) was twice that of controls living in the same area without an occupational history involving waste collection (median: 8.16 μg/g Cre) and thrice that of controls living 30 km away (median: 6.07 μg/g Cre). The concentrations of OH-PAHs were positively associated with urinary 8-OHdG levels (β = 0.283, p < 0.05). Serum GGT and ALT were slightly increased in waste collectors. Urinary 8-OHdG levels were similar in one-year and longer-term workers, suggesting that rubber and plastic waste collection/incineration carries a high PAH exposure risk. These data provide solid baseline information, emphasizing the importance of monitoring the long-term health outcomes of waste collectors and changes in exposure patterns associated with rural development and regulation of waste disposal.
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http://dx.doi.org/10.1021/acs.est.8b02024DOI Listing
August 2018

Safety and efficacy of enhanced recovery after surgery (ERAS) programs in patients undergoing hepatectomy: A prospective randomized controlled trial.

J Clin Lab Anal 2018 Jul 24;32(6):e22434. Epub 2018 Mar 24.

Department of Hepatopancreatobiliary Surgery, The First Affiliated Hospital of University of South China, Hengyang Hunan, China.

Background And Aim: Enhanced recovery after surgery (ERAS) programs, following a variety of perioperative treatments with evidence-based medical evidence, has indicated its validity to accelerate rehabilitation in a wide variety of surgical procedures. This randomized controlled trial (RCT) study was implemented to verify the safety and efficacy of the perioperative effects in patients undergoing hepatectomy with ERAS or with conventional surgery (CS).

Methods: From August 2016 to November 2017, according to the inclusion criteria, 160 patients with liver diseases were suitable for participating in this experiment. Patients before liver resection were randomized into ERAS group (n = 80) and CS group (n = 80), and then the outcome measures were compared between the two groups.

Results: Enhanced recovery after surgery group had significantly less complications than CS group (P = .009). Compared with CS group, patients in ERAS group had low peak of WBCs in postoperative day (POD1), ALT in POD1 and POD3 (P < .05), high value of ALB in POD3 and POD5 (P < .05), less pain and higher patient satisfaction (P < .001), earlier exhaust, oral feeding, ambulation and extubation time (P < .05),and also had less hospital stay and cost (P < .001). There were no significant differences in readmission rate (<30 days) between two groups (P = .772).

Conclusions: Enhanced recovery after surgery programs applied to patients undergoing hepatectomy can safely and effectively relieve stress response, reduce the incidence of complications, improve patient satisfaction, accelerate patient recovery, reduce financial burden, and bring economic benefits.
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http://dx.doi.org/10.1002/jcla.22434DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6816868PMC
July 2018

Perfluoroalkyl substances, glucose homeostasis, and gestational diabetes mellitus in Chinese pregnant women: A repeat measurement-based prospective study.

Environ Int 2018 05 20;114:12-20. Epub 2018 Feb 20.

Department of Nutrition and Food Hygiene, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China. Electronic address:

Background: Exposure to perfluoroalkyl substances (PFASs) can affect glucose homeostasis and has been suggested as a potential risk of diabetes mellitus, but data are limited for pregnant women.

Objectives: We aimed to explore the associations of exposure to PFASs with glucose homeostasis and gestational diabetes mellitus (GDM) in Chinese pregnant women.

Methods: The current study was conducted in Hebei Province of Northern China between 2013 and 2014 and 560 pregnant women were recruited in their early term of pregnancy and two representative serum PFASs, perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS), were measured. In 385 pregnant women who completed oral glucose tolerance test (OGTT), the associations of serum PFOA and PFOS concentrations with fasting blood glucose (FBG), fasting insulin (FIns), and homeostasis model assessment of insulin resistance (HOMA-IR) in the early, middle, and late terms of pregnancy and occurrence of GDM were examined using linear and Cox proportional hazard regression models. The reproducibility of serum PFASs during pregnancy was assessed in 230 pregnant women.

Results: The intraclass correlation coefficients of serum PFASs, covariates, and outcomes based on averaged repeat measurement (0.35-0.96) were higher than those based on single measurement (0.16-0.92). Serum PFOA was positively associated with averaged FIns and HOMA-IR in the early, middle, and late terms of pregnancy and averaged blood glucose level at 1 h and 2 h of OGTT, but serum PFOS tended to be negatively associated with averaged FBG and OGTT blood glucose. The adjusted hazard ratios of GDM associated with serum PFOA and PFOS were 1.98 (95% confidence interval: 0.70-5.57; p-value: 0.197) and 0.71 (0.29-1.75; 0.453), respectively.

Conclusions: Our data raised a possibility that exposure to PFASs might have different influences on glucose homeostasis and GDM in Chinese pregnant women. More lab and human studies are needed to further test the hypothesis and investigate potential mechanisms.
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http://dx.doi.org/10.1016/j.envint.2018.01.027DOI Listing
May 2018

A genome-wide association study identifies six novel risk loci for primary biliary cholangitis.

Nat Commun 2017 04 20;8:14828. Epub 2017 Apr 20.

Department of Gastroenterology, Eastern Hepatobiliary Surgery Hospital, Shanghai 201805, China.

Primary biliary cholangitis (PBC) is an autoimmune liver disease with a strong hereditary component. Here, we report a genome-wide association study that included 1,122 PBC cases and 4,036 controls of Han Chinese descent, with subsequent replication in a separate cohort of 907 PBC cases and 2,127 controls. Our results show genome-wide association of 14 PBC risk loci including previously identified 6p21 (HLA-DRA and DPB1), 17q12 (ORMDL3), 3q13.33 (CD80), 2q32.3 (STAT1/STAT4), 3q25.33 (IL12A), 4q24 (NF-κB) and 22q13.1 (RPL3/SYNGR1). We also identified variants in IL21, IL21R, CD28/CTLA4/ICOS, CD58, ARID3A and IL16 as novel PBC risk loci. These new findings and histochemical studies showing enhanced expression of IL21 and IL21R in PBC livers (particularly in the hepatic portal tracks) support a disease mechanism in which the deregulation of the IL21 signalling pathway, in addition to CD4 T-cell activation and T-cell co-stimulation are critical components in the development of PBC.
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http://dx.doi.org/10.1038/ncomms14828DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5429142PMC
April 2017

The Effect of Early Life Factors and Early Interventions on Childhood Overweight and Obesity 2016.

J Obes 2017 5;2017:3642818. Epub 2017 Feb 5.

School of Public Health, Fudan University, Shanghai 200032, China.

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http://dx.doi.org/10.1155/2017/3642818DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5316452PMC
January 2019

Urinary Antibiotics of Pregnant Women in Eastern China and Cumulative Health Risk Assessment.

Environ Sci Technol 2017 03 9;51(6):3518-3525. Epub 2017 Mar 9.

Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University , Shanghai 200032, People's Republic of China.

Exposure to antibiotics during pregnancy can pose a systematic effect on human health. A few biomonitoring studies have demonstrated an extensive exposure of children to antibiotics, but there is still a lack of data for pregnant women. To assess the exposure of pregnant women to antibiotics and potential health risk, we investigated 536 pregnant women aged 16-42 years from two geographically different study sites in Eastern China in 2015. We measured 21 antibiotics of five categories (seven fluoroquinolones, three phenicols, four tetracyclines, three macrolides, and four sulfonamides) in urine using the isotope dilution ultraperformance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry. The hazard index (HI) was calculated on the basis of estimated daily exposure dose and acceptable daily intakes. A total of 16 antibiotics were found in urine, with detection frequencies between 0.2 and 16.0%. Antibiotics were overall detected in 41.6% of urine, and two or more antibiotics were detected in 13.1% of urine. Ciprofloxacin, ofloxacin, and trimethoprim were most frequently detected in urine, with detection frequencies between 10 and 20%. The majority of the antibiotics tested had an estimated daily exposure dose less than 1 μg/kg/day, and 4.3% of pregnant women had a HI value of more than 1. These findings indicated that pregnant women were frequently exposed to antibiotics and some individuals were in the potential risk of adverse microbiological effects induced by antibiotics.
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http://dx.doi.org/10.1021/acs.est.6b06474DOI Listing
March 2017

Application of Laparoscopic Lumbar Discectomy and Artificial Disc Replacement: At Least Two Years of Follow-Up.

Spine (Phila Pa 1976) 2016 Oct;41 Suppl 19:B38-B43

*Department of Spinal Surgery, the First Affiliated Hospital of University of South China, Hengyang, HuNan Province, China †The Orthopaedic Department of Sun YiXian Hospital of Zhongshan University, Guangzhou, Guangdong Province, China.

Study Design: This prospective observational study included 22 patients who were diagnosed with symptomatic degenerative disc disease treated via artificial disc replacement (ADR) with a laparoscopic technique.

Objective: The current study aimed to assess the safety and efficacy of ADR using a laparoscopic technique for lumbar disc herniation.

Summary Of Background Data: Symptomatic degenerative disc disease is the major cause of low back pain with lumbar segmental instability. ADR has increased in popularity as an alternative treatment for lumbar disc herniation. However, the traditional approach to spinal surgery carries the risk of catastrophic bleeding from injury to major vessels, as well as iatrogenic injury to the viscera and associated structures. Therefore, laparoscopic lumbar discectomy and ADR may represent a useful alternative.

Methods: Twenty-two patients (8 males and 14 females) who were diagnosed with symptomatic degenerative disc disease were included in this study. Seven cases involved the L4/5 level, and 15 cases involved the L5/S1 level. All patients were ineffective after at least 6 months of conservative treatments; all patients were informed of the surgery before the operation and provided consent. Three-dimensional computed tomographic angiography (3D-CTA) of the iliac great blood vessels was completed before the surgery. All surgical procedures were performed under a laparoscope. All patients were followed up.

Results: All surgeries were successfully completed. The average operation time was 120 minutes (range 110-150 min), and the average hemorrhage was 145 mL (range 80-360 mL). All cases underwent X-rays at 3 days, 3 months, 6 months, 1 year, and the final postoperative follow-up. The outcome indicated that there was no mobilization, displacement, or subsidence in all patients with the exception of one case with prosthesis migration. The follow-up time was 43.8 months (range 24-64 months). The mean visual analog scale (VAS) and Oswestry scores were decreased postoperatively. The mean improvement rate of the VAS score was 73.5%.

Conclusion: Lumbar ADR using a laparoscope represents a novel, minimally invasive treatment for symptomatic degenerative disc disease and severe lumbar discogenic pain.
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http://dx.doi.org/10.1097/BRS.0000000000001820DOI Listing
October 2016

Low expression of GNAI3 predicts poor prognosis in patients with HCC.

Int J Clin Exp Med 2015 15;8(11):21482-6. Epub 2015 Nov 15.

Department of General Surgery, Zhujiang Hospital, Southern Medical University Guangzhou, China.

Purposes: This study was performed with an aim to explain the underlying role of GNAI3 on the prognosis of patients with HCC.

Methods: The expression of GNAI3 at protein level was detected with the utilization of Immunohistochemistry (IHC). Chi-square test was conducted to assay the relationship between GNAI3 expression and clinical parameters of HCC patients. The correlation between expression level of GNAI3 and survival time after surgeries of HCC patients was evaluated by Kaplan-Meier method. Finally, the Cox regression was established to evaluate the relationship between GNAI3 expression and the prognosis of patients with HCC.

Results: In this study, the negative rate of GNAI3 expression in HCC samples was about 76.6%, which was significantly higher than that in paired normal specimens (12.5%). Result showed that there was no correlation between GNAI3 expression and age, gender, liver cirrhosis and vein invasion (P>0.05), but tight relationship between GNAI3 expression and TNM stage and tumor size was found (P<0.05). The following Kaplan-Meier analysis result illustrated that negative expression of GNAI3 induced high mortality of HCC patients. Cox regression result revealed that GNAI3 might be a biomarker for prognosis of patients with HCC (HR: 0.218, P=0.016, 95% CI 0.063-0.750).

Conclusion: Generally, results of this study demonstrated that expression of GNAI3 shared a tight relationship with the prognosis of patients with HCC. Therefore, GNAI3 could be considered as a novel index for prognosis of patients with HCC.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4723941PMC
February 2016

Antibiotics detected in urines and adipogenesis in school children.

Environ Int 2016 Apr-May;89-90:204-11. Epub 2016 Feb 13.

Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.

Background: Although antibiotic use during early life has been demonstrated to be related to the altered adipogenesis in later life, limited data are available for the effect of antibiotic exposure in school children on adiposity from various sources, including from the use or contaminated food or drinking water.

Objective: To explore the association between the internal exposure of antibiotics from various sources and adipogenesis in school children using the biomonitoring of urinary antibiotics.

Methods: After 586 school children aged 8-11years were selected from Shanghai in 2013, total urinary concentrations (free and conjugated) of 21 common antibiotics from six categories (macrolides, β-lactams, tetracyclines, fluoroquinolones, sulfonamides, and phenicols), including five human antibiotics (HAs), two antibiotics preferred as HA, four veterinary antibiotics (VAs), and ten antibiotics preferred as VA, were measured by ultra-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry. Creatinine-corrected urinary concentrations of antibiotics were used to assess their exposure. Overweight or obesity was determined by the body mass index or waist circumference-based criteria deriving from national data.

Results: All 21 antibiotics were found in urines with the overall detection frequency of 79.6%. The multinomial logistic regression analyses showed the significant associations of overweight and obesity with the exposure to VAs and antibiotics preferred as VA, but not with HAs or antibiotics preferred as HA. After adjusted for a number of obesity-relevant variables, the odds ratios (95% confidence interval) of BMI-based obesity risk of tertiles 2 and 3 of urinary concentrations relative to tertile 1 were respectively 2.54 (1.27, 5.07) and 2.92 (1.45, 5.87) for florfenicol, 0.57 (0.12, 2.63) and 3.63 (1.41, 9.32) for trimethoprim, and 3.00 (1.56, 5.76) and 1.99 (0.99, 4.01) for sum of veterinary antibiotics. Similar results were found when the outcome used WC-based obesity risk. The associations were sex related and mainly observed in boys.

Conclusions: Some types of antibiotic exposure, which were mainly from food or drinking water, were associated with an increased risk of obesity in school children. Due to the cross-sectional design, more longitudinal and experimental studies are warranted to further test these findings.
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http://dx.doi.org/10.1016/j.envint.2016.02.005DOI Listing
November 2016

[Dietary exposure assessment of deoxynivalenol and its acetylate & derivatives in wheat flour in Shanghai].

Wei Sheng Yan Jiu 2015 Jul;44(4):661-5

Objective: To assess the dietary exposure of Shanghai residents to a compound of deoxynivalenol (DON) and its acetylated derivatives, 3-acetyl-deoxynivalenol (3-Ac-DON) and 15-acetyl-deoxynivalenol (15-Ac-DON) through wheat flour.

Methods: DON, 3-Ac-DON and 15-Ac-DON in wheat flour collected from 2011 to 2013 were respectively analyzed by high performance liquid chromatography tandem mass spectrometry. (HPLC-MS/MS) method and the total content of the compound was calculated. Dietary intake assessments of the compound through wheat flour were carried out in combination of wheat flour consumption data of Shanghai residents with the compound content data using both the point estimate method and the probabilistic assessment method. Group provisional maximum tolerable daily intake(PMTDI, 1 jg/(kg BW- d) )of the compound was used to assess the risk of the exposure.

Results: (1) At the mean and 50th percentile consumption level of wheat flour, the dietary exposure of people to the compound accounted for 18%-83% of PMTDI based on different content levels (mean and the 50th, 75th, 90th and 95th percentiles) of the compound. At the 95th percentile consumption level of wheat flour, the exposure was 1.08-2.55 times higher than PMTDI based on different toxin levels (mean and the 50th, 75th, 90th and 95th percentiles). (2) 89.99% of total Shanghai residents, 87.00% of Shanghai wheat flour consumers, and 76.55% of Shanghai residents under 15 years old had a daily exposure to the compound lower than PMTDI.

Conclusion: The dietary exposure of Shanghai residents to the compound of DON, 3-Ac-DON and 15-Ac-DON increased along with the increase of wheat flour consumption. Most of the residents were safe through wheat flour consumption, but still 10.01% of the population was at risk, and residents under 15 years old were a high-risk group for the compound exposure.
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July 2015

Dietary exposure to aluminium from wheat flour and puffed products of residents in Shanghai, China.

Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2015 2;32(12):2018-26. Epub 2015 Nov 2.

a Department of Nutrition and Food Hygiene, School of Public Health, Key Laboratory of Public Health Safety , Fudan University , Shanghai , China.

A dietary survey of 3431 residents was conducted by a 24-h dietary recall method in Shanghai, China, quarterly from September 2013 to September 2014. A total of 400 food samples were tested for aluminium concentration, including wheat flour and puffed products from 2011 to 2013. Probabilistic analysis was used to estimate the dietary exposure to aluminium from wheat and puffed products. The means of dietary aluminium exposure for children (2-6 years old), juveniles (7-17 years old), adults (18-65 years old) and seniors (over 65 years old) were 1.88, 0.94, 0.44 and 0.42 mg kg(-1) body weight (bw) week(-1) respectively, with a population average of 0.51 mg kg(-1) bw week(-1). The proportions of those who had aluminium exposure from wheat and puffed products lower than the provisional tolerable weekly intake (PTWI) were 77%, 90%, 97%, and 97% respectively from children to seniors. We estimated that the proportions of people at risk would decrease by 13%, 6%, 2% and 2% respectively under the new China National Standards - GB 2760-2014 National Food Safety for Standards for using food additives. The results indicated that aluminium from wheat flour and puffed products is unlikely to cause adverse health effects in the general population in Shanghai; however, children were at a higher risk of excess aluminium exposure. Significant improvements in reducing the dietary exposure to aluminium are expected in the population, especially for children after the implementation of GB 2760-2014.
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http://dx.doi.org/10.1080/19440049.2015.1099078DOI Listing
September 2016

Human urinary/seminal phthalates or their metabolite levels and semen quality: A meta-analysis.

Environ Res 2015 Oct 11;142:486-94. Epub 2015 Aug 11.

Key Laboratory of the Public Health Safety, Ministry of Education, Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, PR China. Electronic address:

Health concerns surrounding human exposure to phthalates include diminished semen quality. Epidemiological findings remain inconsistent. We have performed a quality appraisal and meta-analysis to quantitatively summarize evidence for associations between phthalate exposures and human semen quality. Pubmed and Web of Science were searched for pertinent studies through October 2014. Cited references were reviewed to identify secondary studies. Studies that reported quantitative estimates of the association between phthalates or their metabolite levels in humans and semen quality were eligible. Random effects models were used to calculate pooled effects estimates. Overall, 20 studies met our inclusion criteria. Subsequently, 14 studies were included in the meta-analysis. Urinary monobutyl phthalate (MBP) and monobenzyl phthalate (MBzP) were associated with reduced sperm concentration (MBP [7.4-25.3 µg/L], pooled odds ratio [OR]=2.60, 95% confidence interval [CI]=1.32-5.15; MBzP [14.0-540.2 µg/L], pooled OR=2.23, 95% CI=1.16-4.30). Both MBP (24.6-14,459.0 µg/L) and MEHP (3.1-208.1 µg/L) were inversely associated with straight line velocity (VSL; MBP, pooled β=-2.51, 95% CI=-4.44, -0.59; MEHP, pooled β=-1.06, 95% CI=-1.99, -0.12). An IQR increase in MBzP and MEP levels (MBzP, IQR=11.35 µg/L; MEP, IQR=449.4 µg/L) was associated with an increase in comet extent (CE; MBzP, pooled β=3.57, 95% CI=0.89-6.25; MEP, pooled β=4.22, 95% CI=1.66-6.77). No associations were observed between monomethyl phthalate and any semen parameters. Our meta-analysis strengthens the evidence that specific phthalates or their metabolite levels may affect semen quality.
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http://dx.doi.org/10.1016/j.envres.2015.07.008DOI Listing
October 2015