Associations between Serum Aflatoxin-B1 and Anemia in Pregnant Women: Evidence from Guangxi Zhuang Birth Cohort in China

Lei Lei; Shun Liu; Ye Ye; Xiaoqiang Qiu; Dongping Huang; Dongxiang Pan; Jiehua Chen; Zhengmin Qian; Stephen Edward McMillin; Michael G. Vaughn; Xingxi Luo; Kaili Wu; Suyang Xiao; Jinxiu Li; Meiliang Liu; Yu Yang; Mingshuang Lai; Guanghui Dong; Xiaoyun Zeng

doi:10.3390/toxins13110806

Toxins (Nov 2021)

Associations between Serum Aflatoxin-B1 and Anemia in Pregnant Women: Evidence from Guangxi Zhuang Birth Cohort in China

Lei Lei,
Shun Liu,
Ye Ye,
Xiaoqiang Qiu,
Dongping Huang,
Dongxiang Pan,
Jiehua Chen,
Zhengmin Qian,
Stephen Edward McMillin,
Michael G. Vaughn,
Xingxi Luo,
Kaili Wu,
Suyang Xiao,
Jinxiu Li,
Meiliang Liu,
Yu Yang,
Mingshuang Lai,
Guanghui Dong,
Xiaoyun Zeng

Affiliations

Lei Lei: Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China
Shun Liu: Department of Maternal, Child and Adolescent Health, School of Public Health, Guangxi Medical University, Nanning 530021, China
Ye Ye: Center for Disease Control and Prevention, Guangxi Liuzhou Iron & Steel Group Co., Ltd., Liuzhou 545002, China
Xiaoqiang Qiu: Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China
Dongping Huang: Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, Nanning 530021, China
Dongxiang Pan: Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China
Jiehua Chen: Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China
Zhengmin Qian: Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO 63103, USA
Stephen Edward McMillin: School of Social Work, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO 63103, USA
Michael G. Vaughn: School of Social Work, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO 63103, USA
Xingxi Luo: Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China
Kaili Wu: Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China
Suyang Xiao: Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China
Jinxiu Li: Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China
Meiliang Liu: Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China
Yu Yang: Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China
Mingshuang Lai: Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China
Guanghui Dong: Department of Environmental and Occupational Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
Xiaoyun Zeng: Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China

DOI: https://doi.org/10.3390/toxins13110806
Journal volume & issue: Vol. 13, no. 11
p. 806

Abstract

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Aflatoxin B1 (AFB1) is a common toxic mycotoxin and is detectable in pregnant women. Animal studies have revealed that AFB1 caused the lysis of erythrocytes and a decrease in hemoglobin. We conducted a prospective cohort study in Guangxi, China, in order to evaluate the association between AFB1 exposure and anemia in pregnant women during the entire pregnancy. A total of 616 pregnant women from the Guangxi Zhuang Birth Cohort were included in the study. Serum AFB1-albumin (AFB1-ALB) adduct levels were measured. The effect of AFB1-ALB adducts on hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were analyzed by using multivariable linear regression. The risks of anemia from AFB1-ALB adduct exposure were assessed by multivariable logistic regression. We found that the AFB1-ALB adduct was significantly associated with a decrease in Hb (β = −4.99, 95% CI: −8.42, −1.30), MCV (β = −4.58, 95% CI: −7.23, −1.94), MCH (β = −1.86, 95% CI: −2.87, −0.85), and MCHC (β = −5.23, 95% CI: −8.28, −2.17) in the first trimester with the third tertile of AFB1-ALB adducts when compared with the first tertile. Furthermore, the third tertile of the AFB1-ALB adduct significantly increased the risk of anemia by 2.90 times than compared to the first tertile in the first trimester (OR = 3.90, 95% CI: 1.67, 9.14). A significant positive does–response relationship existed between AFB1-ALB adduct levels and anemia risk (Ptrend = 0.001). When dividing anemia types, we only found that the third tertile of AFB1-ALB adduct increased the risk of microcytic hypochromic anemia (MHA) in the first trimester (OR = 14.37, 95% CI: 3.08, 67.02) and second trimester (OR = 4.75, 95% CI: 1.96, 11.51). These findings demonstrate the correlation between maternal AFB1 exposure during early pregnancy and risk of anemia, especially MHA, and during different trimesters in Southern China. More efforts should be made to diminish AFB1 exposure for pregnant women.

Published in Toxins

ISSN: 2072-6651 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Medicine
Website: http://www.mdpi.com/journal/toxins/

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