Aflatoxin Exposure May Contribute to Chronic Hepatomegaly in Kenyan School Children

作者：Gong Yun Yun^*; Wilson Shona; Mwatha Joseph K; Routledge Michael N; Castelino Jovita M; Zhao Bin; Kimani Gachuhi; Kariuki H Curtis; Vennervald Birgitte J; Dunne David W; Wild Christopher P

来源：Environmental Health Perspectives, 2012, 120(6): 893-896.

DOI：10.1289/ehp.1104357

• aflatoxicosis outbreak
• aflatoxin
• aflatoxin albumin adducts
• biomarker
• child health
• hepatomegaly
• hepatosplenomegaly
• malaria
• schistosomiasis

BACKGROUND: Presentation with a firm type of chronic hepatomegaly of multifactorial etiology is common among school-age children in sub-Saharan Africa. %26lt;br%26gt;OBJECTIVE: Aflatoxin is a liver toxin and carcinogen contaminating staple maize food. In this study we examined its role in chronic hepatomegaly. %26lt;br%26gt;METHODS: Plasma samples collected in 2002 and again in 2004 from 218 children attending two schools in neighboring villages were assayed for aflatoxin exposure using the aflatoxin-albumin adduct (AF-alb) biomarker. Data were previously examined for associations among hepatomegaly, malaria, and schistosomiasis. %26lt;br%26gt;RESULTS: AF-alb levels were high in children from both schools, but the geometric mean (95% confidence interval) in year 2002 was significantly higher in Matangini [206.5 (175.5, 243.0) pg/mg albumin] than in Yumbuni [73.2 (61.6, 87.0) pg/mg; p %26lt; 0.001]. AF-alb levels also were higher in children with firm hepatomegaly [176.6 (129.6, 240.7) pg/mg] than in normal children [79.9 (49.6, 128.7) pg/mg; p = 0.029]. After adjusting for Schistosoma mansoni and Plasmodium infection, we estimated a significant 43% increase in the prevalence of hepatomegaly/hepatosplenomegaly for every natural-log-unit increase in AF-alb. In 2004, AF-alb levels were markedly higher than in 2002 [539.7 (463.3, 628.7) vs. 114.5 (99.7, 131.4) pg/mg; p %26lt; 0.001] but with no significant difference between the villages or between hepatomegaly and normal groups [539.7 (436.7, 666.9) vs. 512.6 (297.3, 883.8) pg/mg], possibly because acute exposures during an aflatoxicosis outbreak in 2004 may have masked any potential underlying relationship. %26lt;br%26gt;CONCLUSIONS: Exposure to aflatoxin was associated with childhood chronic hepatomegaly in 2002. These preliminary data suggest an additional health risk that may be related to aflatoxin exposure in children, a hypothesis that merits further testing.

• 出版日期2012-6