title: Association between lead and cadmium and reproductive hormones in peripubertal U.S. girls.
abstract: BACKGROUND
  Lead (Pb) and cadmium (Cd) are known reproductive toxicants thought to disrupt hormone production throughout sensitive developmental windows, although this has not been previously examined in nationally representative peripubertal children.
  
  
  OBJECTIVE
  We examined the association between blood Pb and urinary Cd concentrations and the reproductive hormones inhibin B and luteinizing hormone (LH) in girls 6-11 years of age who participated in the cross-sectional Third National Health and Nutrition Examination Survey (NHANES III) (1988-1994).
  
  
  METHODS
  Pb (micrograms per deciliter) was measured in whole blood, and Cd was measured in urine (nanograms per milliliter). Inhibin B (picograms per milliliter) and LH (milli-International units per milliliter) were measured in residual sera for 705 girls. Survey logistic regression was used to estimate associations with pubertal onset based on inhibin B concentration > 35 pg/mL or LH concentration > 0.4 mIU/mL, and multinomial logistic regression was used to estimate the association between Pb and increasing categories of hormone concentrations.
  
  
  RESULTS
  High Pb (≥ 5 µg/dL) was inversely associated with inhibin B > 35 pg/mL [odds ratio (OR) = 0.26; 95% confidence interval (CI), 0.11-0.60; compared with Pb < 1 µg/dL]. At 10 and 11 years of age, girls with low Pb (< 1 µg/dL) had significantly higher inhibin B than did girls with moderate (1-4.99 µg/dL) or high Pb (≥ 5 µg/dL). In the subsample of 260 girls with levels of inhibin B above the level of detection and using survey regression modeling, inhibin B levels were lower among girls with both high Pb and high Cd (ß= -0.52; 95% CI, -0.09 to -1.04) than among girls with high Pb alone (ß= -0.35; 95% CI, -0.13 to -0.57), relative to girls with low Pb and low Cd.
  
  
  CONCLUSIONS
  Higher Pb was inversely associated with inhibin B, a marker of follicular development, and estimated effects suggestive of pubertal delays appeared to be stronger in the context of higher Cd concentrations. These data underscore the importance of Pb and Cd as reproductive toxicants for young girls.
authors.affiliation: Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland, USA.
authors.forename: Audra L
authors.initials: AL
authors.lastname: Gollenberg
authors.forename: Mary L
authors.initials: ML
authors.lastname: Hediger
authors.forename: Peter A
authors.initials: PA
authors.lastname: Lee
authors.forename: John H
authors.initials: JH
authors.lastname: Himes
authors.forename: Germaine M Buck
authors.initials: GM
authors.lastname: Louis
mesh_terms: D002104:Cadmium / Q000633:toxicity / Q000652:urine*; D002648:Child; D004781:Environmental Exposure / Q000032:analysis / Q000706:statistics & numerical data; D004785:Environmental Pollutants / Q000097:blood / Q000633:toxicity* / Q000652:urine; D005260:Female; D006801:Humans; D007265:Inhibins / Q000097:blood*; D007854:Lead / Q000097:blood* / Q000633:toxicity; D007986:Luteinizing Hormone / Q000097:blood*; D009749:Nutrition Surveys; D011627:Puberty / Q000187:drug effects*; D011628:Puberty, Delayed / Q000139:chemically induced / Q000453:epidemiology / Q000378:metabolism; D014481:United States
chemical_list: D004785:Environmental Pollutants; C422364:inhibin B; D002104:Cadmium; D007854:Lead; D007265:Inhibins; D007986:Luteinizing Hormone