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

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

doi:10.3390/toxins13110806

Abstract

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.

Highlights

Aflatoxins are a harmful mycotoxin [1]
We examined the association between Aflatoxin B1 (AFB1) exposure and anemia, as well as different types of anemia, across the three trimesters of pregnancy in an ongoing prospective birth cohort study
There were 34 low birth weight (LBW) infants; 15.3% of the infants were small for gestational age (SGA), while 7% were large for gestational age (LGA) (Table 1)

Summary

Introduction

Among the various types of aflatoxins, aflatoxin B1(AFB1) is the predominant form with the most toxic effect [2]. AFB1 is produced by Aspergillus, which usually contaminates a wide range of agricultural products, such as grain, nuts, or spices, especially in tropical and subtropical climatic regions [3]. Aflatoxin contamination has been a concern in China due to the high consumption of cereal products in daily food and peanut as the major oil crop. A recent study reported that the contamination of peanut oil with AFB1 is relatively high in provinces experiencing a subtropical climate [5]. Fan et al [6] assessed the mycotoxins exposure of the population in Nanjing, China, and noted that AFB1 was common in both human serum and urine. AFB1 contaminations are posing a threat to public health in the Chinese population

Methods

Results

Conclusion