Associations of trace elements in blood with the risk of isolated ventricular septum defects and abnormal cardiac structure in children
- 15 Downloads
This study sought to determine correlations between the presence of isolated ventricular septum defects (VSDs) and blood levels of trace elements. A total of 144 patients with VSDs and 144 controls were recruited for cross-sectional assessment of trace elements and examination of cardiac structures in the Jiangsu and Anhui provinces between 2016 and 2018. Logistic regression was performed to explore the relationships between VSDs and trace elements. Additionally, general linear regression models were used to investigate relationships between trace elements and echocardiography indicators. Relative to the lowest zinc (Zn) concentrations, the highest Zn concentrations may be associated with lower odds of VSD development (OR = 0.03, 95% confidence interval [CI] = 0.01–0.29, P < 0.001). However, no significant relationships between the concentrations of other trace elements and the risk of VSD were identified. Aorta (AO) diameters were markedly smaller in the VSD group, whereas no significant between-group differences were observed for other echocardiography indicators. After adjusting for age and gender, linear regression indicated a significant association between Zn level and mean AO diameter (beta coefficient = 0.247, 95% CI = 0.126–0.367). Zn deficiency was observed in patients with isolated VSDs. Further work to explore the mechanisms by which Zn deficiency leads to VSDs is warranted.
KeywordsTrace elements Isolated ventricular septum defects Cardiac structure
Statement of financial support
This work was supported by funding from the Maternal and Child Health Research Project of Jiangsu Province (F201755), the China Postdoctoral Science Foundation (2018M630585), the Key Project of Science and Technology Development Fund of Nanjing Medical University (2017NJMUZD060), the National Key Research and Development Program of China (2016YFC1101001; 2017YFC1308105), Nanjing Medical University School Project (NMUC2018012A), and Key Project supported by Medical Science and technology development Foundation, Nanjing Department of Health (YKK18139).
Yu Zhu and Cheng Xu wrote the main manuscript text, and Yuxi Zhang and Yaqin Shu and Changgui Lu prepared Tables 1, 2, and 3, Fig. 1, and the supplemental information. Cheng Xu and Xuming Mo were responsible for the accuracy of all content in the proof. All authors reviewed the manuscript.
Compliance with ethical standards
The authors declare that they have no competing interests.
This study was approved by the Institutional Review Board of Nanjing Medical University (No. NJMU001235) and adhered to the tenets of the Declaration of Helsinki.
Statement of informed consent
All participants and their parents volunteered to participate in the study, and written informed consent was obtained before participants were enrolled.
- Juriol LV, Gobetto MN, Mendes Garrido Abregu F, Dasso ME, Pineda G, Guttlein L, Carranza A, Podhajcer O, Toblli JE, Elesgaray R, Arranz CT, Tomat AL (2018) Cardiac changes in apoptosis, inflammation, oxidative stress, and nitric oxide system induced by prenatal and postnatal zinc deficiency in male and female rats. Eur J Nutr 57:569–583CrossRefGoogle Scholar
- Kelishadi R, Ataei E, Motlagh ME, Yazdi M, Tajaddini MH, Heshmat R, Ardalan G (2015) Association of serum concentrations of magnesium and some trace elements with cardiometabolic risk factors and liver enzymes in adolescents: the CASPIAN-III study. Biol Trace Elem Res 163:97–102CrossRefGoogle Scholar
- Liu S, Joseph KS, Lisonkova S, Rouleau J, Van den Hof M, Sauve R, Kramer MS, Canadian Perinatal Surveillance S (2013): Association between maternal chronic conditions and congenital heart defects: a population-based cohort study. Circulation 128, 583–589Google Scholar
- Liu Z, Lin Y, Tian X, Li J, Chen X, Yang J, Li X, Deng Y, Li N, Liang J, Li S, Zhu J (2016) Association between maternal aluminum exposure and the risk of congenital heart defects in offspring. Birth Defects Res A Clin Mol Teratol 106:95–103Google Scholar
- Moskowitz IP, Wang J, Peterson MA, Pu WT, Mackinnon AC, Oxburgh L, Chu GC, Sarkar M, Berul C, Smoot L, Robertson EJ, Schwartz R, Seidman JG, Seidman CE (2011) Transcription factor genes Smad4 and Gata4 cooperatively regulate cardiac valve development. [corrected]. Proc Natl Acad Sci U S A 108:4006–4011CrossRefGoogle Scholar
- Posch MG, Gramlich M, Sunde M, Schmitt KR, Lee SH, Richter S, Kersten A, Perrot A, Panek AN, Al Khatib IH, Nemer G, Megarbane A, Dietz R, Stiller B, Berger F, Harvey RP, Ozcelik C (2010) A gain-of-function TBX20 mutation causes congenital atrial septal defects, patent foramen ovale and cardiac valve defects. J Med Genet 47:230–235CrossRefGoogle Scholar
- Shauq A, Gladman G, Ladusans EJ (2009): Pulmonary atresia with intact ventricular septum associated with aortic coarctation. Cardiol Young 19, 522–3Google Scholar
- Soemedi R, Wilson IJ, Bentham J, Darlay R, Töpf A, Zelenika D, Cosgrove C, Setchfield K, Thornborough C, Granados-Riveron J, Blue GM, Breckpot J, Hellens S, Zwolinkski S, Glen E, Mamasoula C, Rahman TJ, Hall D, Rauch A, Devriendt K, Gewillig M, O’ Sullivan J, Winlaw DS, Bu’Lock F, Brook JD, Bhattacharya S, Lathrop M, Santibanez-Koref M, Cordell HJ, Goodship JA, Keavney BD (2012) Contribution of global rare copy-number variants to the risk of sporadic congenital heart disease. Am J Hum Genet 91:489–501CrossRefGoogle Scholar
- Stingone JA, Luben TJ, Daniels JL, Fuentes M, Richardson DB, Aylsworth AS, Herring AH, Anderka M, Botto L, Correa A, Gilboa SM, Langlois PH, Mosley B, Shaw GM, Siffel C, Olshan AF, National Birth Defects Prevention S (2014) Maternal exposure to criteria air pollutants and congenital heart defects in offspring: results from the national birth defects prevention study. Environ Health Perspect 122:863–872CrossRefGoogle Scholar
- Sullivan PM, Dervan LA, Reiger S, Buddhe S, Schwartz SM (2015) Risk of congenital heart defects in the offspring of smoking mothers: a population-based study. J Pediatr 166(978–984):e2Google Scholar
- Wang S, Wang B, Wang Y, Tong Q, Liu Q, Sun J, Zheng Y, Cai L (2017) Zinc prevents the development of diabetic cardiomyopathy in db/db mice. Int J Mol Sci 18Google Scholar
- Wu LL, Mao SS, Lin X, Yang RW, Zhu ZW (2019) Evaluation of whole blood trace element levels in Chinese children with autism spectrum disorder. Biol Trace Elem ResGoogle Scholar
- Xia XR, Jiang SW, Zhang Y, Hu YF, Yi HG, Liu J, Zhao NN, Chen J, Gao L, Cui YG, Liu JY (2018): Serum levels of trace elements in children born after assisted reproductive technology. Clinica chimica acta; international journal of clinical chemistryGoogle Scholar
- Zhu Y, Romitti PA, Caspers Conway KM, Shen DH, Sun L, Browne ML, Botto LD, Lin AE, Druschel CM, National Birth Defects Prevention S (2015): Maternal periconceptional alcohol consumption and congenital heart defects. Birth Defects Res A Clin Mol Teratol 103, 617–629Google Scholar