1
|
Li J, Wu Z, Xin S, Xu Y, Wang F, Liu Y, Wang S, Dong Y, Guo Y, Han Y, Zhao J, Gao Y, Sun M, Li B. Body mass index mediates the association between four dietary indices and phenotypic age acceleration in adults: a cross-sectional study. Food Funct 2024. [PMID: 38916856 DOI: 10.1039/d4fo01088d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Background: Diet and body mass index (BMI) are widely recognized as being closely associated with aging. However, it remains unclear which dietary indices are associated with aging, and the extent to which BMI mediates the relationship between diet and aging. Therefore, this study investigates the mediating role of BMI in the association between various dietary indices and phenotypic age acceleration (PhenoAgeAccel). Methods: Data were sourced from the National Health and Nutrition Examination Survey (NHANES), using two 24 hour recall interviews to compute four dietary indices: the Dietary Inflammatory Index (DII), Healthy Eating Index-2020 (HEI-2020), Alternative Healthy Eating Index-2010 (AHEI-2010), and Composite Dietary Antioxidant Index (CDAI). Linear regression analyses and mediation analyses assessed the associations between dietary indices and PhenoAgeAccel and the mediating effects of BMI. Z-score transformations (zDII, zHEI-2020, zAHEI-2010, and zCDAI) were used to ensure comparability between different dietary indices. Results: After adjusting for covariates, the zHEI-2020, zAHEI-2010, and zCDAI were negatively associated with PhenoAgeAccel (P < 0.05), with β values being -0.36, -0.40, and -0.41, respectively. The zDII was positively associated with PhenoAgeAccel (P < 0.001) with a β value of 0.70. Mediation analyses suggested that BMI significantly mediated the relationships between these dietary indices and PhenoAgeAccel. The mediation proportions were 23.7% for zDII, 43.3% for zHEI-2020, 24.5% for zAHEI-2010, and 23.6% for zCDAI. Conclusions: This study indicates that all dietary indices and BMI were significantly associated with PhenoAgeAccel. In addition, BMI exhibited the highest mediation proportion in the relationship between HEI-2020 and PhenoAgeAccel.
Collapse
Affiliation(s)
- Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Zibo Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Sitong Xin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Yang Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Fengdan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Yan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Sizhe Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Yibo Dong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Yuangang Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Yu Han
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Jing Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Yuqi Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| | - Mengzi Sun
- The First Affiliated Hospital of Xi'an Jiaotong University, No. 69, Xiaozhai West Road, Xi'an, 710061, P. R. China
- Global Health Institute, School of Public Health, Xi'an Jiaotong University, Xi'an, Shaanxi, 710100, P. R. China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun, 130021, P. R. China.
| |
Collapse
|
2
|
Ou J, Xian R, Li J, Zhao J, Zhang K, Mo P, Fang J, Shen Y, Hu X, Fang S, Liu W, Pan H. Associations of dichlorophenols, trichlorophenols, and ortho-phenylphenol with the risk and prognosis of diabetes and prediabetes: A population-based study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 277:116345. [PMID: 38653021 DOI: 10.1016/j.ecoenv.2024.116345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/14/2024] [Accepted: 04/16/2024] [Indexed: 04/25/2024]
Abstract
2,4-dichlorophenol (2,4-DCP), 2,5-DCP, 2,4,5-trichlorophenol (2,4,5-TCP), 2,4,6-TCP, and ortho-phenylphenol (OPP) are widely present in the environment. However, their associations with risk and prognosis of diabetes and prediabetes remains unclear. We investigated the associations of these five phenols with the risk of diabetes and prediabetes, and with all-cause and cardiovascular disease (CVD) mortality, in adults with diabetes or prediabetes (n=6419). Information on diabetes and prediabetes indicators, and mortality data was collected from the National Health and Nutrition Examination Survey. Logistic and Cox regression models were used to explore the associations of the five phenols with risk and prognosis of diabetes and prediabetes. Participants in the highest urinary 2,4-DCP and 2,5-DCP tertiles had higher odds of diabetes [adjusted odds ratio (aOR), 1.34, 95 % confidence interval (CI): 1.10, 1.62; aOR, 1.29, 95 % CI: 1.07, 1.56, respectively] than those in the lowest tertiles. Participants with urinary OPP concentrations above the limit of detection (LOD), but below median had an aOR of 1.25 (95 % CI: 1.08, 1.46) for prediabetes compared to those with concentrations below the LOD. In adults with diabetes, the highest 2,4-DCP and 2,5-DCP tertiles were associated with all-cause mortality [adjusted hazard ratio (aHR), 1.49; 95 % CI: 1.08, 2.06; aHR, 1.49; 95 % CI: 1.08, 2.05, respectively] and CVD mortality (aHR, 2.58; 95 % CI: 1.33, 4.97; aHR, 1.96; 95 % CI: 1.06, 3.60, respectively) compared with the lowest tertiles. Compared with 2,4,5-TCP concentrations below the LOD, those above median were associated with all-cause mortality (aHR: 1.75; 95 % CI: 1.24, 2.48) and CVD mortality (aHR: 2.34; 95 % CI: 1.19, 4.63) in adults with prediabetes. Furthermore, the associations between these phenols and mortality were strengthened in some subgroups. Environmental exposure to 2,4-DCP, 2,5-DCP, 2,4,5-TCP, and OPP increases the risk or adverse prognosis of diabetes or prediabetes in adults in the US. Further studies are required to confirm these findings.
Collapse
Affiliation(s)
- Jiayin Ou
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Ronghui Xian
- Shenzhen Bao'an Traditiona Chinese Medicine Hospital, The Seventh Clinical College, Guangzhou University of Chinese Medicine, Shenzhen 518100, China
| | - Jiayu Li
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Jianhe Zhao
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Kaiyao Zhang
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou 510006, China
| | - Peishan Mo
- The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Jiansong Fang
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Yue Shen
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Xiaoling Hu
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Shuhuan Fang
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China.
| | - Wei Liu
- The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, China; Guangdong Clinical Research Academy of Chinese Medicine Guangzhou, Guangzhou 510405, China; The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China.
| | - Huafeng Pan
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China.
| |
Collapse
|
3
|
Yang K, Jia RY, Li XS, Lu SY, Liu JJ, Zhang ZP, Fang ZZ. Identification of UDP-glucuronosyltransferase (UGT) isoforms involved in the metabolism of Chlorophenols (CPs). CHEMOSPHERE 2024; 358:142249. [PMID: 38705405 DOI: 10.1016/j.chemosphere.2024.142249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 05/01/2024] [Accepted: 05/03/2024] [Indexed: 05/07/2024]
Abstract
Chlorophenols (CPs) are a group of pollutants that pose a great threat to the environment, they are widely used in industrial and agricultural wastes, pesticides, herbicides, textiles, pharmaceuticals and plastics. Among CPs, pentachlorophenol was listed as one of the persistent organic pollutants (POPs) by the Stockholm convention. This study aims to identify the UDP-glucosyltransferase (UGT) isoforms involved in the metabolic elimination of CPs. CPs' mono-glucuronide was detected in the human liver microsomes (HLMs) incubation mixture with co-factor uridine-diphosphate glucuronic acid (UDPGA). HLMs-catalyzed glucuronidation metabolism reaction equations followed Michaelis-Menten or substrate inhibition type. Recombinant enzymes and chemical reagents inhibition experiments were utilized to phenotype the main UGT isoforms involved in the glucuronidation of CPs. UGT1A6 might be the major enzyme in the glucuronidation of mono-chlorophenol isomer. UGT1A1, UGT1A6, UGT1A9, UGT2B4 and UGT2B7 were the most important five UGT isoforms for metabolizing the di-chlorophenol and tri-chlorophenol isomers. UGT1A1 and UGT1A3 were the most important UGT isoforms in the catalysis of tetra-chlorophenol and pentachlorophenol isomers. Species differences were investigated using rat liver microsomes (RLMs), pig liver microsomes (PLMs), dog liver microsomes (DLMs), and monkey liver microsomes (MyLMs). All these results were helpful for elucidating the metabolic elimination and toxicity of CPs.
Collapse
Affiliation(s)
- Kai Yang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China; School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China; Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Ruo-Yong Jia
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiao-Song Li
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shao-You Lu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Jian-Jun Liu
- Shenzhen Key Laboratory of Modern Toxicology, Shenzhen Medical Key Discipline of Health Toxicology (2020-2024), Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Zhi-Peng Zhang
- Department of Surgery, Peking University Third Hospital, Beijing, China.
| | - Zhong-Ze Fang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China.
| |
Collapse
|
4
|
Liu H, Wang J, Tao L, Hao Y. Association between DCP levels and kidney stone prevalence in US female adults based on NHANES data. Sci Rep 2024; 14:6457. [PMID: 38499640 PMCID: PMC10948765 DOI: 10.1038/s41598-024-56832-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 03/12/2024] [Indexed: 03/20/2024] Open
Abstract
Our study aimed to evaluate the correlation between levels of 2,4-DCP(2,4-Dichlorophenol) and 2,5-DCP(2,5-Dichlorophenol) and the prevalence of kidney stones in US female adults. Participants were chosen from the National Health and Nutrition Examination Survey database, spanning the years 2007-2016. Dose-response curves were analyzed using logistic regression, subgroup analyses, and other statistical methods to evaluate the relationship between 2,4-DCP and 2,5-DCP levels and the prevalence of kidney stones. The final study included 3220 participants aged over 20 years, with 252 females reporting a history of kidney stones. After accounting for all interfering variables, we found that every 0.1 ug/ml increase in 2.4-DCP correlated with a 1% rise in kidney stone prevalence (OR = 1.01, 95% CI 1.00, 1.01), whereas the same increase in 2.5-DCP was linked to a 27% growth in prevalence (OR = 1.27, 95% CI 1.01, 1.61). Sensitivity analysis was performed by triangulating 2,4-DCP and 2,5-DCP levels. The dose-response curves demonstrated a linear positive relationship between 2,4-DCP and 2,5-DCP levels and the risk of stone development. Our findings indicate a positive correlation between 2,4-DCP and 2,5-DCP levels and the prevalence of kidney stones in US female adults. This association is of clinical significance; however, a direct causal relationship cannot be definitively established.
Collapse
Affiliation(s)
- Heqian Liu
- Department of Urology, The Second People's Hospital of Wuhu City (Affiliated Wuhu Hospital of East China Normal University), Wuhu, 241000, China
| | - Jiawei Wang
- Department of Urology, The Second People's Hospital of Wuhu City (Affiliated Wuhu Hospital of East China Normal University), Wuhu, 241000, China
| | - Lingsong Tao
- Department of Urology, The Second People's Hospital of Wuhu City (Affiliated Wuhu Hospital of East China Normal University), Wuhu, 241000, China
| | - Yunwu Hao
- Department of Urology, Lu'an Hospital Affiliated of Anhui Medical University, Lu'an, 237000, Anhui, China.
| |
Collapse
|
5
|
Forté CA, Millar JA, Colacino JA. Integrating NHANES and toxicity forecaster data to compare pesticide exposure and bioactivity by farmwork history and US citizenship. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024; 34:208-216. [PMID: 37474644 PMCID: PMC10799167 DOI: 10.1038/s41370-023-00583-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/28/2023] [Accepted: 07/06/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Farmworkers in the United States, especially migrant workers, face unique barriers to healthcare and have documented disparities in health outcomes. Exposure to pesticides, especially those persistent in the environment, may contribute to these health disparities. OBJECTIVE Quantify differences in pesticide exposure bioactivity by farmworker category and US citizenship status. METHODS We queried the National Health and Nutrition Examination Study (NHANES) from 1999-2014 for pesticide exposure biomarker concentrations among farmworkers and non-farmworkers by citizenship status. We combined this with toxicity assay data from the US Environmental Protection Agency's (EPA's) Toxicity Forecaster (ToxCast). We estimated adverse biological effects that occur across a range of human population-relevant pesticide doses. RESULTS In total, there were 844 people with any farmwork history and 23,592 non-farmworkers. Of 12 commonly detectable pesticide biomarkers in NHANES, 2,4-dichlorophenoxyacetic acid (OR = 3.76, p = 1.33 × 10-6) was significantly higher in farmworkers than non-farmworkers. Farmworkers were 1.15 times more likely to have a bioactive pesticide biomarker measurement in comparison to non-farmworkers (adjusted OR = 1.15, 95% CI: 0.87, 1.51). Non-U.S. citizens were 1.39 times more likely to have bioactive pesticide biomarker concentrations compared to people with U.S. citizenship (adjusted OR 1.39, 95% CI: 1.17, 1.64). Additionally, non-citizens were significantly more exposed to bioactive levels of β-hexachlorocyclohexane (BHC) (OR = 8.10, p = 1.33 × 10-6), p,p-DDE (OR = 2.60, p = 0.02), and p,p'-DDT (OR = 7.75, p = 0.01). IMPACT STATEMENT Farmworkers are a vulnerable population due to social determinants of health and occupational exposures. Here, we integrate US population chemical biomonitoring data and toxicity outcome data to assess pesticide exposure by farmwork history and citizenship. We find that farmworkers and those without US citizenship are significantly more likely to be exposed to concentrations of pesticides which are bioactive in toxicological assays. Thus, farmworkers employed in the US but who are not citizens could be at increased risk of harm to their health due to pesticides. These findings are important to shape evidence-based policies in regulatory science to promote worker safety.
Collapse
Affiliation(s)
- Chanese A Forté
- The University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, USA
- The University of Michigan, College of Engineering, Michigan Institute of Computational Discovery and Engineering, Ann Arbor, MI, USA
| | - Jess A Millar
- The University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI, USA
- The University of Michigan Medical School, Department of Computational Medicine and Bioinformatics, Ann Arbor, MI, USA
| | - Justin A Colacino
- The University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, USA.
- The University of Michigan School of Public Health, Department of Nutritional Sciences, Ann Arbor, MI, USA.
- The University of Michigan College of Literature, Sciences, and the Arts, Program in the Environment, Ann Arbor, MI, USA.
| |
Collapse
|
6
|
Andre KE, Hood RB, Gaskins AJ, Kawwass JF, Almquist RG, Kramer MR, Hipp HS. Neighborhood deprivation and racial differences in in vitro fertilization outcomes. Am J Obstet Gynecol 2024; 230:352.e1-352.e18. [PMID: 37939983 DOI: 10.1016/j.ajog.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND There are significant racial disparities in in vitro fertilization outcomes, which are poorly explained by individual-level characteristics. Environmental factors such as neighborhood-level socioeconomic factors may contribute to these disparities. However, few studies have directly addressed this research question in a large, racially diverse cohort. OBJECTIVE This study aimed to investigate whether neighborhood deprivation is associated with differences in in vitro fertilization outcomes. STUDY DESIGN Our retrospective cohort study included 1110 patients who underwent 2254 autologous in vitro fertilization cycles between 2014 and 2019 at an academic fertility center in the Southeastern United States. Neighborhood deprivation was estimated using the Neighborhood Deprivation Index, a composite variable measuring community levels of material capital based on poverty, occupation, housing, and education domains. Using multivariable log-binomial generalized estimating equations with cluster weighting, risk ratios and 95% confidence intervals were estimated for cycle cancellation, miscarriage (defined as spontaneous pregnancy loss before 20 weeks after a confirmed intrauterine gestation), and live birth according to patient Neighborhood Deprivation Index. RESULTS There were positive associations between increasing Neighborhood Deprivation Index (indicating worsening neighborhood deprivation) and body mass index, as well as increasing prevalence of tubal and uterine factor infertility diagnoses. The crude probability of live birth per cycle was lower among Black (24%) than among White patients (32%), and the crude probability of miscarriage per clinical pregnancy was higher among Black (22%) than among White patients (12%). After adjustment, the Neighborhood Deprivation Index was not significantly associated with risk of cycle cancellation or live birth. Results were consistent when analyses were stratified by race. CONCLUSION Our research demonstrates racial disparities between Black and White women in the incidence of miscarriage and live birth following in vitro fertilization. Although the level of neighborhood deprivation was closely related to race, it did not have strong associations with in vitro fertilization outcomes in our population as a whole or within strata of race.
Collapse
Affiliation(s)
- Kerri E Andre
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA.
| | - Robert B Hood
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Audrey J Gaskins
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Jennifer F Kawwass
- Division of Reproductive Endocrinology, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA
| | - R Garland Almquist
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA
| | - Michael R Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Heather S Hipp
- Division of Reproductive Endocrinology, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA
| |
Collapse
|
7
|
Wang H, Liu Y, Liang Y, Guo Z, Wang Y, Zhang C, Qu L, Sun G, Li Y. The urinary level of 2,4,5-trichlorophenol was positively associated with both all-cause and cause-specific mortalities in general adult residents of United States. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 269:115793. [PMID: 38086262 DOI: 10.1016/j.ecoenv.2023.115793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 12/03/2023] [Accepted: 12/04/2023] [Indexed: 01/12/2024]
Abstract
Chlorophenols are widespread environmental organic pollutants with harmful effects on human beings. Although relationships between chlorophenols and various dysfunctions/diseases have been reported, the contribution of chlorophenols exposure to mortalities is underdetermined. In this cohort study, we included 4 types of urinary chlorophenols, aiming to estimate associations of chlorophenols exposure with all-cause and cause-specific mortalities. Urinary chlorophenols were examined at baseline of National Health and Nutrition Examination Survey (NHANES) 2003-2010, and adjusted for the urinary creatinine level. Associations between chlorophenols and mortalities were estimated using COX regression analyses, results were shown as hazard ratio (HR) and 95% confidence interval (95% CI). By dividing participants into four subgroups based on quartiles of urinary levels of chlorophenols, associations between mortalities and categorical variables of chlorophenols were estimated. Furthermore, the quantile g-computation analysis was used to estimate the joint effects of 4 chlorophenols on mortalities. Among 5817 adults (2863 men), 1034 were deceased during the follow-up. After adjusted for confounders, 2,4,5-trichlorophenol (2,4,5-TCP) was found to be positively associated with both all-cause (HR = 1.46; 95% CI: 1.16, 1.84) and cardiovascular disease (CVD) mortalities (HR = 1.60; 95% CI: 1.00, 2.55). Compared to the subgroup of the lowest level of chlorophenols, participants in subgroups of higher 2,4,5-TCP levels showed higher risk of all-cause mortality (P-value for trend = 0.003). For CVD mortality, HRs in subgroups of higher levels of 2,4-dichlorophenol (2,4-DCP) and 2,4,6-trichlorophenol (2,4,6-TCP) were statistically significant (P-values for trend were 0.017 for 2,4-DCP and 0.049 for 2,4,6-TCP). The HRs (95% CI) of joint effects of 4 chlorophenols were 1.11 (1.01, 1.21) and 1.32 (1.10, 1.57) for all-cause and CVD-specific mortalities, and 2,4,5-TCP showed the highest weight in joint effects. All of these findings implied that among 4 urinary chlorophenols we included, 2,4,5-TCP might be a sensitive one in associations with mortalities among general populations.
Collapse
Affiliation(s)
- Huan Wang
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention (China Medical University), Ministry of Education, China; School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Yuyan Liu
- Department of Clinical Epidemiology, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yuanhong Liang
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention (China Medical University), Ministry of Education, China; School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Zijun Guo
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention (China Medical University), Ministry of Education, China; School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Ying Wang
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention (China Medical University), Ministry of Education, China; School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Chengwen Zhang
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention (China Medical University), Ministry of Education, China; School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Litong Qu
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention (China Medical University), Ministry of Education, China; School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Guifan Sun
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention (China Medical University), Ministry of Education, China; School of Public Health, China Medical University, Shenyang, Liaoning, China; The Key Laboratory of Liaoning Province on Toxic and Biological Effects of Arsenic, Shenyang, China
| | - Yongfang Li
- Key Laboratory of Environmental Stress and Chronic Disease Control & Prevention (China Medical University), Ministry of Education, China; School of Public Health, China Medical University, Shenyang, Liaoning, China; The Key Laboratory of Liaoning Province on Toxic and Biological Effects of Arsenic, Shenyang, China.
| |
Collapse
|
8
|
Cai J, Yang Z, Zhao S, Ke X. Associations of dichlorophenol with metabolic syndrome based on multivariate-adjusted logistic regression: a U.S. nationwide population-based study 2003-2016. Environ Health 2023; 22:88. [PMID: 38102676 PMCID: PMC10722741 DOI: 10.1186/s12940-023-01037-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Para-dichlorobenzene (p-DCB) exposure associated with oxidative stress has indeed raised public concerns. However, whether p-DCB is linked with metabolic syndrome (MetS) remains unclear. We hypothesized that higher exposure to p-DCB would be linked with a higher risk of MetS in the U.S population. This study aimed to examine the associations of exposure to p-DCB with MetS prevalence. METHODS We included 10,428 participants (5,084 men and 5,344 women), aged ≥ 20 years, from the National Health and Nutrition Examination Survey (2003-2016). The cases of MetS were diagnosed by NCEP/ATPIII. Logistic regression models were conducted to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of MetS prevalence. Moreover, the mix associations of p-DCB metabolites were assessed using quantile sum (WQS) regression and quantile g-computation (qgcomp) methods. RESULTS We documented 2,861 (27.1%) MetS cases. After adjustment for the potential risk factors, the ORs (95% CI) of MetS prevalence across the quartile of urinary 2,5-dichlorophenol (2,5-DCP) were 1.09 (0.93-1.28), 1.22 (1.00-1.49), and 1.34 (1.04-1.73). Moreover, 2,5 DCP is significantly associated with a higher prevalence of abdominal obesity [ORQ4vsQ1 (95% CI): 1.23 (1.03-1.48)]. The WQS and qgcomp index also showed significant associations between p-DCB metabolites and MetS. Moreover, we further examined that 2,5 DCP was correlated with higher systolic blood pressure (r = 0.022, P = 0.027), waist circumference (r = 0.099, P < 0.001), and glycohemoglobin (r = 0.027, P = 0.008) and a lower high density cholesterol (r = -0.059, P < 0.001). In addition, the significant positive associations between 2,5 DCP and MetS were robust in the subgroup and sensitivity analyses. CONCLUSION These findings indicated that increased urinary p-DCB concentration, especially 2,5 DCP, had a higher MetS prevalence. These results should be interpreted cautiously and further research is warranted to validate our findings.
Collapse
Affiliation(s)
- Jing Cai
- Key Laboratory of Drug Prevention and Control Technology of Zhejiang Province, Zhejiang Police College, Hangzhou, 310053, P.R. China
| | - Zhichao Yang
- Key Laboratory of Drug Prevention and Control Technology of Zhejiang Province, Zhejiang Police College, Hangzhou, 310053, P.R. China
| | - Sen Zhao
- Key Laboratory of Drug Prevention and Control Technology of Zhejiang Province, Zhejiang Police College, Hangzhou, 310053, P.R. China
| | - Xing Ke
- Key Laboratory of Drug Prevention and Control Technology of Zhejiang Province, Zhejiang Police College, Hangzhou, 310053, P.R. China.
| |
Collapse
|
9
|
Skonieski C, Fagundes KR, Silva LD, Segat HJ, Martino Andrade AJ, Cordeiro Bolzan R, Hirata MH, Monteiro Ferreira G, Moter Benvegnú D. Association of occupational exposure to pesticides with overweight in farmers in Southern Brazil. Biomarkers 2023; 28:608-616. [PMID: 37815377 DOI: 10.1080/1354750x.2023.2268859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/01/2023] [Indexed: 10/11/2023]
Abstract
INTRODUCTION Exposure to pesticides may be related to overweight and associated comorbidities. The aim of this work was to evaluate occupational exposure to pesticides, overweight and associated comorbidities among farmers in Southern Brazil. METHODS This cross-sectional study included a random sample of 257 farmers, living in the municipality of Mafra and Planalto, southern Brazil. Data on pesticide use and overweight prevalence from farmers were collected using an in-person interview questionnaire, followed by blood collection and biochemical analyses. RESULTS Pesticide exposure was positively correlated with body mass index, waist circumference, waist-to-hip ratio, triglycerides and glucose levels, presence of hypertension and metabolic syndrome. Besides that, the fact of being exposed to pesticides represents a decrease of no protein thiol groups. Furthermore, the main pesticides used by farmers have hepatic toxicity. CONCLUSION These findings suggest that exposure to pesticides may be associated with overweight and associated comorbidities. Further studies are required to validate our findings and elucidate the specific mechanisms by which these pollutants contribute to the development of overweight.
Collapse
Affiliation(s)
- Calinca Skonieski
- Campus Realeza, Federal University of Fronteira Sul (UFFS), Realeza, Brazil
| | | | - Larissa da Silva
- Campus Realeza, Federal University of Fronteira Sul (UFFS), Realeza, Brazil
| | - Hecson Jesser Segat
- Department of Physiology and Pharmacology, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | | | | | - Mario Hiroyuki Hirata
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo (USP), São Paulo, Brazil
| | - Glaucio Monteiro Ferreira
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo (USP), São Paulo, Brazil
| | - Dalila Moter Benvegnú
- Campus Realeza, Federal University of Fronteira Sul (UFFS), Realeza, Brazil
- Health-Applied Sciences Post Graduation Program, State University of West Paraná (Unioeste), Francisco Beltrão, Brazil
| |
Collapse
|
10
|
Arab A, Mostafalou S. Pesticides and insulin resistance-related metabolic diseases: Evidences and mechanisms. PESTICIDE BIOCHEMISTRY AND PHYSIOLOGY 2023; 195:105521. [PMID: 37666627 DOI: 10.1016/j.pestbp.2023.105521] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/01/2023] [Accepted: 07/05/2023] [Indexed: 09/06/2023]
Abstract
The use of pesticides in the past century has lot helped humankind in improving crops' field and general hygiene level. Nevertheless, there has been countless evidences on the toxic effects of pesticides on the living systems. The link of exposure to pesticides with different human chronic diseases in the context of carcinogenicity, neurotoxicity, developmental toxicity, etc., have been evaluated in various types of studies. There are also some evidences on the link of exposure to pesticides with higher incidence of metabolic diseases associated with insulin resistance like diabetes, obesity, metabolic syndrome, hypertension, polycystic ovary syndrome and chronic kidney diseases. Physiologically, weakening intracellular insulin signaling is considered as a compensatory mechanism for cells to cope with cellular stresses like xenobiotic effects, oxidative stress and inflammatory responses, but it can pathologically lead to a defective cycle with lowered sensitivity of the cells to insulin which happens in metabolic disorders. In this work, the data related to metabolic toxicity of pesticides categorized in the mentioned metabolic diseases with a focus on the effects of pesticides on insulin signaling pathway and the mechanisms of development of insulin resistance will be systematically reviewed and presented.
Collapse
Affiliation(s)
- Ali Arab
- Department of Pharmacology and Toxicology, School of Pharmacy, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Sara Mostafalou
- Department of Pharmacology and Toxicology, School of Pharmacy, Ardabil University of Medical Sciences, Ardabil, Iran.
| |
Collapse
|
11
|
Pridgen GW, Zhu J, Wei Y. Exposure to p-dichlorobenzene and prevalent endocrine-related reproductive cancers among US women. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-27876-4. [PMID: 37269516 DOI: 10.1007/s11356-023-27876-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/19/2023] [Indexed: 06/05/2023]
Abstract
P-dichlorobenzene (p-DCB) is a pest repellent and air deodorant that is commonly found in the household and public buildings. Exposure to p-DCB has been suggested to have potential metabolic and endocrine effects. Little is known about its association with endocrine-related female cancers. In this cross-sectional study, a nationally representative subsample of 4459 women, aged 20 years or older, in the 2003-2016 National Health and Nutrition Examination Survey was analyzed for the association between p-DCB exposure, measured as urinary concentrations of 2,5-dichlorophenol (2,5-DCP), the primary metabolite of p-DCB, and prevalent endocrine-related female cancers (defined as breast, ovarian, and uterine cancers) using multivariate logistic regression models, adjusting for potential confounders. Of the study participants, 202 women (weighted prevalence, 4.20%) reported being diagnosed with any of these endocrine-related reproductive cancers. Women with reproductive cancers showed a statistically significant increase in urinary 2,5-DCP concentrations (weighted geometric mean, 7.97 vs. 5.84 µg/g creatinine; p < 0.0001), compared to women without these cancers. After adjusting for potential confounders, we found that women in the moderate (1.94- < 28.10 µg/g creatinine) and high level (≥ 28.10 µg/g creatinine) of 2,5-DCP had significantly increased odds of endocrine-related reproductive cancers (odds ratio of 1.66 (95% CI: 1.02, 2.71) and 1.89 (1.08, 3.29), respectively), as compared with those in the low exposure group (< 1.94 µg/g creatinine). This study demonstrates a potential relation between p-DCB exposure and prevalent endocrine-related reproductive cancers in US women. Prospective and mechanistic studies would further explore these interactions and elucidate the pathogenesis of endocrine-related female cancers potentially associated with p-DCB exposure.
Collapse
Affiliation(s)
| | - Jianmin Zhu
- Department of Mathematics and Computer Science, Fort Valley State University, Fort Valley, GA, USA
| | - Yudan Wei
- Department of Community Medicine, Mercer University School of Medicine, 1501 Mercer University Dr., Macon, GA, 31207, USA.
| |
Collapse
|
12
|
Zhang H, Zhao F, Liu Y, Li Y, Liu H, Sun H. Assessment of the inhibition risk of chlorophenol substances on cytochrome P450 via cocktail inhibition assays. Toxicol Appl Pharmacol 2023; 461:116401. [PMID: 36706924 DOI: 10.1016/j.taap.2023.116401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 12/17/2022] [Accepted: 01/20/2023] [Indexed: 01/26/2023]
Abstract
Chlorophenols (CPs) are widespread pollutants in nature. CPs have raised significant concern due to their potential hepatotoxic effects on humans. This research aimed to ascertain the inhibitory potential of eleven CPs (2-CP, 3-CP, 4-CP, 2,4-DCP, 2,3,4-TCP, 2,4,5-TCP, 2,4,6-TCP, 2,3,4,5-TeCP, 2,3,4,6-TeCP, 2,3,5,6-TeCP, and PCP) on nine human CYP isoforms (CYP1A2, 2A6, 2B6, 2C8, 2C9, 2C19, 2D6, 2E1, and 3A4). The CPs that inhibit the activity of CYP isoforms were detected with human liver microsomes (HLM) using a cocktail approach in vitro. The results demonstrated that trichlorophenols, tetrachlorophenols, and PCP strongly inhibited CYP2C8 and CYP2C9. The half inhibition concentration (IC50) value of 2,3,4,6-TeCP and PCP for CYP2C8 inhibition was 27.3 μM and 12.3 μM, respectively. The IC50 for the inhibition of 2,4,6-TCP, 2,3,4,6-TeCP and PCP towards CYP2C9 were calculated to be 30.3 μM, 5.8 μM and 2.2 μM, respectively. 2,3,4,6-TeCP, and PCP exhibited non-competitive inhibition towards CYP2C8. 2,4,6-TCP, 2,3,4,6-TeCP, and PCP exhibited competitive inhibition towards CYP2C9. The inhibition kinetics parameters (Ki) were 51.51 μM, 22.28 μM, 37.86 μM, 7.27 μM, 0.68 μM for 2,3,4,6-TeCP-CYP2C8, PCP-CYP2C8, 2,4,6-TCP-CYP2C9, 2,3,4,6-TeCP-CYP2C9, PCP-CYP2C9, respectively. This study also defined clear structure-activity relationships (SAR) of CPs on CYP2C8, supported by molecular docking studies. Overall, CPs were found to cause inhibitory effects on CYP isoforms in vitro, and this finding may provide a basis for CPs focused on CYP isoforms inhibition endpoints.
Collapse
Affiliation(s)
- Haoqian Zhang
- Key Laboratory of Liaoning Tumor Clinical Metabolomics (KLLTCM), Jinzhou Medical University, Jinzhou 121001, China; First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121001, China
| | - Furong Zhao
- Key Laboratory of Liaoning Tumor Clinical Metabolomics (KLLTCM), Jinzhou Medical University, Jinzhou 121001, China; Dalian Innovation Center of Laboratory Medicine Mass Spectrometry Technology, Dalian Runsheng Kangtai Medical Lab Co. Ltd, Dalian 116000, China; Clinical Mass Spectrometry Profession Technology Innovation Center of Liaoning Province, Liaoning Runsheng Kangtai Medical Lab Co. Ltd, Jinzhou 121219, China
| | - Yong Liu
- Key Laboratory of Liaoning Tumor Clinical Metabolomics (KLLTCM), Jinzhou Medical University, Jinzhou 121001, China
| | - Ying Li
- Key Laboratory of Liaoning Tumor Clinical Metabolomics (KLLTCM), Jinzhou Medical University, Jinzhou 121001, China; Dalian Innovation Center of Laboratory Medicine Mass Spectrometry Technology, Dalian Runsheng Kangtai Medical Lab Co. Ltd, Dalian 116000, China; Clinical Mass Spectrometry Profession Technology Innovation Center of Liaoning Province, Liaoning Runsheng Kangtai Medical Lab Co. Ltd, Jinzhou 121219, China
| | - Haiwen Liu
- First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121001, China
| | - Hongzhi Sun
- Key Laboratory of Liaoning Tumor Clinical Metabolomics (KLLTCM), Jinzhou Medical University, Jinzhou 121001, China; First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121001, China.
| |
Collapse
|
13
|
Zhu J, Wei Y. Exposure to p-dichlorobenzene and serum α-Klotho levels among US participants in their middle and late adulthood. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 858:159768. [PMID: 36309252 DOI: 10.1016/j.scitotenv.2022.159768] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 06/16/2023]
Abstract
P-dichlorobenzene (p-DCB) is a volatile compound commonly used as pest repellent and air deodorant in the home and public buildings, leading to a widespread exposure in indoor environments. There has been an increasing concern about its metabolic and endocrine effects. In this study, we explored the relation between p-DCB exposure and serum levels of soluble α-Klotho, an anti-aging hormone, in US adults. A nationally representative subsample of 1485 adults 40-79 ages in the 2013-2016 National Health and Nutrition Examination Survey was analyzed for the association between p-DCB exposure, measured as urinary concentrations of 2,5-dichlorophenol (2,5-DCP), the major metabolite of p-DCB, and serum α-Klotho levels using multiple general linear models, adjusting for potential confounders. Age- and sex-specific analyses were further conducted. The weighted geometric mean of urinary 2,5-DCP was 2.43 μg/L and the weighted mean of serum α-Klotho was 831.97 pg/mL in the study participants during 2013-2016. After adjusting for potential confounders and urinary creatinine, urinary 2,5-DCP was significantly associated with decreased serum levels of α-Klotho (regression coefficient β = -9.88; p = 0.0133) in the total study population. When age- and sex-specific analyses being conducted, a significantly inverse association was found in older adults aged 60-79 years (β = -20.40; p = 0.0001) and in males (β = -13.81; p = 0.0097), but not in the middle ages (40-59 years) and in females. The strongest association was observed in older (60-79 years) male participants, with a 25.43 pg/mL reduction of α-Klotho levels per 1-unit increase of 2,5-DCP concentrations (p = 0.0008). This is the first study demonstrating a relation between p-DCB exposure, measured as 2,5-DCP, and decreased α-Klotho levels in older males. Additional studies would further explore these interactions and elucidate the pathogenesis of the potential effects of p-DCB exposure on aging.
Collapse
Affiliation(s)
- Jianmin Zhu
- Department of Mathematics and Computer Science, Fort Valley State University, Fort Valley, GA, USA
| | - Yudan Wei
- Department of Community Medicine, Mercer University School of Medicine, Macon, GA, USA.
| |
Collapse
|
14
|
Forté CA, Millar JA, Colacino J. Integrating NHANES and Toxicity Forecaster Data to Compare Pesticide Exposure and Bioactivity by Farmwork History and US Citizenship. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.01.24.23284967. [PMID: 36747730 PMCID: PMC9901040 DOI: 10.1101/2023.01.24.23284967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Introduction Farmworkers in the United States, especially migrant workers, face unique barriers to healthcare and have documented disparities in health outcomes. Exposure to pesticides, especially those persistent in the environment, may contribute to these health disparities. Methods We queried the National Health and Nutrition Examination Study (NHANES) from 1999-2014 for pesticide exposure biomarker concentrations among farmworkers and non-farmworkers by citizenship status. We combined this with toxicity assay data from the US Environmental Protection Agency's (EPA's) Toxicity Forecast Dashboard (ToxCast). We estimated adverse biological effects that occur across a range of human population-relevant pesticide doses. Results In total, there were 1,137 people with any farmwork history and 20,205 non-farmworkers. Of the 14 commonly detectable pesticide biomarkers in NHANES, 2,4-dichlorophenol (OR= 4.32, p= 2.01×10 -7 ) was significantly higher in farmworkers than non-farmworkers. Farmworkers were 1.37 times more likely to have a bioactive pesticide biomarker measurement in comparison to non-farmworkers (adjusted OR=1.37, 95% CI: 1.10, 1.71). Within farmworkers only, those without U.S. citizenships were 1.31 times more likely to have bioactive pesticide biomarker concentrations compared those with U.S. citizenship (adjusted OR 1.31, 95% CI: 0.75, 2.30). Additionally, non-citizen farmworkers were significantly more exposed to bioactive levels of β -hexachlorocyclohexane (BHC) (OR= 8.50, p= 1.23×10 -9 ), p,p-DDE (OR= 2.98, p= 3.11×10 -3 ), and p,p'-DDT (OR= 10.78, p= 8.70×10 -4 ). Discussion These results highlight pesticide exposure disparities in farmworkers, particularly those without U.S. citizenship. Many of these exposures are occurring at doses which are bioactive in toxicological assays.
Collapse
Affiliation(s)
- Chanese A. Forté
- The University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, USA
- The University of Michigan, College of Engineering, Michigan Institute of Computational Discovery and Engineering, Ann Arbor, MI, USA
| | - Jess A. Millar
- The University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI, USA
- The University of Michigan Medical School, Department of Computational Medicine and Bioinformatics, Ann Arbor, MI, USA
| | - Justin Colacino
- The University of Michigan School of Public Health, Department of Environmental Health Sciences, Ann Arbor, MI, USA
- The University of Michigan School of Public Health, Department of Nutritional Sciences, Ann Arbor, MI, USA
- University of Michigan College of Literature, Sciences, and the Arts, Program in the Environment, Ann Arbor, MI, USA
| |
Collapse
|
15
|
Sun M, Wang L, Wang X, Tong L, Fang J, Wang Y, Yang Y, Li B. Interaction between sleep quality and dietary inflammation on frailty: NHANES 2005-2008. Food Funct 2023; 14:1003-1010. [PMID: 36546877 DOI: 10.1039/d2fo01832b] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Aims: The underlying mechanism of both sleep disorders and frailty is chronic inflammation, which can be reflected by the dietary inflammatory index (DII). Therefore, we aimed to explore the association between sleep quality, frailty, and dietary inflammation. Methods: 9007 participants aged over 20 years from the National Health and Nutrition Examination Survey (NHANES) in 2005-2008 were involved in the study. Dietary inflammation was assessed by DII, sleep quality was assessed by the Pittsburgh sleep quality index (PSQI), and frailty was assessed by the 36-item frailty index (FI). Logistic regression, stratified analysis of sub-groups, and forest plots were used in this study. Results: Both pro-inflammatory diet and poor sleep quality were risk factors for frailty. There was an interaction between dietary inflammation and sleep quality (P-interaction = 0.003). Pro-inflammatory diet was associated with increased risk of frailty among the population with poor sleep quality. Compared with the anti-inflammatory diet and good sleep quality group, the OR of frailty was 1.44 (1.21, 1.73) and 2.16 (1.64, 2.80) for the anti-inflammatory diet and poor sleep quality and pro-inflammatory diet and poor sleep quality groups, respectively. Conclusion: There was an interaction between dietary inflammation and sleep quality on frailty. Anti-inflammatory diet may attenuate the detrimental impacts of poor sleep quality on frailty.
Collapse
Affiliation(s)
- Mengzi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, P. R. China.
| | - Ling Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, P. R. China.
| | - Xuhan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, P. R. China.
| | - Li Tong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, P. R. China.
| | - Jiaxin Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, P. R. China.
| | - Yuxiang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, P. R. China.
| | - Yixue Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, P. R. China.
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, P. R. China.
| |
Collapse
|
16
|
Rosen Vollmar AK, Weinberg CR, Baird DD, Wilcox AJ, Calafat AM, Deziel NC, Johnson CH, Jukic AMZ. Urinary phenol concentrations and fecundability and early pregnancy loss. Hum Reprod 2023; 38:139-155. [PMID: 36346334 PMCID: PMC10089295 DOI: 10.1093/humrep/deac230] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/22/2022] [Indexed: 11/09/2022] Open
Abstract
STUDY QUESTION Are urinary phenol concentrations of methylparaben, propylparaben, butylparaben, triclosan, benzophenone-3, 2,4-dichlorophenol or 2,5-dichlorophenol associated with fecundability and early pregnancy loss? SUMMARY ANSWER 2,5-dichlorophenol concentrations were associated with an increased odds of early pregnancy loss, and higher concentrations of butylparaben and triclosan were associated with an increase in fecundability. WHAT IS KNOWN ALREADY Phenols are chemicals with endocrine-disrupting potential found in everyday products. Despite plausible mechanisms of phenol reproductive toxicity, there are inconsistent results across few epidemiologic studies examining phenol exposure and reproductive function in non-fertility treatment populations. STUDY DESIGN, SIZE, DURATION Specimens and data were from the North Carolina Early Pregnancy Study prospective cohort of 221 women attempting to conceive naturally from 1982 to 1986. This analysis includes data from 221 participants across 706 menstrual cycles, with 135 live births, 15 clinical miscarriages and 48 early pregnancy losses (before 42 days after the last menstrual period). PARTICIPANTS/MATERIALS, SETTING, METHODS Participants collected daily first-morning urine specimens. For each menstrual cycle, aliquots from three daily specimens across the cycle were pooled within individuals and analyzed for phenol concentrations. To assess sample repeatability, we calculated intraclass correlation coefficients (ICCs) for each phenol. We evaluated associations between phenol concentrations from pooled samples and time to pregnancy using discrete-time logistic regression and generalized estimating equations (GEE), and early pregnancy loss using multivariable logistic regression and GEE. MAIN RESULTS AND THE ROLE OF CHANCE ICCs for within-person variability across menstrual cycles in pooled phenol concentrations ranged from 0.42 to 0.75. There was an increased odds of early pregnancy loss with 2,5-dichlorophenol concentrations although the CIs were wide (5th vs 1st quintile odds ratio (OR): 4.79; 95% CI: 1.06, 21.59). There was an increased per-cycle odds of conception at higher concentrations of butylparaben (OR: 1.62; 95% CI: 1.08, 2.44) and triclosan (OR: 1.49; 95% CI: 0.99, 2.26) compared to non-detectable concentrations. No associations were observed between these endpoints and concentrations of other phenols examined. LIMITATIONS, REASONS FOR CAUTION Limitations include the absence of phenol measurements for male partners and a limited sample size, especially for the outcome of early pregnancy loss, which reduced our power to detect associations. WIDER IMPLICATIONS OF THE FINDINGS This study is the first to use repeated pooled measures to summarize phenol exposure and the first to investigate associations with fecundability and early pregnancy loss. Within-person phenol concentration variability underscores the importance of collecting repeated samples for future studies. Exposure misclassification could contribute to differences between the findings of this study and those of other studies, all of which used one urine sample to assess phenol exposure. This study also contributes to the limited literature probing potential associations between environmental exposures and early pregnancy loss, which is a challenging outcome to study as it typically occurs before a pregnancy is clinically recognized. STUDY FUNDING/COMPETING INTEREST(S) This research was supported by the National Institute of Environmental Health Sciences of the National Institutes of Health (award number F31ES030594), the Intramural Research Program of the National Institutes of Health, the National Institute of Environmental Health Sciences (project numbers ES103333 and ES103086) and a doctoral fellowship at the Yale School of Public Health. The authors declare they have no competing interests to disclose. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- Ana K Rosen Vollmar
- Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Clarice R Weinberg
- Biostatistics & Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle, NC, USA
| | - Donna D Baird
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle, NC, USA
| | - Allen J Wilcox
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle, NC, USA
| | - Antonia M Calafat
- Organic Analytical Toxicology Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Nicole C Deziel
- Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Caroline H Johnson
- Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Anne Marie Z Jukic
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle, NC, USA
| |
Collapse
|
17
|
Fu YP, Chen WY, Guo LQ, Zhu YQ, Yuan JS, Liu YH. The association between hearing threshold and urinary personal care and consumer product metabolites in middle-aged and elderly people from the USA. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:81076-81086. [PMID: 35731440 DOI: 10.1007/s11356-022-21459-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/10/2022] [Indexed: 06/15/2023]
Abstract
Endocrine disruptors have been reported to be associated with hearing ability. However, the association between personal care and consumer product chemicals, known as commonly detected endocrine disruptors, and age-related hearing loss still remains unclear. This study aimed to examine the association between exposure to 7 personal care and consumer product chemicals and hearing thresholds in middle-aged and elderly people. A nationally representative cross-sectional study was performed. Eight hundred forty-five adults aged over 45 from the National Health and Nutrition Examination Survey (NHANES) were included in this study. Bayesian kernel machine regression (BKMR) and the k-medoid cluster analysis were used to evaluate the mixture effect of exposure to 7 chemicals on pure-tone average (PTA). Exposure to these chemicals was negatively associated with PTA. 2,5-Dichlorophenol had the greatest contribution to the mixture effect. The mixture effect was stronger in women, elderly people. Four pooled clusters were identified according to 7 chemicals exposures. Cluster 4 (high TCS exposure) showed a lower HFPTA (P = 0.00258) than cluster 3 (the lowest exposure cluster, as a reference). Our study provides evidence that exposure to personal care and consumer product chemicals might be inversely associated with PTA. More studies are needed to fully understand the association of exposure to these chemicals with hearing threshold.
Collapse
Affiliation(s)
- Yan-Peng Fu
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Nanchang University, No.1 Minde Road, Nanchang, China
| | - Wen-Yu Chen
- Interventional Cardiology Department, Second Affiliated Hospital of Nanchang University, No.1 Minde Road, Nanchang, China
| | - Li-Qing Guo
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Nanchang University, No.1 Minde Road, Nanchang, China
| | - Ya-Qiong Zhu
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Nanchang University, No.1 Minde Road, Nanchang, China
| | - Jia-Sheng Yuan
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Nanchang University, No.1 Minde Road, Nanchang, China
| | - Yue-Hui Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Nanchang University, No.1 Minde Road, Nanchang, China.
| |
Collapse
|
18
|
Weng X, Liang H, Liu K, Chen J, Fei Q, Liu S, Guo X, Wen L, Wu Y, Nie Z, Jing C. Relationship between urinary dichlorophenols and cognitive function among people over 60 years old from NHANES. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:73341-73352. [PMID: 35624369 DOI: 10.1007/s11356-022-20840-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
Studies have shown that exposure to dichlorophenols (DCPs) and their precursors might have potential neurotoxicity, which may be related to low cognitive function, but there are few large-scale, representative population data to explore the association between DCP exposure and cognitive function. We aimed to examine the relationship between urinary DCPs and cognitive function in the US older people. A total of 952 participants ≥ 60 years old from the National Health and Nutrition Examination Survey (NHANES) in two cycles (2011-2014) were enrolled. The Consortium to Establish a Registry for Alzheimer's disease Word Learning subtest (CERAD W-L), the Animal Fluency test (AFT), and the Digit Symbol Substitution test (DSST) were used to assess cognition. Multivariate logistic regression and restricted cubic spline (RCS) were used to evaluate the relationship between DCP exposure and cognitive function. A positive association between 2,5-DCP and the risk of bad performance of DSST was observed (P for trend = 0.024) after adjusting for the covariates. Compared to the lowest quartile, OR of DSST for the highest quartile of 2,5-DCP was 1.72 (95%CI:1.03-2.87, P = 0.039). There were no significant associations between DCPs and the other tests. The RCS plot showed an inverted J-shaped relationship between 2,5-DCP, 2,4-DCP, and the DSST score. The inflection points for the curves were found at 1.531 μg/L and 0.230 μg/L, respectively. On the right side of the inflection points, the DSST score dropped sharply. In subgroup analysis, those under 70 years old, smokers, and alcohol drinkers had a higher risk of bad performance in DSST when exposed to 2,5-DCP. The higher concentration of urinary DCPs is associated with a lower score of DSST in the US older people.
Collapse
Affiliation(s)
- Xueqiong Weng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Huanzhu Liang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Kun Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Jingmin Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Qiaoyuan Fei
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Shan Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Xinrong Guo
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Lin Wen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Yingying Wu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China
| | - Zhiqiang Nie
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Chunxia Jing
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China.
- Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou, 510632, Guangdong, China.
| |
Collapse
|
19
|
Truong N, Tesfamariam K, Visintin L, Goessens T, De Saeger S, Lachat C, De Boevre M. Associating multiple mycotoxin exposure and health outcomes: current statistical approaches and challenges. WORLD MYCOTOXIN J 2022. [DOI: 10.3920/wmj2022.2784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Mycotoxin contamination is a global challenge to food safety and population health. A diversity of adverse effects in human health such as organ damage, immunity disorders and carcinogenesis are attributed to acute and chronic exposure to mycotoxins. While there is a high likelihood of mycotoxin co-occurrence in the daily diet, multiple mycotoxin exposures represent a considerable challenge in understanding the accumulative effects of groups of exposures on health outcomes. Nevertheless, previous studies on mycotoxin exposure-health outcome associations have focused on a single or a limited number of exposures. To guide multi-exposure assessment, careful considerations of statistical approaches available are required. In addition, the issue of multicollinearity in high-dimensional settings of multiple exposure analysis underlies the controversy surrounding the reliability and consistency of statistical conclusions about the exposure-health outcome associations. Conventional approaches such as generalised linear regressions (GLR) in conjunction with regularisation methods, including ridge regression, lasso and elastic net, offer some clear advantages in terms of results’ interpretation and model selection. However, when highly-correlated variables are observed, these methods have shown a low specificity in variable selection. Principal component analysis (PCA) that has been widely used as a dimensionality reduction technique also has the limitation to identify important predictor variables as this approach may overlook the associations between certain components and health outcomes. Recently, some alternative approaches have been introduced to address the issues of high dimensionality and highly-correlated data in the context of epidemiological and environmental research. Two of the noticeable approaches are weighted quantile sum regression (WQSR) and Bayesian kernel machine regression (BKMR). Combining different methods of inference allows us to interpret the role of certain exposures, their interactions and the combined effects on human health under diverse statistical perspectives, which ultimately facilitate the construction of the toxicological profile of multiple mycotoxins’ exposure.
Collapse
Affiliation(s)
- N.N. Truong
- Center of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| | - K. Tesfamariam
- Center of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000 Ghent, Belgium
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
- Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - L. Visintin
- Center of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| | - T. Goessens
- Center of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| | - S. De Saeger
- Center of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
- Department of Biotechnology and Food Technology, Faculty of Science, University of Johannesburg, P.O. Box 17011, Doornfontein Campus 2028, Gauteng, South Africa
| | - C. Lachat
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000 Ghent, Belgium
| | - M. De Boevre
- Center of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| |
Collapse
|
20
|
Schildroth S, Wise LA, Wesselink AK, Bethea TN, Fruh V, Taylor KW, Calafat AM, Baird DD, Claus Henn B. Correlates of non-persistent endocrine disrupting chemical mixtures among reproductive-aged Black women in Detroit, Michigan. CHEMOSPHERE 2022; 299:134447. [PMID: 35358566 PMCID: PMC9215202 DOI: 10.1016/j.chemosphere.2022.134447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/14/2022] [Accepted: 03/24/2022] [Indexed: 06/14/2023]
Abstract
Some studies indicate that Black women have higher exposure to multiple non-persistent endocrine disrupting chemicals (EDCs) than white women, but little is known about correlates of exposure to EDC mixtures. Using baseline data from a prospective cohort study of reproductive-aged Black women (N = 751), we characterized profiles of EDC mixtures and identified correlates of exposure. At baseline, we quantified biomarkers of 16 phthalates, 7 phenols, 4 parabens, and triclocarban in urine and collected covariate data through self-administered questionnaires and interviews. We used principal component (PC) analysis and k-means clustering to describe EDC mixture profiles. Associations between correlates and PCs were estimated as the mean difference (β) in PC scores, while associations between correlates and cluster membership were estimated as the odds ratio (OR) of cluster membership. Personal care product use was consistently associated with profiles of higher biomarker concentrations of non-persistent EDCs. Use of nail polish, menstrual and vaginal products (e.g., vaginal powder, vaginal deodorant), and sunscreen was associated with a mixture of phthalate and some phenol biomarkers using both methods. Current vaginal ring use, a form of hormonal contraception placed inside the vagina, was strongly associated with higher concentrations of high molecular weight phthalate biomarkers (k-means clustering: OR = 2.42, 95% CI = 1.28, 4.59; PCA: β = -0.32, 95% CI = -0.71, 0.07). Several dietary, reproductive, and demographic correlates were also associated with mixtures of EDC biomarkers. These findings suggest that personal care product use, diet, and contraceptive use may be sources of exposure to multiple non-persistent EDCs among reproductive-aged Black women. Targeted interventions to reduce exposure to multiple EDCs among Black women are warranted.
Collapse
Affiliation(s)
- Samantha Schildroth
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Amelia K Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Traci N Bethea
- Office of Minority Health & Health Disparities Research, Georgetown Lombardi Comprehensive Cancer Center, Washington DC, USA
| | - Victoria Fruh
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Kyla W Taylor
- National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Donna D Baird
- National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| |
Collapse
|
21
|
Noppakun K, Juntarawijit C. Association between pesticide exposure and obesity: A cross-sectional study of 20,295 farmers in Thailand. F1000Res 2022; 10:445. [PMID: 35646323 PMCID: PMC9127373 DOI: 10.12688/f1000research.53261.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Obesity is a serious condition because it is associated with other chronic diseases which affect the quality of life. In addition to problems associated with diet and exercise, recent research has found that pesticide exposure might be another important risk factor. The objective of this study was to determine the association between pesticide exposure and obesity among farmers in Nakhon Sawan and Phitsanulok province, Thailand. Methods: This study was a population-based cross-sectional study. Data on pesticide use and obesity prevalence from 20,295 farmers aged 20 years and older were collected using an in-person interview questionnaire. The association was analysed using multivariable logistic regression, adjusted for its potential confounding factors. Results: Obesity was found to be associated with pesticide use in the past. The risk of obesity was significantly predicted by types of pesticides, including insecticides (OR = 2.10, 95% CI 1.00-4.38), herbicides (OR = 4.56, 95% CI 1.11-18.62), fungicides (OR = 2.12, 95% CI 1.34-3.36), rodenticides (OR = 2.55, 95% CI 1.61-4.05), and molluscicides (OR = 3.40, 95% CI 2.15-5.40). Among 35 surveyed individual pesticides, 22 were significantly associated with higher obesity prevalence (OR = 1.78, 95% CI 1.10-2.88 to OR = 8.30, 95% CI 2.54-27.19), including herbicide butachlor, 15 insecticides (two carbamate insecticides, five organochlorine insecticides, and eight organophosphate insecticides), and six fungicides. Conclusion: This study found obesity in farmers in Nakhon Sawan and Phitsanulok province, Thailand, to be associated with the long-term use of several types of pesticides. The issue should receive more public attention, and pesticide use should be strictly controlled.
Collapse
Affiliation(s)
- Kajohnsak Noppakun
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Pharmacoepidemiology and Statistics Research Center (PESRC), Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
| | - Chudchawal Juntarawijit
- Faculty of Agriculture, Natural Resources and Environment, Naresuan University, Phitsanulok, 65000, Thailand
| |
Collapse
|
22
|
Measurement of Urinary Triclocarban and 2,4-Dichlorophenol Concentration and Their Relationship with Obesity and Predictors of Cardiovascular Diseases among Children and Adolescents in Kerman, Iran. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:2939022. [PMID: 35096073 PMCID: PMC8794682 DOI: 10.1155/2022/2939022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 01/05/2022] [Indexed: 11/17/2022]
Abstract
Exposure to Endocrine-Disrupting Chemicals (EDCs) at an early age can lead to chronic diseases. 2,4-Dichlorophenol (2,4-DCP) and Triclocarban (TCC) are among EDCs that disrupt the endocrine system and alter the body's metabolism. In the present study, the hypothesis that exposure to 2,4-DCP and TCC affects obesity and predictors of cardiovascular diseases was investigated. Fasting Blood Sugar (FBS), Total Cholesterol (TC), Triglyceride (TG), Low-Density Lipoprotein (LDL), High-Density Lipoprotein (HDL (tests were performed on 79 children and adolescents. Also, blood pressure, Body Mass Index (BMI), and BMI z-score were measured to examine the hypothesis. Urinary concentrations of TCC and 2,4-DCP were measured by Gas Chromatography-Mass Spectrometry (GC/MS). Mean concentrations of TCC and 2,4-DCP (µg/L) were higher in obese individuals (5.50 ± 2.35, 0.29 ± 0.13, respectively). After adjusting for possible confounding factors, the results showed an increase in TCC concentration among girls and a decrease in 2,4-DCP among boys with increasing age. The 2,4-DCP concentration among girls increased by 0.007 and 0.01 units with a one-unit increase in Diastolic Blood Pressure (DBP) and FBS, respectively. There was a significant relationship between TCC and TG (Odds Ratio (OR) = 1.02,
-value = 0.007), LDL (OR = 1.05,
-value = 0.003), and HDL (OR = 0.88,
-value = 0.002). There was also a significant relationship between 2,4-DCP and TG (OR = 1.02,
-value = 0.002), LDL (OR = 1.12,
-value = 0.007), and HDL (OR = 0.92,
-value = 0.02). Exposure to TCC and 2,4-DCP can increase some heart risk factors and increase the risk of cardiovascular diseases and obesity. However, to confirm the results of the present study, it is necessary to conduct further studies, such as cohort and case-control studies, with a larger sample size to examine the causal relationships.
Collapse
|
23
|
Wang L, Sun M, Guo Y, Yan S, Li X, Wang X, Hu W, Yang Y, Li J, Li B. The Role of Dietary Inflammatory Index on the Association Between Sleep Quality and Long-Term Cardiovascular Risk: A Mediation Analysis Based on NHANES (2005-2008). Nat Sci Sleep 2022; 14:483-492. [PMID: 35330783 PMCID: PMC8939873 DOI: 10.2147/nss.s357848] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/10/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE People with poor sleep quality have higher risk of cardiovascular disease (CVD), and one potential mechanism of CVD is chronic inflammation. The aim of this study was to investigate the role of dietary inflammation in the relationship between sleep quality and CVD risk. METHODS This study involved 5594 participants from the National Health and Nutrition Examination Survey (NHANES) in 2005-2008. Sleep quality, dietary inflammation, and 10-year CVD risk were evaluated via the Pittsburgh Sleep Quality Index (PSQI), the Energy-adjusted Dietary Inflammatory Index (E-DII), and the Framingham Risk Score (FRS), respectively. We used generalized additive model (GAM) and mediation analysis to investigate the relationship among sleep quality, 10-year CVD risk, and E-DII. RESULTS PSQI had a non-linear relationship with 10-year CVD risk (P < 0.001). Meanwhile, among the participants with poor sleep quality, PSQI was positively associated with increased 10-year CVD risk (P < 0.001) and E-DII (P < 0.001). Furthermore, the association between sleep quality and CVD risk was partially mediated by E-DII, and the mediated proportion was 14.6%, and the mediating effect of E-DII varied in different gender and age groups. However, in the subjects with good sleep quality, the association among PSQI, E-DII, and 10-year CVD risk was not existed. CONCLUSION Ten-year CVD risk could be reduced by controlling the intake of inflammatory food, especially for whom with sleep disorders. In general, the reduction of inflammatory diet could weaken the effect of sleep disorders on the CVD risk.
Collapse
Affiliation(s)
- Ling Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
| | - Mengzi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
| | - Yinpei Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
| | - Shoumeng Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
| | - Xiaotong Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
| | - Xuhan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
| | - Wenyu Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
| | - Yixue Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
| | - Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, People's Republic of China
| |
Collapse
|
24
|
Abstract
The increased prevalence and adverse health consequences of obesity have made it one of the leading public health issues in recent years. Importantly, several epidemiological studies have revealed significant associations between BMI and organic food consumption. However, although these studies have suggested that this factor holds promise to prevent obesity, they all suffer from methodological limitations, including self-reporting methods to assess BMI, not controlling for potential confounding factors or using a non-representative sample. Moreover, all were restricted to an adult sample. We present the results of a cross-sectional epidemiological study assessing the association of organic food consumption with BMI and obesity in a representative lifespan French sample (INCA3 study). Objective methods were used to measure BMI, and several potentially confounding variables were controlled for. In total, 1775 children and adolescents and 2121 adults underwent anthropometric measurements and completed questionnaires concerning their dietary habits and lifestyle. Unadjusted models systematically revealed negative associations between organic food consumption and both BMI and obesity across all age groups. These associations tended to remain statistically significant even after controlling for several confounding variables concerning socio-economic status, quality of the diet and physical activity. The effect sizes were, however, small. These data confirm the association between organic food consumption and obesity during both childhood and adulthood. Evidence from randomised controlled trials is required to investigate causality between organic food consumption and lower BMI or obesity rate.
Collapse
|
25
|
Seo MY, Choi MH, Hong Y, Kim SH, Park MJ. Association of urinary chlorophenols with central obesity in Korean girls. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:1966-1972. [PMID: 32862346 DOI: 10.1007/s11356-020-10628-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 08/25/2020] [Indexed: 06/11/2023]
Abstract
This study aimed to assess the association between urinary concentrations of chlorophenols and childhood central obesity. The study subjects were 165 girls (91 with central obesity and 74 with non-central obesity) aged 7-8 years who visited a hospital for regular health check-ups. The urinary concentrations of chlorophenols including 2,4-dichlorophenol (2,4-DCP), 2,5-dichlorophenol (2,5-DCP), 2,4,5-trichlorophenol (2,4,5-TCP), and 2,4,6-trichlorophenol (2,4,6-TCP) were analyzed using liquid chromatography-tandem mass spectrometry. The central obesity group showed significantly higher urinary concentrations of 2,5-DCP (0.56 vs. 0.28 ng/mL) and 2,4,5-TCP (0.06 vs. 0.03 ng/mL) than the non-central obesity group. The sum of molar concentrations of urinary chlorophenols was also significantly higher in the central obesity group than in the non-central obesity group (9.83 vs. 5.26 nmol/L). Girls in the highest quartile of the molar sum of chlorophenols showed significantly higher body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) compared with the lowest quartile after adjusting for covariates. WC and WHtR, but not BMI, were significantly associated with higher quartiles of the molar sum of chlorophenols (P-for-trend = 0.025 and 0.028, respectively). We found a positive association between chlorophenol exposure and central obesity in Korean girls. Large-scale prospective studies are needed to confirm our findings.
Collapse
Affiliation(s)
- Moon Young Seo
- Department of Pediatrics, Inje University Sanggye Paik Hospital, 1342, Dongil-ro, Nowon-gu, Seoul, 01757, Korea
| | - Man Ho Choi
- Molecular Recognition Research Center, Korea Institute of Science and Technology, Seoul, 02792, Korea
| | - Youngmin Hong
- R&D Center, Shimadzu Scientific Korea Corp., Seoul, 08506, Korea
| | - Shin-Hye Kim
- Department of Pediatrics, Inje University Sanggye Paik Hospital, 1342, Dongil-ro, Nowon-gu, Seoul, 01757, Korea.
| | - Mi Jung Park
- Department of Pediatrics, Inje University Sanggye Paik Hospital, 1342, Dongil-ro, Nowon-gu, Seoul, 01757, Korea.
| |
Collapse
|
26
|
Berger K, Coker E, Rauch S, Eskenazi B, Balmes J, Kogut K, Holland N, Calafat AM, Harley K. Prenatal phthalate, paraben, and phenol exposure and childhood allergic and respiratory outcomes: Evaluating exposure to chemical mixtures. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 725:138418. [PMID: 32302842 PMCID: PMC7255953 DOI: 10.1016/j.scitotenv.2020.138418] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 05/10/2023]
Abstract
BACKGROUND Chemicals found in personal care products and plastics have been associated with asthma, allergies, and lung function, but methods to address real life exposure to mixtures of these chemicals have not been applied to these associations. METHODS We quantified urinary concentrations of eleven phthalate metabolites, four parabens, and five other phenols in mothers twice during pregnancy and assessed probable asthma, aeroallergies, and lung function in their age seven children. We implemented Bayesian Profile Regression (BPR) to cluster women by their exposures to these chemicals and tested the clusters for differences in outcome measurements. We used Bayesian Kernel Machine Regression (BKMR) to fit biomarkers into one model as joint independent variables. RESULTS BPR clustered women into seven groups characterized by patterns of personal care product and plastic use, though there were no significant differences in outcomes across clusters. BKMR showed that monocarboxyisooctyl phthalate and 2,4-dichlorophenol were associated with probable asthma (predicted probability of probable asthma per IQR of biomarker z-score (standard deviation) = 0.08 (0.09) and 0.11 (0.12), respectively) and poorer lung function (predicted probability per IQR = -0.07 (0.05) and -0.07 (0.06), respectively), and that mono(3-carboxypropyl) phthalate and bisphenol A were associated with aeroallergies (predicted probability per IQR = 0.13 (0.09) and 0.11 (0.08), respectively). Several biomarkers demonstrated positive additive effects on other associations. CONCLUSIONS BPR and BKMR are useful tools to evaluate associations of biomarker concentrations within a mixture of exposure and should supplement single-chemical regression models when data allow.
Collapse
Affiliation(s)
- Kimberly Berger
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA 94704, USA.
| | - Eric Coker
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA 94704, USA.
| | - Stephen Rauch
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA 94704, USA.
| | - Brenda Eskenazi
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA 94704, USA.
| | - John Balmes
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA 94704, USA.
| | - Katie Kogut
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA 94704, USA.
| | - Nina Holland
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA 94704, USA.
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA 30341, USA.
| | - Kim Harley
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA 94704, USA.
| |
Collapse
|
27
|
Ribeiro CM, Beserra BTS, Silva NG, Lima CL, Rocha PRS, Coelho MS, Neves FDAR, Amato AA. Exposure to endocrine-disrupting chemicals and anthropometric measures of obesity: a systematic review and meta-analysis. BMJ Open 2020; 10:e033509. [PMID: 32565448 PMCID: PMC7311014 DOI: 10.1136/bmjopen-2019-033509] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Endocrine-disrupting chemicals (EDCs) are viewed as a major potential link between the environment and obesity development. We did a systematic review and meta-analysis to examine the association between exposure to EDCs and obesity. DATA SOURCES, DESIGN AND ELIGIBILITY CRITERIA PubMed, Scopus and Web of Science were searched from inception to 6 June 2018 for studies primarily addressing the association between exposure to EDCs after the age of 2 years and anthropometric measures of obesity or body fat. The Newcastle-Ottawa scale was used to assess the risk of bias. DATA EXTRACTION AND SYNTHESIS Two independent reviewers screened and conducted data extraction and synthesis. A third reviewer resolved disagreements. RESULTS A total of 73 studies investigating bisphenol A (32 286 individuals), organochlorine compounds (34 567 individuals), phthalates (21 401 individuals), polybrominated biphenyls (2937 individuals), polycyclic aromatic hydrocarbons (5174 individuals), parabens (4097 individuals), benzoic acid (3671 individuals) and polyfluoroalkyl substances (349 individuals) met our inclusion criteria. Most had a cross-sectional design and low or medium risk of bias. In qualitative analysis, bisphenol A and phthalates were consistently associated with general and abdominal obesity, in children and adults, and some studies suggested this association was age-dependent and gender-dependent. Meta-analysis indicated a significant association between exposure to bisphenol A and overweight (OR 1.254, 95% CI 1.005 to 1.564), obesity (OR 1.503, 95% CI 1.273 to 1.774) and increased waist circumference (OR 1.503, 95% CI 1.267 to 1.783) in adults, and between exposure to 2,5-dichlorophenol and obesity in children (OR 1.8, 95% CI 1.1018 to 3.184). CONCLUSION Most observational studies supported a positive association between obesity and exposure to EDCs. Although causality cannot be determined from these data, they underscore the need to limit human exposure to EDCs in light of the evidence from animal and cell-based studies indicating the effects of these chemicals on adiposity. PROSPERO REGISTRATION NUMBER CRD42018074548.
Collapse
Affiliation(s)
- Carolina Martins Ribeiro
- Laboratory of Molecular Pharmacology, Department of Pharmaceutical Sciences, University of Brasilia, Brasilia, Brazil
| | - Bruna Teles Soares Beserra
- Laboratory of Molecular Pharmacology, Department of Pharmaceutical Sciences, University of Brasilia, Brasilia, Brazil
| | - Nadyellem Graciano Silva
- Laboratory of Molecular Pharmacology, Department of Pharmaceutical Sciences, University of Brasilia, Brasilia, Brazil
| | - Caroline Lourenço Lima
- Laboratory of Molecular Pharmacology, Department of Pharmaceutical Sciences, University of Brasilia, Brasilia, Brazil
| | - Priscilla Roberta Silva Rocha
- Laboratory of Molecular Pharmacology, Department of Pharmaceutical Sciences, University of Brasilia, Brasilia, Brazil
| | - Michella Soares Coelho
- Laboratory of Molecular Pharmacology, Department of Pharmaceutical Sciences, University of Brasilia, Brasilia, Brazil
| | | | - Angélica Amorim Amato
- Laboratory of Molecular Pharmacology, Department of Pharmaceutical Sciences, University of Brasilia, Brasilia, Brazil
| |
Collapse
|
28
|
Bethea TN, Wesselink AK, Weuve J, McClean MD, Hauser R, Williams PL, Ye X, Calafat AM, Baird DD, Wise LA. Correlates of exposure to phenols, parabens, and triclocarban in the Study of Environment, Lifestyle and Fibroids. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2020; 30:117-136. [PMID: 30692588 PMCID: PMC6661224 DOI: 10.1038/s41370-019-0114-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 12/10/2018] [Accepted: 12/26/2018] [Indexed: 05/22/2023]
Abstract
We performed a cross-sectional analysis to identify correlates of urinary concentrations of seven phenols (bisphenols A, F, and S; 2,4-dichlorophenol; 2,5-dichlorophenol; benzophenone-3; triclosan), triclocarban, and four parabens (butyl, ethyl, methyl, and propyl). We analyzed baseline data from 766 participants in the Study of Environment, Lifestyle, and Fibroids, a prospective cohort study of 1693 Black women aged 23-34 years residing in Detroit, Michigan (2010-2012). We collected data on demographic, behavioral, and anthropometric factors via telephone interviews, clinic visits, and self-administered questionnaires. For each biomarker, we used linear regression models to estimate mean differences in log-transformed, creatinine-corrected concentrations across factors of interest. Each biomarker was detected in >50% of participants. Median creatinine-corrected concentrations were the highest for methyl paraben (116.8 μg/g creatinine), propyl paraben (16.8 μg/g creatinine), and benzophenone-3 (13.4 μg/g creatinine). Variables most strongly associated with biomarker concentrations included season of urine collection, education, and body mass index (BMI). BMI was positively associated with bisphenol A and S and triclocarban concentrations and inversely associated with butyl and methyl paraben concentrations. In this cohort of Black women, exposure to phenols, parabens, and triclocarban was prevalent and several factors were associated with biomarker concentrations.
Collapse
Affiliation(s)
- Traci N Bethea
- Slone Epidemiology Center at Boston University, Boston, MA, USA.
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
| | - Amelia K Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Jennifer Weuve
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Michael D McClean
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Paige L Williams
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Xiaoyun Ye
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Donna D Baird
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| |
Collapse
|
29
|
Zhang Y, Dong T, Hu W, Wang X, Xu B, Lin Z, Hofer T, Stefanoff P, Chen Y, Wang X, Xia Y. Association between exposure to a mixture of phenols, pesticides, and phthalates and obesity: Comparison of three statistical models. ENVIRONMENT INTERNATIONAL 2019; 123:325-336. [PMID: 30557812 DOI: 10.1016/j.envint.2018.11.076] [Citation(s) in RCA: 259] [Impact Index Per Article: 51.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 11/29/2018] [Accepted: 11/29/2018] [Indexed: 05/25/2023]
Abstract
BACKGROUND The evaluation of the chemical impact on human health is usually constrained to the analysis of the health effects of exposure to a single chemical or a group of similar chemicals at one time. The effects of chemical mixtures are seldom analyzed. In this study, we applied three statistical models to assess the association between the exposure to a mixture of seven xenobiotics (three phthalate metabolites, two phenols, and two pesticides) and obesity. METHODS Urinary levels of environmental phenols, pesticides, and phthalate metabolites were measured in adults who participated in the U.S.-based National Health and Nutrition Examination Survey (NHANES) from 2013 to 2014. Body examination was conducted to determine obesity. We fitted multivariable models, using generalized linear (here both logistic and linear) regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) models to estimate the association between chemical exposures and obesity. RESULTS Of 1269 individuals included in our final analysis, 38.5% had general obesity and 58.0% had abdominal obesity. In the logistic regression model established for each single chemical, bisphenol S (BPS), mono (carboxyoctyl) phthalate (MCOP), and mono (2-ethyl-5-carboxypentyl) phthalate (MECPP) were associated with both general and abdominal obesity (fourth vs. first quartile). In linear regression, MCOP was associated with BMI and waist circumference. In WQS regression analysis, the WQS index was significantly associated with both general obesity (OR = 1.63, 95% CI: 1.21-2.20) and abdominal obesity (OR = 1.66, 95% CI: 1.18-2.34). MCOP, bisphenol A (BPA), bisphenol S (BPS), and mono ethyl phthalate (MEP) were the most heavily weighing chemicals. In BKMR analysis, the overall effect of mixture was significantly associated with general obesity when all the chemicals were at their 60th percentile or above it, compared to all of them at their 50th percentile. MCOP, BPA, and BPS showed positive trends. By contrast, MECPP showed a flat and modest inverse trend. CONCLUSION When comparing results from these three models, MCOP, BPA, and BPS were identified as the most important factors associated with obesity. We recommend estimating the joint effects of chemical mixtures by applying diverse statistical methods and interpreting their results together, considering their advantages and disadvantages.
Collapse
Affiliation(s)
- Yuqing Zhang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Tianyu Dong
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Weiyue Hu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Xu Wang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Bo Xu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Zhongning Lin
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Tim Hofer
- Department of Toxicology and Risk Assessment, Norwegian Institute of Public Health, 0456 Oslo, Norway
| | - Pawel Stefanoff
- Department of Zoonotic, Food- and Waterborne Infections, Norwegian Institute of Public Health, 0456 Oslo, Norway
| | - Ying Chen
- Wuxi Maternal and Child Health Hospital, Nanjing Medical University, Wuxi 214002, China
| | - Xinru Wang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Yankai Xia
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
| |
Collapse
|
30
|
Przybyla J, Kile M, Smit E. Description of exposure profiles for seven environmental chemicals in a US population using recursive partition mixture modeling (RPMM). JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2019; 29:61-70. [PMID: 29269752 DOI: 10.1038/s41370-017-0008-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 10/16/2017] [Indexed: 06/07/2023]
Abstract
Biomonitoring studies have shown that humans are exposed to numerous environmental chemicals. Previous work provides limited insights into the dynamic relationship between different chemicals within a population. The objective of this study is to develop an analytical method identifying exposure profiles of seven common environmental chemicals and determine how exposure profiles differ by sociodemographic groups and National Health and Nutrition Examination Survey (NHANES) 2003-2012 cycle year. We used recursive partition mixture modeling (RPMM) to define classes of the population with similar exposure profiles of lead, cadmium, 2,4-dichlorophenol, 2,5-dichlorophenol, bisphenol A (BPA), triclosan, and benzophenone-3 in individuals aged ≥6 years. Additionally, quasibinomial logistic regression was used to examine the association between each class and selected demographic characteristics. Eight exposure profiles were identified. Individuals who clustered together and had the highest chemical exposures were more likely to be older, to be Non-Hispanic Black (NHB) or Other Hispanic (OH), more likely to live below the poverty line, more likely to be male, and more likely to have participated in the earlier NHANES cycle (2003-2004). The developed method described the dynamic relationship between chemicals and shows that this relationship is different for subpopulations based on their sociodemographic characteristics.
Collapse
Affiliation(s)
- Jennifer Przybyla
- School of Biological and Population Health, College of Public Health and Human Sciences, Corvallis, OR, 97330, USA.
| | - Molly Kile
- School of Biological and Population Health, College of Public Health and Human Sciences, Corvallis, OR, 97330, USA
| | - Ellen Smit
- School of Biological and Population Health, College of Public Health and Human Sciences, Corvallis, OR, 97330, USA
| |
Collapse
|
31
|
Berger K, Eskenazi B, Balmes J, Holland N, Calafat AM, Harley KG. Associations between prenatal maternal urinary concentrations of personal care product chemical biomarkers and childhood respiratory and allergic outcomes in the CHAMACOS study. ENVIRONMENT INTERNATIONAL 2018; 121:538-549. [PMID: 30293015 PMCID: PMC6239199 DOI: 10.1016/j.envint.2018.09.027] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/13/2018] [Accepted: 09/16/2018] [Indexed: 05/19/2023]
Abstract
BACKGROUND Personal care product chemicals may be contributing to risk for asthma and other atopic illnesses. The existing literature is conflicting, and many studies do not control for multiple chemical exposures. METHODS We quantified concentrations of three phthalate metabolites, three parabens, and four other phenols in urine collected twice during pregnancy from 392 women. We measured T helper 1 (Th1) and T helper 2 (Th2) cells in their children's blood at ages two, five, and seven, and assessed probable asthma, aeroallergies, eczema, and lung function at age seven. We conducted linear and logistic regressions, controlling for additional biomarkers measured in this population as selected by Bayesian Model Averaging. RESULTS The majority of comparisons showed null associations. Mono-n-butyl phthalate (MnBP) was associated with higher Th2% (RR: 10.40, 95% CI: 3.37, 17.92), and methyl paraben was associated with lower Th1% (RR: -3.35, 95% CI: -6.58, -0.02) and Th2% at borderline significance (RR: -4.45, 95% CI: -8.77, 0.08). Monoethyl phthalate was associated with lower forced expiratory flow from 25 to 75% of forced vital capacity (FEF25-75%) (RR: -3.22 L/s, 95% CI: -6.02, -0.34). Propyl paraben (OR: 0.86, 95% CI: 0.74, 0.99) was associated with decreased odds of probable asthma. CONCLUSIONS While some biomarkers, particularly those from low molecular weight phthalates, were associated with an atopic cytokine profile and poorer lung function, no biomarkers were associated with a corresponding increase in atopic disease.
Collapse
Affiliation(s)
- Kimberly Berger
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA 94704, USA
| | - Brenda Eskenazi
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA 94704, USA
| | - John Balmes
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA 94704, USA
| | - Nina Holland
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA 94704, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA 30341, USA
| | - Kim G Harley
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA 94704, USA.
| |
Collapse
|
32
|
Rooney MR, Lutsey PL, Bhatti P, Prizment A. Urinary 2,5-dicholorophenol and 2,4-dichlorophenol concentrations and prevalent disease among adults in the National Health and Nutrition Examination Survey (NHANES). Occup Environ Med 2018; 76:181-188. [PMID: 30377258 DOI: 10.1136/oemed-2018-105278] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 10/08/2018] [Accepted: 10/15/2018] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To test cross-sectional associations between urinary concentrations of 2,5-dichlorophenol (2,5-DCP) and 2,4-dichlorophenol (2,4-DCP) with the prevalence of cardiovascular disease (CVD), cancer, lung disease, thyroid problems and liver conditions. METHODS Logistic regression was used to evaluate associations of urinary concentrations of 2,5-DCP and 2,4-DCP with prevalence of various medical conditions among 3617 National Health and Nutrition Examination Survey participants from 2007-2008 and 2009-2010. ORs and 95% CIs for each disease were estimated. All regression models were adjusted for urinary creatinine. RESULTS We observed a monotonically increasing association between quartiles of 2,5-DCP and prevalence of CVD. After adjustment for sociodemographic and lifestyle characteristics, participants with the highest versus lowest quartile of urinary 2,5-DCP had an OR=1.84 (95% CI 1.26 to 2.70) (p linear trend=0.006). The association was similar with further adjustment for established clinical CVD risk factors. Higher 2,5-DCP was also associated with prevalence of all cancers combined (ORQ4 vs Q1=1.50 (95% CI 1.00 to 2.26); p trend=0.05) and, in exploratory analyses, with gynaecological cancers (ORQ4 vs Q1=4.15 (95% CI 1.51 to 11.40; p trend=0.01)). No associations were detected between 2,5-DCP and lung diseases, thyroid problems or liver conditions, nor between 2,4-DCP and prevalent disease. CONCLUSION In this nationally representative study, higher urinary 2,5-DCP concentrations were associated with greater prevalence of CVD and all cancers combined. Further examination may be warranted to assess whether chronic exposure to 2,5-DCP is associated with incidence of adverse health outcomes.
Collapse
Affiliation(s)
- Mary R Rooney
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Parveen Bhatti
- Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.,Program in Epidemiology, Public Health Sciences Divisions, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Anna Prizment
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
33
|
Smith A, Yu X, Yin L. Diazinon exposure activated transcriptional factors CCAAT-enhancer-binding proteins α (C/EBPα) and peroxisome proliferator-activated receptor γ (PPARγ) and induced adipogenesis in 3T3-L1 preadipocytes. PESTICIDE BIOCHEMISTRY AND PHYSIOLOGY 2018; 150:48-58. [PMID: 30195387 PMCID: PMC6697052 DOI: 10.1016/j.pestbp.2018.07.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 06/12/2018] [Accepted: 07/05/2018] [Indexed: 05/16/2023]
Abstract
Environmental chemical exposure could be a contributor to the increasing obesity epidemic. Diazinon, an organophosphate insecticide, has been widely used in the agriculture, and exposure of the general population to diazinon has been reported. Diazinon has been known to induce neurotoxic effects mainly through the inhibition of acetylcholinesterase (AChE). However, its association with dysregulation of adipogenesis has been poorly investigated. The current study aimed to examine the mechanism of diazinon's effect on adipogenesis using the 3T3-L1 preadipocytes combined with a single-cell-based high-content analysis. The results showed that diazinon induced lipid droplet accumulation in a dose-dependent manner. The dynamic changes of adipogenic regulatory proteins and genes were examined at the three stages of adipogenesis (induction, differentiation, and maturation) in 3T3-L1 cells treated with various doses of diazinon (0, 1, 10, 100 μM) using real-time quantitative RT-PCR and Western Blot respectively. Diazinon significantly induced protein expression of transcriptional factors CCAAT-enhancer-binding proteins α (C/EBPα) and peroxisome proliferator-activated receptor γ (PPARγ), their downstream proteins, fatty acid synthase (FASN), acetyl CoA carboxylase (ACC), fatty acid-binding protein 4 (FABP4), lipoprotein lipase (LPL), adiponectin and perilipin in dose and time-dependent manners. Similarly, the adipogenic genes were significantly induced in a dose and time-dependent manner compared to the relative controls. The current study demonstrates that diazinon promotes lipid accumulation and activates the adipogenic signaling pathway in the in vitro model.
Collapse
Affiliation(s)
- Adrianne Smith
- Department of Environmental Health Science, College of Public Health, University of Georgia, 150 Green Street, Athens, GA 30602, USA..
| | - Xiaozhong Yu
- Department of Environmental Health Science, College of Public Health, University of Georgia, 150 Green Street, Athens, GA 30602, USA
| | - Lei Yin
- ReproTox Biotech LLC, 111 Riverbend Drive, Athens, GA, USA.
| |
Collapse
|
34
|
Berger K, Gunier RB, Chevrier J, Calafat AM, Ye X, Eskenazi B, Harley KG. Associations of maternal exposure to triclosan, parabens, and other phenols with prenatal maternal and neonatal thyroid hormone levels. ENVIRONMENTAL RESEARCH 2018; 165:379-386. [PMID: 29803919 PMCID: PMC6470297 DOI: 10.1016/j.envres.2018.05.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 04/24/2018] [Accepted: 05/07/2018] [Indexed: 05/05/2023]
Abstract
Environmental phenols and parabens are commonly used in personal care products and other consumer products and human exposure to these chemicals is widespread. Although human and animal studies suggest an association between exposure to phenols and parabens and thyroid hormone levels, few studies have investigated the association of in utero exposure to these chemicals and thyroid hormones in pregnant women and their neonates. We measured four environmental phenols (triclosan, benzophenone-3, and 2,4- and 2,5-dichlorophenol), and three parabens (methyl-, propyl-, and butyl paraben) in urine collected from mothers at two time points during pregnancy as part of the CHAMACOS (Center for the Health Assessment of Mothers and Children of Salinas) study. We measured free thyroxine (T4), total T4, and thyroid-stimulating hormone (TSH) in serum of the pregnant women (N = 454) and TSH in their neonates (N = 365). We examined potential confounding by a large number of additional chemical exposures and used Bayesian Model Averaging (BMA) to select the most influential chemicals to include in regression models. We observed negative associations of prenatal urinary concentrations of propyl paraben and maternal TSH (β for two-fold increase = -3.26%, 95% CI: -5.55, -0.90) and negative associations of 2,4-dichlorophenol and maternal free T4 (β for two-fold increase = -0.05, 95% CI: -0.08, -0.02), after controlling for other chemical exposures. We observed negative associations of triclosan with maternal total T4 after controlling for demographic variables, but this association became non-significant after controlling for other chemicals (β for two-fold increase = -0.05, 95% CI: -0.11, 0.00). We found evidence that environmental phenols and parabens are associated with lower TSH and free T4 in pregnant women after controlling for related chemical exposures.
Collapse
Affiliation(s)
- Kimberly Berger
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA 94704, USA
| | - Robert B Gunier
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA 94704, USA
| | - Jonathan Chevrier
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA 94704, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA 30341, USA
| | - Xiaoyun Ye
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA 30341, USA
| | - Brenda Eskenazi
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA 94704, USA
| | - Kim G Harley
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California, Berkeley, 1995 University Avenue, Berkeley, CA 94704, USA.
| |
Collapse
|
35
|
Park H, Kim K. Concentrations of 2,4-Dichlorophenol and 2,5-Dichlorophenol in Urine of Korean Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040589. [PMID: 29587398 PMCID: PMC5923631 DOI: 10.3390/ijerph15040589] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 03/20/2018] [Accepted: 03/20/2018] [Indexed: 12/22/2022]
Abstract
Humans are exposed to the environmental pollutants 2,4-dichlorophenol (2,4-DCP) and 2,5-dichlorophenol (2,5-DCP) through air, the use of water and the consumption of products. In this study, we evaluated the urinary concentrations of these compounds in Korean people between the ages of 18 to 69 years, by making use of data from the Korean National Human Biomonitoring Survey that was completed in 2009. Of 1865 representative Koreans, 63.4% and 97.9% were found to have concentrations of 2,4-DCP and 2,5-DCP > 0.05 μg/L (limit of detection) in their urine, respectively. The geometric mean of urinary concentrations was 0.14 μg/L (confidence interval of 95% = 0.13–0.16) and 0.44 μg/L (confidence interval = 0.41–0.48), respectively. It was found that the adjusted proportional changes in 2,4-DCP concentrations were significantly associated with body mass index, whereas those of 2,5-DCP concentrations were influenced by place of residence. From these findings, it is evident that most adults in Korea have levels of 2,4-DCP and 2,5-DCP that are detectable in their urine and the burden of these compounds on their bodies varies depending on numerous demographic factors.
Collapse
Affiliation(s)
- Hyejin Park
- Department of International Healthcare Administration, Daegu Catholic University, Kyungbuk 38430, Korea.
| | - Kisok Kim
- College of Pharmacy, Keimyung University, Daegu 42601, Korea.
| |
Collapse
|
36
|
Parastar S, Ebrahimpour K, Hashemi M, Maracy MR, Ebrahimi A, Poursafa P, Kelishadi R. Association of urinary concentrations of four chlorophenol pesticides with cardiometabolic risk factors and obesity in children and adolescents. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:4516-4523. [PMID: 29188597 DOI: 10.1007/s11356-017-0771-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 11/15/2017] [Indexed: 05/10/2023]
Abstract
This study was undertaken to determine the association of four chlorophenol pesticides with cardiometabolic risk factors and obesity in children and adolescents. This cross-sectional study was conducted in 2016 on 242 children and adolescents, aged 6 to 18 years. The concentrations of 2,4-dichlorophenol (2,4-DCP), 2,5-dichlorophenol (2,5-DCP), 2,4,5-trichlorophenol (2,4,5-TCP), and 2,4,6-trichlorophenol (2,4,6-TCP) in the urine were examined and their association with indices of obesity and cardiometabolic risk factors was determined. Multivariate linear regression and multinomial logistic regression analyses were applied. Overall, 242 participants with mean (SD) ages of 11.3 (2.5) years completed the survey. After adjustment for confounders, a significant positive association was found between body mass index (BMI) z-score and waist circumference (WC) with 2,5-DCP (0.07 (95% CI 0.04, 0.1)) and 0.79 (95% CI 0.54, 1.03), respectively. A significant association of 2,4,5-TCP was only found with WC (0.23 (95% CI 0.0, 0.46), but the relationship with 2,4-DCP was not significant. 2,5-DCP had a significant relationship only with obesity (1.09 (95% CI 1.1, 1.19)), while 2,4-DCP and 2,4,5-TCP showed no significant correlation with overweight or obesity. 2,4-DCP showed a significant positive relationship with high density lipoprotein-cholesterol (HDL-C). Moreover, 2,5-DCP showed a significant negative relationship only with systolic blood pressure and 2,4,5-TCP had a statistically significant inverse association with total cholesterol and HDL-C (-0.71 (95% CI -0.98, -0.45)). This study suggests potential associations of chlorophenol pesticides with overweight, obesity, lipid profile, and blood pressure in children and adolescents. Longitudinal studies are necessary to assess the clinical impact of these findings.
Collapse
Affiliation(s)
- Saeed Parastar
- Environment Research Center, Research Institute for Primordial Prevention of Non communicable disease, Isfahan University of Medical Sciences, P.O. Box 81746-73461, Isfahan, Iran
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Karim Ebrahimpour
- Environment Research Center, Research Institute for Primordial Prevention of Non communicable disease, Isfahan University of Medical Sciences, P.O. Box 81746-73461, Isfahan, Iran
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Hashemi
- Environment Research Center, Research Institute for Primordial Prevention of Non communicable disease, Isfahan University of Medical Sciences, P.O. Box 81746-73461, Isfahan, Iran
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Maracy
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Afshin Ebrahimi
- Environment Research Center, Research Institute for Primordial Prevention of Non communicable disease, Isfahan University of Medical Sciences, P.O. Box 81746-73461, Isfahan, Iran.
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Parinaz Poursafa
- Environment Research Center, Research Institute for Primordial Prevention of Non communicable disease, Isfahan University of Medical Sciences, P.O. Box 81746-73461, Isfahan, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
37
|
Martinez KE, Tucker LA, Bailey BW, LeCheminant JD. Expanded Normal Weight Obesity and Insulin Resistance in US Adults of the National Health and Nutrition Examination Survey. J Diabetes Res 2017; 2017:9502643. [PMID: 28812029 PMCID: PMC5547730 DOI: 10.1155/2017/9502643] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 06/08/2017] [Indexed: 12/17/2022] Open
Abstract
This study aims to expand the evaluation of normal weight obesity (NWO) and its association with insulin resistance using an NHANES (1999-2006) sample of US adults. A cross-sectional study including 5983 men and women (50.8%) was conducted. Body fat percentage (BF%) was assessed using dual-energy X-ray absorptiometry. Expanded normal weight obesity (eNWO) categories, pairings of BMI and body fat percentage classifications, were created using standard cut-points for BMI and sex-specific median for BF%. Homeostatic model assessment-insulin resistance (HOMA-IR) levels were used to index insulin resistance. Mean ± SE values were BMI: 27.9 ± 0.2 (women) and 27.8 ± 0.1 (men); body fat percentage: 40.5 ± 0.2 (women) and 27.8 ± 0.2 (men); and HOMA-IR: 2.04 ± 0.05 (women) and 2.47 ± 0.09 (men). HOMA-IR differed systematically and in a dose-response fashion across all levels of the eNWO categories (F = 291.3, P < 0.0001). As BMI levels increased, HOMA-IR increased significantly, and within each BMI category, higher levels of body fat were associated with higher levels of HOMA-IR. Both high BMI and high BF% were strongly related to insulin resistance. Insulin resistance appears to increase incrementally according to BMI levels primarily and body fat levels secondarily. Including a precise measure of body fat with BMI adds little to the utility of BMI in the prediction of insulin resistance.
Collapse
Affiliation(s)
- Keilah E. Martinez
- Department of Exercise Sciences, College of Life Sciences, Brigham Young University, Provo, UT 84602, USA
| | - Larry A. Tucker
- Department of Exercise Sciences, College of Life Sciences, Brigham Young University, Provo, UT 84602, USA
- *Larry A. Tucker:
| | - Bruce W. Bailey
- Department of Exercise Sciences, College of Life Sciences, Brigham Young University, Provo, UT 84602, USA
| | - James D. LeCheminant
- Department of Exercise Sciences, College of Life Sciences, Brigham Young University, Provo, UT 84602, USA
| |
Collapse
|
38
|
Wei Y, Zhu J. Para-Dichlorobenzene Exposure Is Associated with Thyroid Dysfunction in US Adolescents. J Pediatr 2016; 177:238-243. [PMID: 27476635 DOI: 10.1016/j.jpeds.2016.06.085] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 05/24/2016] [Accepted: 06/28/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the association between exposure to para-dichlorobenzene, measured as urinary concentrations of 2,5-dichlorophenol (2,5-DCP), and thyroid function in US adolescents. STUDY DESIGN A nationally representative subsample of 618 adolescents aged 12-19 years in the 2007-2008 and 2011-2012 National Health and Nutrition Examination Survey was analyzed for the association of urinary 2,5-DCP with serum thyroid function measures using multivariate logistic and general linear regression models. RESULTS After adjusting for potential confounders, we found a significantly positive association between urinary concentrations of 2,5-DCP and serum levels of thyroid-stimulating hormone and thyroglobulin in adolescents. Furthermore, urinary 2,5-DCP was associated with an increased prevalence of hypothyroidism in the study population. CONCLUSIONS This study demonstrates a potential relationship between para-dichlorobenzene exposure, measured as urinary 2,5-DCP, and thyroid dysfunction in adolescents; however, further studies are needed to confirm our findings and to elucidate mechanisms of action.
Collapse
Affiliation(s)
- Yudan Wei
- Department of Community Medicine, Mercer University School of Medicine, Macon, GA.
| | - Jianmin Zhu
- Department of Mathematics and Computer Science, Fort Valley State University, Fort Valley, GA
| |
Collapse
|
39
|
Guo J, Wu C, Lv S, Lu D, Feng C, Qi X, Liang W, Chang X, Xu H, Wang G, Zhou Z. Associations of prenatal exposure to five chlorophenols with adverse birth outcomes. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2016; 214:478-484. [PMID: 27131805 DOI: 10.1016/j.envpol.2016.04.074] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/20/2016] [Accepted: 04/20/2016] [Indexed: 05/27/2023]
Abstract
Exposures to chlorophenols (CPs) have been linked with adverse health effects on wildlife and humans. This study aimed to evaluate prenatal exposure to five CP compounds using maternal urinary concentrations during pregnancy and the potential associations with birth outcomes of their infants at birth. A total of 1100 mother-newborn pairs were recruited during June 2009 to January 2010 in an agricultural region, China. Urinary concentrations of five CPs from dichlorophenol (DCP) to pentachlorophenol (PCP), namely, 2,5-DCP, 2,4-DCP, 2,4,5-trichlorophenol (2,4,5-TCP), 2,4,6-TCP and PCP, were measured using large-volume-injection gas chromatography-tandem mass spectrometry (LVI-GC-MS-MS), and associations between CP levels and weight, length as well as head circumference at birth were examined. Median urinary creatinine-adjusted concentrations of 2,5-DCP, 2,4-DCP, 2,4,5-TCP, 2,4,6-TCP and PCP were 3.34 μg/g, 1.03 μg/g, < LOD, 1.78 μg/g and 0.39 μg/g creatinine, respectively. We found lower birth weight 30 g [95% confidence interval (CI): -57, -3; p = 0.03] for per SD increase in log10-transformed concentrations of 2,4,6-TCP and lower birth weight 37 g (95% CI: -64, -10; p = 0.04) for PCP, respectively. Similarly, head circumference decrease in associations with creatinine-corrected 2,4,6-TCP and PCP concentrations were also achieved. Considering sex difference, the associations of lower birth weight were only found among male neonates, while head circumference was associated with 2,4-DCP and 2,5-DCP only found among female neonates. This study showed significant negative associations between CPs exposure and reduction in neonatal anthropometric measures. The biological mechanisms concerning CPs exposure on fetal growth deserved further investigations.
Collapse
Affiliation(s)
- Jianqiu Guo
- School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, No.130 Dong'an Road, Shanghai, 200032, China
| | - Chunhua Wu
- School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, No.130 Dong'an Road, Shanghai, 200032, China.
| | - Shenliang Lv
- School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, No.130 Dong'an Road, Shanghai, 200032, China; Shanghai Municipal Center for Disease Control and Prevention, No. 1380 Zhongshan West Road, Shanghai, 200336, China
| | - Dasheng Lu
- School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, No.130 Dong'an Road, Shanghai, 200032, China; Shanghai Municipal Center for Disease Control and Prevention, No. 1380 Zhongshan West Road, Shanghai, 200336, China
| | - Chao Feng
- Shanghai Municipal Center for Disease Control and Prevention, No. 1380 Zhongshan West Road, Shanghai, 200336, China
| | - Xiaojuan Qi
- School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, No.130 Dong'an Road, Shanghai, 200032, China; Zhejiang Provincial Center for Disease Control and Prevention, No. 3399, Binsheng Road, Hangzhou, 310051, China
| | - Weijiu Liang
- Changning District, Shanghai Center for Disease Control and Prevention, No.39 Yunwushan Road, Shanghai, 200051, China
| | - Xiuli Chang
- School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, No.130 Dong'an Road, Shanghai, 200032, China
| | - Hao Xu
- Changning District, Shanghai Center for Disease Control and Prevention, No.39 Yunwushan Road, Shanghai, 200051, China
| | - Guoquan Wang
- Shanghai Municipal Center for Disease Control and Prevention, No. 1380 Zhongshan West Road, Shanghai, 200336, China
| | - Zhijun Zhou
- School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, No.130 Dong'an Road, Shanghai, 200032, China
| |
Collapse
|
40
|
Wei Y, Zhu J. Urinary concentrations of 2,5-dichlorophenol and diabetes in US adults. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2016; 26:329-333. [PMID: 25827312 DOI: 10.1038/jes.2015.19] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 01/06/2015] [Accepted: 02/09/2015] [Indexed: 06/04/2023]
Abstract
Para-dichlorobenzene (p-DCB) products are widely used in the home and public buildings, leading to exposure to this chemical in indoor environments. In this study, we explored potential relationships between p-DCB exposure and diabetes in US adults by analyzing a nationally representative subsample of 3063 adult participants aged 20-79 years randomly selected for measurement of urinary concentrations of 2,5-dichlorophenol (2,5-DCP), the major metabolite of p-DCB, in the 2007-2010 National Health and Nutrition Examination Survey. Median urinary 2,5-DCP concentration was 7.0 μg/l (interquartile range: 2.1-29.9). Of the participants, 560 (13.6%) were diabetic. A dose-dependent increase in the prevalence of diabetes was observed in the study participants across quartiles of urinary 2,5-DCP (P-trend<0.0001). After adjusting for potential confounders, individuals in the highest quartile of urinary 2,5-DCP had an increased odds of diabetes (OR=1.59 (95% CI: 1.06, 2.40)) compared with individuals with the lowest quartile. The highest quartile of urinary 2,5-DCP was also positively associated with insulin resistance (adjusted β=0.75; 95% CI: 0.27, 1.24). This study demonstrated a potential association between exposure to p-DCB, measured as urinary concentrations of 2,5-DCP, and diabetes in US adults. Additional epidemiologic and mechanistic studies would further explore these interactions.
Collapse
Affiliation(s)
- Yudan Wei
- Department of Community Medicine, Mercer University School of Medicine, Macon, Georgia, USA
| | - Jianmin Zhu
- Department of Mathematics and Computer Science, Fort Valley State University, Fort Valley, Georgia, USA
| |
Collapse
|
41
|
Buckley JP, Herring AH, Wolff MS, Calafat AM, Engel SM. Prenatal exposure to environmental phenols and childhood fat mass in the Mount Sinai Children's Environmental Health Study. ENVIRONMENT INTERNATIONAL 2016; 91:350-6. [PMID: 27037776 PMCID: PMC4834980 DOI: 10.1016/j.envint.2016.03.019] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 02/20/2016] [Accepted: 03/17/2016] [Indexed: 05/21/2023]
Abstract
Early life exposure to endocrine disrupting chemicals may alter adipogenesis and energy balance leading to changes in obesity risk. Several studies have evaluated the association of prenatal bisphenol A exposure with childhood body size but only one study of male infants has examined other environmental phenols. Therefore, we assessed associations between prenatal exposure to environmental phenols and fat mass in a prospective birth cohort. We quantified four phenol biomarkers in third trimester maternal spot urine samples in a cohort of women enrolled in New York City between 1998 and 2002 and evaluated fat mass in their children using a Tanita scale between ages 4 and 9years (173 children with 351 total observations). We estimated associations of standard deviation differences in natural log creatinine-standardized phenol biomarker concentrations with percent fat mass using linear mixed effects regression models. We did not observe associations of bisphenol A or triclosan with childhood percent fat mass. In unadjusted models, maternal urinary concentrations of 2,5-dichlorophenol were associated with greater percent fat mass and benzophenone-3 was associated with lower percent fat mass among children. After adjustment, phenol biomarkers were not associated with percent fat mass. However, the association between benzophenone-3 and percent fat mass was modified by child's sex: benzophenone-3 concentrations were inversely associated with percent fat mass in girls (beta=-1.51, 95% CI=-3.06, 0.01) but not boys (beta=-0.20, 95% CI=-1.69, 1.26). Although we did not observe strong evidence that prenatal environmental phenols exposures influence the development of childhood adiposity, the potential antiadipogenic effect of benzophenone-3 in girls may warrant further investigation.
Collapse
Affiliation(s)
- Jessie P Buckley
- Department of Epidemiology, University of North Carolina at Chapel Hill, McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599-7435, USA.
| | - Amy H Herring
- Department of Biostatistics and Carolina Population Center, University of North Carolina at Chapel Hill, McGavran-Greenberg Hall, CB #7420, Chapel Hill, NC 27599-7420, USA.
| | - Mary S Wolff
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1057, New York, NY 10029, USA.
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-F17, Atlanta, GA 30341, USA.
| | - Stephanie M Engel
- Department of Epidemiology, University of North Carolina at Chapel Hill, McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599-7435, USA.
| |
Collapse
|
42
|
Pontelli RCN, Nunes AA, Oliveira DSVWB. [Impact on human health of endocrine disruptors present in environmental water bodies: is there an association with obesity?]. CIENCIA & SAUDE COLETIVA 2016; 21:753-66. [PMID: 26960088 DOI: 10.1590/1413-81232015213.25212015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 12/17/2015] [Indexed: 01/05/2023] Open
Abstract
There is growing evidence that endocrine disruptors (ED) may adversely affect humans. Surface and underground water are the main sources for obtaining potable water, however they can be contaminated with ED, which are not completely removed by conventional water and sewage treatment processes. Some health problems are related to the exposure of humans to ED, obesity being one of them. There is currently an increase in the prevalence of obesity worldwide, a fact that is considered a concern in view of its potential impact on the health care system, since obesity is the major risk factor of the leading chronic diseases including diabetes and cardiovascular disease. By means of a review of the literature, this paper sought to gather scientific publications linking exposure to ED with obesity, in order to verify the importance of removal of ED from water bodies, thereby preserving the population's health and aquatic biota. Most of the selected studies suggest an association between ED and obesity in humans.
Collapse
Affiliation(s)
- Regina Célia Nucci Pontelli
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil,
| | - Altacilio Aparecido Nunes
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil,
| | - de Sonia Valle Walter Borges Oliveira
- Departamento de Administração, Faculdade de Economia, Administração e Contabilidade de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| |
Collapse
|
43
|
Wei Y, Zhu J. Associations between urinary concentrations of 2,5-dichlorophenol and metabolic syndrome among non-diabetic adults. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:581-588. [PMID: 26330318 DOI: 10.1007/s11356-015-5291-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 08/20/2015] [Indexed: 06/05/2023]
Abstract
We investigated in this study the relationship between exposure to para-dichlorobenzene (p-DCB), measured as urinary concentrations of 2,5-dichlorophenol (2,5-DCP), and metabolic syndrome in non-diabetic adult participants. A nationally representative subsample of 1706 non-diabetic adult participants aged 20-79 years randomly selected for measurement of urinary concentrations of 2,5-DCP in the 2007-2010 US National Health and Nutrition Examination Survey was analyzed. A dose-dependent increase in the prevalence of metabolic syndrome was observed in the study participants across quartiles of urinary 2,5-DCP (p-trend = 0.0025). After adjusting for potential confounders, individuals in the third and fourth quartile of urinary 2,5-DCP had 1.47 (95% CI 1.02, 2.14) and 1.56 (95% CI 1.10, 2.23) increased odds of metabolic syndrome, respectively, compared with individuals with the lowest quartile. Of the five components of metabolic syndrome, waist circumference and HDL-cholesterol showed a significant and monotonic association with urinary 2,5-DCP. Participants with the highest quartile of 2,5-DCP had 3.18 cm (95% CI 1.34, 5.02) higher mean waist circumference and 2.83 mg/dL (95% CI -4.68, -0.98) lower mean HDL-cholesterol than the participants in the lowest quartile. This study suggests a potential relationship between p-DCB exposure and metabolic syndrome in non-diabetic adults. Prospective epidemiological and mechanistic studies are needed to further explore these interactions.
Collapse
Affiliation(s)
- Yudan Wei
- Department of Community Medicine, Mercer University School of Medicine, 1550 College St., Macon, GA, 31207, USA.
| | - Jianmin Zhu
- Department of Mathematics and Computer Science, Fort Valley State University, 1005 State University Dr., Fort Valley, GA, USA
| |
Collapse
|
44
|
Buser MC, Murray HE, Scinicariello F. Association of urinary phenols with increased body weight measures and obesity in children and adolescents. J Pediatr 2014; 165:744-9. [PMID: 25063718 PMCID: PMC8114784 DOI: 10.1016/j.jpeds.2014.06.039] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 05/19/2014] [Accepted: 06/11/2014] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To examine the association of urinary levels of the environmental phenol pesticides 2,5-dichlorophenol, 2,4-dichlorophenol, and triclosan with body weight outcomes in children and adolescent participants in the National Health and Nutrition Examination Survey 2007-2010. STUDY DESIGN We performed multivariate linear and multinomial logistic regressions to analyze the association of body mass index (BMI) z-score, waist circumference (WC), and obesity with urinary pesticide concentration in children and adolescents. RESULTS After adjustment for covariates, we found a statistically significant positive association (P < .05) between both 2,5-dichlorophenol and 2,4-dichlorophenol with BMI z-score, WC, and obesity in children and adolescents. After stratification by age, the significant associations remained only in adolescents (ages 12-19). No associations were found between triclosan and any of the body weight outcomes. CONCLUSIONS We found an association between dichlorophenols and increased body weight measures (BMI z-score, WC, and obesity) in adolescents. However, further studies, such as a longitudinal study, are needed to confirm and elucidate on our findings.
Collapse
Affiliation(s)
| | | | - Franco Scinicariello
- Division of Toxicology and Human Health Sciences, Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, Atlanta, GA.
| |
Collapse
|
45
|
Jerschow E, Parikh P, McGinn AP, de Vos G, Jariwala S, Hudes G, Rosenstreich D. Relationship between urine dichlorophenol levels and asthma morbidity. Ann Allergy Asthma Immunol 2014; 112:511-518.e1. [PMID: 24726197 DOI: 10.1016/j.anai.2014.03.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 03/19/2014] [Accepted: 03/21/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND Chlorinated phenols are associated with atopic conditions, but it is not known whether they are associated with wheeze or asthma and whether atopy is involved in these associations. OBJECTIVES To test the association between urine levels of 2 dichlorophenols (2,4- and 2,5-dichlorophenols) and asthma morbidity in atopic and nonatopic wheezers and between total serum immunoglobulin E (IgE) levels. METHODS Data from a sample of 2,125 participants at least 6 years old from the US National Health and Nutrition Examination Survey 2005 to 2006 were analyzed. Asthma morbidity data were available for those participants who reported wheezing in the past year ("wheezers"; n = 250). This subsample was categorized as atopic or nonatopic. RESULTS Atopic wheezers with higher 2,5-dichlorophenol levels were more frequently diagnosed with asthma by a physician (odds ratio [OR] 4.7 for highest vs lowest tertile, P < .001), required more prescriptions for asthma medications (OR 2.2, P = .046), and reported more exercise-induced wheezing (OR 5.8, P = .045) than atopic wheezers with low dichlorophenol levels. Atopic wheezers with higher 2,5- or 2,4-dichloropheonol levels also were more likely to miss work or school because of wheezing (OR 10.0, P < .001; OR 11.4, P < .01, respectively). In contrast, in nonatopic wheezers, there were no significant associations between dichlorophenol levels and asthma morbidity measurements. The 2 dichlorophenol metabolites were positively associated with increased serum IgE levels in the larger study sample. CONCLUSION These findings indicate that in patients with atopy and a history of wheezing, asthma morbidity is associated with high urinary dichlorophenol levels. Increased urine dichlorophenol levels are associated with higher total serum IgE.
Collapse
Affiliation(s)
- Elina Jerschow
- Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York.
| | - Purvi Parikh
- Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| | - Aileen P McGinn
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Gabriele de Vos
- Department of Medicine, Albert Einstein College of Medicine/Jacobi Medical Center, Bronx, New York
| | - Sunit Jariwala
- Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| | - Golda Hudes
- Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| | - David Rosenstreich
- Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York
| |
Collapse
|