Blood Cholinesterase Level is Associated with Cognitive Function in Indonesian School-age Children Exposed to Pesticides

Abstract

BACKGROUND: Pesticides are known as depressors of acetylcholinesterase (AChE) activity, resulting in the nervous system toxicity. The previous studies have described associations between AChE, a stable marker of pesticide poisoning, and cognitive performance in children.
 AIM: This study aimed to identify the association between blood AChE level and cognitive function in children exposed to pesticides in the Magelang Regency, Indonesia.
 METHODS: A cross-sectional study involving school-age children with a history of pesticide exposure in Ngablak, Magelang Regency, Central Java, Indonesia, was conducted. Blood AChE level was evaluated, and the Modified Mini–Mental State Examination for Children (MMMSEC) was used to analyze the cognitive function of the children.
 RESULTS: In total, 56 subjects aged between 9 and 11 years were included in this study. Median blood AChE level was 9.64 kIU/L, and 24 subjects (42.9%) had low blood AChE levels. Median MMMSEC score was 33. Eleven subjects (19.6%) were found to have abnormal cognitive function. Bivariate analysis showed that blood AChE level was associated with MMMSEC score (r = 0.343, p = 0.010). Multiple linear regression showed that blood AChE level had a positive association with cognitive function in children, assessed using the MMMSEC score (β = 0.360; p = 0.006). Further analysis showed that the attention and orientation (memory function) domains of the MMMSEC were significantly associated with blood AChE level (β: 0.371 and 0.297, respectively, p < 0.05).
 CONCLUSIONS: Blood AChE level, a stable marker of pesticide poisoning, was positively associated with cognitive function in children, as assessed using the MMMSEC score. In particular, the orientation and attention domains of the MMMSEC were associated with blood AChE level.