Environmental Science and Pollution Research

, Volume 26, Issue 10, pp 10037–10043 | Cite as

Associations of trace elements in blood with the risk of isolated ventricular septum defects and abnormal cardiac structure in children

  • Yu Zhu
  • Cheng Xu
  • Yuxi Zhang
  • Zongyun Xie
  • Yaqin Shu
  • Changgui Lu
  • Xuming MoEmail author
Research Article


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.


Trace 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).

Author contributions

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

Competing interests

The authors declare that they have no competing interests.

Ethical approval

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.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Yu Zhu
    • 1
  • Cheng Xu
    • 1
  • Yuxi Zhang
    • 1
  • Zongyun Xie
    • 1
  • Yaqin Shu
    • 1
  • Changgui Lu
    • 2
  • Xuming Mo
    • 1
    Email author
  1. 1.Department of Cardiothoracic SurgeryChildren’s Hospital of Nanjing Medical UniversityNanjingChina
  2. 2.Department of Pediatric SurgeryChildren’s Hospital of Nanjing Medical UniversityNanjingChina

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