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Cao S, Wan Y, Li Y, Xu S, Xia W. Urinary polycyclic aromatic hydrocarbon metabolites in Chinese pregnant women: Concentrations, variability, predictors, and association with oxidative stress biomarkers. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 950:175121. [PMID: 39084365 DOI: 10.1016/j.scitotenv.2024.175121] [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: 05/25/2024] [Revised: 07/26/2024] [Accepted: 07/27/2024] [Indexed: 08/02/2024]
Abstract
Polycyclic aromatic hydrocarbons (PAHs) are a class of pervasive contaminants having adverse health effects. Urinary monohydroxylated PAHs (OH-PAHs) are commonly employed as biomarkers to estimate PAH exposure levels in humans. However, little is understood about the variability in OH-PAHs among pregnant women across trimesters and their relationship with oxidative stress biomarkers (OSBs). Based on a prospective birth cohort study conducted in Wuhan, China, we selected 644 women who donated (spot) urine samples across different trimesters and measured the urinary concentrations of eight OH-PAHs and three selected OSBs (8-OHG, 8-OHdG, and HNEMA) to explore the relationship between the OH-PAHs and OSBs. Pregnant women were found to be ubiquitously exposed to the PAHs, with detection rates of the OH-PAHs ranging from 86.3% to 100%. 2-Hydroxynaphthalene (2-OH-Nap) had the highest urinary concentrations among the OH-PAHs during the three trimesters (specific gravity-adjusted median values for the first, second, and third trimesters: 1.86, 2.39, and 2.20 ng/mL, respectively). However, low reproducibility of the OH-PAHs was observed across the three trimesters with intraclass correlation coefficients ranged between 0.02 and 0.22. Most urinary OH-PAHs had the highest concentrations at the first trimester and the lowest at the third trimester. Some OH-PAH concentrations were higher in pregnant women with lower educational level [2-hydroxyphenanthrene (2-OH-Phen) and 3-hydroxyphenanthrene (3-OH-Phen)], those who were overweight [2-OH-Nap, 2/3-hydroxyfluorene (2/3-OH-Fluo), 2-OH-Phen, and 4-hydroxyphenanthrene (4-OH-Phen)], those who were unemployed during pregnancy [1-hydroxynaphthalene, 1/9-hydroxyphenanthrene, and 4-OH-Phen], and the samples donated in summer (most OH-PAHs, except for 2-OH-Nap). In multivariable linear mixed-effects model analyses, every OH-PAH was found to be significantly associated with increased levels of the three OSBs. For example, each interquartile range-fold increase in 2/3-OH-Fluo concentration was associated with the largest increase in 8-OHdG (65.4%) and 8-OHG (49.1%), while each interquartile range-fold increase in 3-OH-Phen concentration was associated with the largest increase in HNEMA (76.3%). Weighted quantile sum regression models, which were used to examine the joint effect of OH-PAH mixture on the OSBs, revealed positive associations between the OH-PAH mixture exposure and the OSBs. Specifically, 2/3-OH-Fluo and 2-OH-Nap were the major contributors in the association with oxidative damage of nucleic acids (8-OHdG and 8-OHG), while hydroxyphenanthrenes and 1-hydroxypyrene were the major contributors in the association with oxidative damage of lipid (HNEMA). Further work is required to examine the potential mediating role of oxidative stress in the relationship of adverse health outcomes with elevated PAH exposure among pregnant women.
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Affiliation(s)
- Shuting Cao
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan 430030, Hubei, China
| | - Yanjian Wan
- Center for Public Health Laboratory Service, Institute of Environmental Health, Wuhan Centers for Disease Control & Prevention, Wuhan, Hubei 430024, PR China
| | - Yuanyuan Li
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan 430030, Hubei, China
| | - Shunqing Xu
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan 430030, Hubei, China
| | - Wei Xia
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan 430030, Hubei, China.
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Ugalde-Resano R, Mérida-Ortega Á, Cebrián ME, López-Carrillo L. Breast cancer immunophenotypes and serum organochlorine pesticides in Mexican women: Mixture exposure approach. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 358:124495. [PMID: 38964647 DOI: 10.1016/j.envpol.2024.124495] [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: 02/12/2024] [Revised: 06/11/2024] [Accepted: 07/01/2024] [Indexed: 07/06/2024]
Abstract
Epidemiological studies on associations between breast cancer (BC) and organochlorine pesticides (OCP) are inconclusive. The majority of studies have evaluated the effect of single compounds without considering multiple OCP exposures and immunophenotypes of BC. We aimed to evaluate the association between BC immunophenotypes and serum OCP mixtures, and identify the main contributors within mixtures. We included 767 histopathologically confirmed incident BC cases and 908 controls from a population-based case-control study conducted from 2007 to 2011 in Northern Mexico. We obtained direct information about sociodemographic, lifestyle and reproductive characteristics. We collected data from clinical records about hormonal receptors (HR) and epidermal growth factor receptor 2 (HER2) expressions. Immunophenotypes were determined as HR+/HER2-, HER2+ or HR-/HER2-. We quantified OCP and metabolites by gas chromatography using an electron capture micro detector. We used Weighted Quantile Sum regression to assess the association of BC and exposure to multiple OCP, and their contribution within the mixture. We found a positive adjusted association between BC and an OCP mixture (OR: 3.48, 95%CI: 2.58, 4.69), whose primary contribution arose from the isomers of hexachlorocyclohexane and endosulfan, as well as endosulfan sulfate. We also identified a mixture negatively associated (OR: 0.13, 95%CI: 0.08, 0.20), characterized by p,p'-DDT and chlordane metabolites. All these associations remained regardless BC immunophenotypes. This is the first epidemiological report that identified serum OCP mixtures associated with BC immunophenotypes. Due to OCP ubiquity, biomagnification, and continuous exposure, they constitute a global problem of persistent exposure that might be related to BC risk.
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Affiliation(s)
- Rodrigo Ugalde-Resano
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Av. Universidad 655, Col. Santa María Ahuacatitlán, C.P. 07360, Cuernavaca, Morelos, Mexico.
| | - Ángel Mérida-Ortega
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Av. Universidad 655, Col. Santa María Ahuacatitlán, C.P. 07360, Cuernavaca, Morelos, Mexico
| | - Mariano E Cebrián
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Av. Instituto Politécnico Nacional 2508, Col. San Pedro Zacatenco, C.P. 07360, México, Mexico
| | - Lizbeth López-Carrillo
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Av. Universidad 655, Col. Santa María Ahuacatitlán, C.P. 07360, Cuernavaca, Morelos, Mexico.
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Chang C, Dai Y, Zhang J, Wu Z, Li S, Zhou Z. Associations between exposure to pesticides mixture and semen quality among the non-occupationally exposed males: Four statistical models. ENVIRONMENTAL RESEARCH 2024; 257:119400. [PMID: 38866311 DOI: 10.1016/j.envres.2024.119400] [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: 06/04/2024] [Accepted: 06/09/2024] [Indexed: 06/14/2024]
Abstract
Most epidemiological studies on the associations between pesticides exposure and semen quality have been based on a single pesticide, with inconsistent major results. In contrast, there was limited human evidence on the potential effect of pesticides mixture on semen quality. Our study aimed to investigate the relationship of pesticide profiles with semen quality parameters among 299 non-occupationally exposed males aged 25-50 without any clinical abnormalities. Serum concentrations of 21 pesticides were quantified by gas chromatography-tandem mass spectrometry (GC-MS/MS). Semen quality parameters were abstracted from medical records. Generalized linear regression models (GLMs) and three mixture approaches, including weighted quantile sum regression (WQS), elastic net regression (ENR) and Bayesian kernel machine regression (BKMR), were applied to explore the single and mixed effects of pesticide exposure on semen quality. In GLMs, as the serum levels of Bendiocarb, β-BHC, Clomazone, Dicrotophos, Dimethenamid, Paclobutrazole, Pentachloroaniline and Pyrimethanil increased, the straight-line velocity (VSL), linearity (LIN) and straightness (STR) decreased. This negative association also occurred between the concentration of β-BHC, Pentachloroaniline, Pyrimethanil and progressive motility, total motility. In the WQS models, pesticides mixture was negatively associated with total motility and several sperm motility parameters (β: -3.07∼-1.02 per decile, FDR-P<0.05). After screening the important pesticides derived from the mixture by ENR model, the BKMR models showed that the decreased qualities for VSL, LIN, and STR were also observed when pesticide mixtures were at ≥ 70th percentiles. Clomazone, Dimethenamid, and Pyrimethanil (Posterior inclusion probability, PIP: 0.2850-0.8900) were identified as relatively important contributors. The study provides evidence that exposure to single or mixed pesticide was associated with impaired semen quality.
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Affiliation(s)
- Chunxin Chang
- Key Laboratory of Public Health Safety of Ministry of Education, Key Laboratory of Health Technology Assessment of National Health Commission, School of Public Health, Fudan University, No. 130 Dong'an Road, Shanghai 200032, China; The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
| | - Yiming Dai
- Key Laboratory of Public Health Safety of Ministry of Education, Key Laboratory of Health Technology Assessment of National Health Commission, School of Public Health, Fudan University, No. 130 Dong'an Road, Shanghai 200032, China
| | - Jiming Zhang
- Key Laboratory of Public Health Safety of Ministry of Education, Key Laboratory of Health Technology Assessment of National Health Commission, School of Public Health, Fudan University, No. 130 Dong'an Road, Shanghai 200032, China
| | - Zhengmu Wu
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
| | - Shuyuan Li
- The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China.
| | - Zhijun Zhou
- Key Laboratory of Public Health Safety of Ministry of Education, Key Laboratory of Health Technology Assessment of National Health Commission, School of Public Health, Fudan University, No. 130 Dong'an Road, Shanghai 200032, China.
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Wu J, Zhang X, Wang Q, Ma N, Zheng F, Chen K, Niu W. Perfluoroalkyl substances and metabolic syndrome: A cross-sectional study using data from the US national health and nutrition examination survey. Heliyon 2024; 10:e36894. [PMID: 39281531 PMCID: PMC11401229 DOI: 10.1016/j.heliyon.2024.e36894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 07/31/2024] [Accepted: 08/23/2024] [Indexed: 09/18/2024] Open
Abstract
Background Epidemiological studies linking metabolic syndrome (MetS) and exposure to perfluoroalkyl substances (PFASs) are limited, and the observations gleaned thus far are inconclusive. The study was performed to explore the association of serum PFASs both singly and in a mixed manner with MetS, and meanwhile to examine whether this association was mediated by serum albumin in a US national population. Methods Total 8108 participants from the National Health and Nutrition Examination Survey, 2007-2018 were included. Four PFASs - including perfluorohexane sulfonic acid (PFHxS), perfluorononanoic acid (PFNA), perfluoromethylheptane sulfonic acid (PFOS), and perfluorooctanoic acid (PFOA), were selected. Weighted quantile sum regression was used to evaluate mixed PFAS exposure and MetS. Multivariable logistic regression models were used to calculate odd ratio (OR) and 95 % confidence interval (95 % CI). Mediating analyses were used to evaluate the mediating effects of albumin. Results Comparing the highest with lowest quartile yielded a multivariable-adjusted OR (95 % CI) of 1.40 (1.14-1.72) for PFHxS, 1.36 (1.09-1.70) for PFNA, 1.26 (1.00-1.58) for PFOA, and 1.50 (1.19-1.88) for PFOS when associating MetS. Per unit increment in ln-transformed PFHxS, PFNA, PFOA, and PFOS concentrations was significantly associated with 16 %, 17 %, 13 %, and 15 % increased risk of MetS, respectively. When stratified by sex, the significant association between four PFASs and MetS was only noted in females. Mixed PFAS exposure was inversely associated with MetS, and 8.1 % of this association was mediated by serum albumin (P < 0.001). Conclusions Our findings indicate a significant and independent association of serum PFASs with MetS, and importantly this association was dose-dependent, sex-specific, and possibly mediated by serum albumin.
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Affiliation(s)
- Jing Wu
- Center for Evidence-Based Medicine, Capital Institute of Pediatrics, Beijing, China
| | - Xiaoqian Zhang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Qiong Wang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Ning Ma
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Fangjieyi Zheng
- Center for Evidence-Based Medicine, Capital Institute of Pediatrics, Beijing, China
| | - Kening Chen
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
| | - Wenquan Niu
- Center for Evidence-Based Medicine, Capital Institute of Pediatrics, Beijing, China
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Salamanca-Fernández E, Espín-Moreno L, Olivas-Martínez A, Pérez-Cantero A, Martín-Rodríguez JL, Poyatos RM, Barbone F, Rosolen V, Mariuz M, Ronfani L, Palkovičová Murínová Ľ, Fábelová L, Szigeti T, Kakucs R, Sakhi AK, Haug LS, Lindeman B, Snoj Tratnik J, Kosjek T, Jacobs G, Voorspoels S, Jurdáková H, Górová R, Petrovičová I, Kolena B, Esteban M, Pedraza-Díaz S, Kolossa-Gehring M, Remy S, Govarts E, Schoeters G, Fernández MF, Mustieles V. Associations between Urinary Phthalate Metabolites with BDNF and Behavioral Function among European Children from Five HBM4EU Aligned Studies. TOXICS 2024; 12:642. [PMID: 39330570 PMCID: PMC11436069 DOI: 10.3390/toxics12090642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 08/20/2024] [Accepted: 08/30/2024] [Indexed: 09/28/2024]
Abstract
Based on toxicological evidence, children's exposure to phthalates may contribute to altered neurodevelopment and abnormal regulation of brain-derived neurotrophic factor (BDNF). We analyzed data from five aligned studies of the Human Biomonitoring for Europe (HBM4EU) project. Ten phthalate metabolites and protein BDNF levels were measured in the urine samples of 1148 children aged 6-12 years from Italy (NACII-IT cohort), Slovakia (PCB-SK cohort), Hungary (InAirQ-HU cohort) and Norway (NEBII-NO). Serum BDNF was also available in 124 Slovenian children (CRP-SLO cohort). Children's total, externalizing and internalizing behavioral problems were assessed using the Child Behavior Checklist at 7 years of age (only available in the NACII-IT cohort). Adjusted linear and negative binomial regression models were fitted, together with weighted quantile sum (WQS) regression models to assess phthalate mixture associations. Results showed that, in boys but not girls of the NACII-IT cohort, each natural-log-unit increase in mono-n-butyl phthalate (MnBP) and Mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) was cross-sectionally associated with higher externalizing problems [incidence rate ratio (IRR): 1.20; 95% CI: 1.02, 1.42 and 1.26; 95% CI: 1.03, 1.55, respectively]. A suggestive mixture association with externalizing problems was also observed per each tertile mixture increase in the whole population (WQS-IRR = 1.15; 95% CI: 0.97, 1.36) and boys (IRR = 1.20; 95% CI: 0.96, 1.49). In NACII-IT, PCB-SK, InAirQ-HU and NEBII-NO cohorts together, urinary phthalate metabolites were strongly associated with higher urinary BDNF levels, with WQS regression confirming a mixture association in the whole population (percent change (PC) = 25.9%; 95% CI: 17.6, 34.7), in girls (PC = 18.6%; 95% CI: 7.92, 30.5) and mainly among boys (PC = 36.0%; 95% CI: 24.3, 48.9). Among CRP-SLO boys, each natural-log-unit increase in ∑DINCH concentration was associated with lower serum BDNF levels (PC: -8.8%; 95% CI: -16.7, -0.3). In the NACII-IT cohort, each natural-log-unit increase in urinary BDNF levels predicted worse internalizing scores among all children (IRR: 1.15; 95% CI: 1.00, 1.32). Results suggest that (1) children's exposure to di-n-butyl phthalate (DnBP) and di(2-ethylhexyl) phthalate (DEHP) metabolites is associated with more externalizing problems in boys, (2) higher exposure to DINCH may associate with lower systemic BDNF levels in boys, (3) higher phthalate exposure is associated with higher urinary BDNF concentrations (although caution is needed since the possibility of a "urine concentration bias" that could also explain these associations in noncausal terms was identified) and (4) higher urinary BDNF concentrations may predict internalizing problems. Given this is the first study to examine the relationship between phthalate metabolite exposure and BDNF biomarkers, future studies are needed to validate the observed associations.
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Affiliation(s)
- Elena Salamanca-Fernández
- Biomedical Research Center (CIBM), Department of Radiology and Physical Medicine, University of Granada, 18012 Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
| | | | | | - Ainhoa Pérez-Cantero
- Biomedical Research Center (CIBM), Department of Radiology and Physical Medicine, University of Granada, 18012 Granada, Spain
| | - José L Martín-Rodríguez
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
- Servicio de Radiodiagnóstico, Hospital Universitario Clínico San Cecilio, 18012 Granada, Spain
| | - Rafael M Poyatos
- Unidad de Gestión Clínica de Laboratorios, Hospital Universitario Clínico San Cecilio, 18012 Granada, Spain
| | - Fabio Barbone
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
| | - Valentina Rosolen
- Central Directorate for Health, Social Policies and Disability, Friuli Venezia Giulia Region, Via Cassa di Risparmio 10, 34121 Trieste, Italy
| | - Marika Mariuz
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
| | - Luca Ronfani
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
| | - Ľubica Palkovičová Murínová
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, 831 04 Bratislava, Slovakia
| | - Lucia Fábelová
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, 831 04 Bratislava, Slovakia
| | - Tamás Szigeti
- Center for Public Health and Pharmacy, Albert Flórián út 2-6, 1097 Budapest, Hungary
| | - Réka Kakucs
- Center for Public Health and Pharmacy, Albert Flórián út 2-6, 1097 Budapest, Hungary
| | - Amrit K Sakhi
- Norwegian Institute of Public Health, P.O. Box 222, Skøyen, N-0213 Oslo, Norway
| | - Line S Haug
- Norwegian Institute of Public Health, P.O. Box 222, Skøyen, N-0213 Oslo, Norway
| | - Birgitte Lindeman
- Norwegian Institute of Public Health, P.O. Box 222, Skøyen, N-0213 Oslo, Norway
| | | | - Tina Kosjek
- Jožef Stefan Institute, 1000 Ljubljana, Slovenia
| | - Griet Jacobs
- VITO GOAL, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium
| | - Stefan Voorspoels
- VITO GOAL, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium
| | - Helena Jurdáková
- Department of Analytical Chemistry, Faculty of Natural Sciences, Comenius University, Ilkovičova 6, Mlynská Dolina, 84215 Bratislava, Slovakia
| | - Renáta Górová
- Department of Analytical Chemistry, Faculty of Natural Sciences, Comenius University, Ilkovičova 6, Mlynská Dolina, 84215 Bratislava, Slovakia
| | - Ida Petrovičová
- Department of Zoology and Anthropology, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, Nabrezie mladeze 91, 94974 Nitra, Slovakia
| | - Branislav Kolena
- Department of Zoology and Anthropology, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, Nabrezie mladeze 91, 94974 Nitra, Slovakia
| | - Marta Esteban
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28034 Madrid, Spain
| | - Susana Pedraza-Díaz
- National Centre for Environmental Health, Instituto de Salud Carlos III, 28034 Madrid, Spain
| | | | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), 2400 Mol, Belgium
| | - Greet Schoeters
- Department of Biomedical Sciences, University of Antwerp, 2610 Antwerp, Belgium
| | - Mariana F Fernández
- Biomedical Research Center (CIBM), Department of Radiology and Physical Medicine, University of Granada, 18012 Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28034 Madrid, Spain
| | - Vicente Mustieles
- Biomedical Research Center (CIBM), Department of Radiology and Physical Medicine, University of Granada, 18012 Granada, Spain
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28034 Madrid, Spain
- Servicio de Radiodiagnóstico, Hospital Universitario Clínico San Cecilio, 18012 Granada, Spain
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Hu CY, Alcala CS, Lamadrid-Figueroa H, Tamayo-Ortiz M, Mercado-Garcia A, Rivera Rivera N, Just AC, Gennings C, Téllez-Rojo MM, Wright RO, Wright RJ, Carroll KN, Rosa MJ. Associations of prenatal exposure to phthalates and their mixture with lung function in Mexican children. JOURNAL OF HAZARDOUS MATERIALS 2024; 475:134863. [PMID: 38885590 PMCID: PMC11250751 DOI: 10.1016/j.jhazmat.2024.134863] [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: 04/20/2024] [Revised: 05/28/2024] [Accepted: 06/07/2024] [Indexed: 06/20/2024]
Abstract
Early life phthalates exposure has been associated with adverse respiratory outcomes. However, evidence linking prenatal phthalates exposure and childhood lung function has been inconclusive. Additionally, few studies have examined phthalates exposure as a mixture and explored sexually dimorphic associations. We aimed to investigate sex-specific associations of prenatal phthalates mixtures with childhood lung function using the PROGRESS cohort in Mexico (N = 476). Prenatal phthalate concentrations were measured in maternal urine collected during the 2nd and 3rd trimesters. Children's lung function was evaluated at ages 8-13 years. Individual associations were assessed using multivariable linear regression, and mixture associations were modeled using repeated holdout WQS regression and hierarchical BKMR; data was stratified by sex to explore sex-specific associations. We identified significant interactions between 2nd trimester phthalates mixture and sex on FEV1 and FVC z-scores. Higher 2nd trimester phthalate concentrations were associated with higher FEV1 (β = 0.054, 95 %CI: 0.005, 0.104) and FVC z-scores (β = 0.074, 95 % CI: 0.024, 0.124) in females and with lower measures in males (FEV1, β = -0.017, 95 %CI: -0.066, 0.026; FVC, β = -0.014, 95 %CI: -0.065, 0.030). This study indicates that prenatal exposure to phthalates is related to childhood lung function in a sex-specific manner.
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Affiliation(s)
- Cheng-Yang Hu
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Cecilia S Alcala
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA
| | - Hector Lamadrid-Figueroa
- Department of Perinatal Health, Center for Population Health Research, National Institute of Public Health (INSP), Av. Universidad #655 Col. Santa Maria Ahuacatitlan C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Marcela Tamayo-Ortiz
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY 10032, USA
| | - Adriana Mercado-Garcia
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad #655 Col. Santa Maria Ahuacatitlan C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Nadya Rivera Rivera
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA
| | - Allan C Just
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA; Department of Epidemiology, Brown University School of Public Health, 121 S Main St, Providence, RI 02903, USA
| | - Chris Gennings
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA
| | - Martha María Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Av. Universidad #655 Col. Santa Maria Ahuacatitlan C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Robert O Wright
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA; Department of Public Health, Icahn School of Medicine at Mount Sinai, 1184 Fifth Avenue, New York, NY 10029, USA; Institute for Climate Change, Environmental Health, and Exposomics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA; Department of Public Health, Icahn School of Medicine at Mount Sinai, 1184 Fifth Avenue, New York, NY 10029, USA; Institute for Climate Change, Environmental Health, and Exposomics, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA
| | - Kecia N Carroll
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA; Department of Public Health, Icahn School of Medicine at Mount Sinai, 1184 Fifth Avenue, New York, NY 10029, USA
| | - Maria José Rosa
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY 10029, USA.
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Zhao FJ, Huo RR, Li FR, You XM. Associations of tumor-related psychiatric symptoms and healthy behaviors with dynamic quality of life after hepatocellular carcinoma hepatectomy. Support Care Cancer 2024; 32:589. [PMID: 39141259 PMCID: PMC11324778 DOI: 10.1007/s00520-024-08790-y] [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: 01/03/2024] [Accepted: 08/06/2024] [Indexed: 08/15/2024]
Abstract
OBJECTIVE To assess the independent and combined associations of tumor-related psychiatric symptoms (TRPS) with dynamic health-related quality of life (HRQL) in patients with hepatocellular carcinoma (HCC) after hepatectomy and to identify related patterns of health behaviors. METHODS This prospective study included patients with HCC who underwent hepatectomy between September 2021 and May 2022. Independent and combined associations between TRPS and HRQL were identified by generalized linear model and weighted quantile sum model, respectively. Trajectories of HRQL were identified by latent class mixed model. RESULTS Among the 205 patients, 174 (84.9%) were male. For the outcome of HRQL at 6 months: Anxiety, depression, fatigue, and sleep disorder were independently associated with a decrease of HRQL (all P < 0.05). A negative combined effect of TRPS was also found (β = - 5.07, 95% CI, - 10.01 to - 0.13), with depression emerged as the predominant contributor (49%). The health behaviors of body mass index, smoking, drinking, or physical exercise were not significantly modified the associations between combined TRPS and HRQL (all P > 0.05 for interaction). Similar results were also found for the HRQL at baseline and at 1 and 3 months. Three HRQL trajectory groups were identified: recover (44.9%), poor (44.4%), and deteriorating (10.7%). Deteriorating group was associated with higher incidence of TRPS (all P < 0.05). CONCLUSIONS TRPS were associated with a decrease of HRQL regardless of healthy behaviors in HCC patients. Therefore, healthy behaviors promotion alone might not substantially increase HRQL associated with TRPS, and other measures tackling TRPS are warranted.
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Affiliation(s)
- Feng-Juan Zhao
- Guangxi Medical University Cancer Hospital, Nanning, China
| | - Rong-Rui Huo
- Guangxi Medical University Cancer Hospital, Nanning, China
| | - Fan-Rong Li
- Guangxi Medical University Cancer Hospital, Nanning, China
| | - Xue-Mei You
- Guangxi Medical University Cancer Hospital, Nanning, China.
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, China.
- Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Nanning, China.
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Agrawal M, Midya V, Maroli A, Magee J, Petrick L, Colombel JF. Per- and Poly-Fluoroalkyl Substances Exposure Is Associated With Later Occurrence of Inflammatory Bowel Disease. Clin Gastroenterol Hepatol 2024; 22:1728-1730.e8. [PMID: 38154728 PMCID: PMC11209830 DOI: 10.1016/j.cgh.2023.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/22/2023] [Accepted: 12/14/2023] [Indexed: 12/30/2023]
Abstract
Inflammatory bowel disease (IBD) is an immune-mediated inflammatory disease of the intestinal tract of elusive etiology. Environmental chemical exposures are increasingly acknowledged as a potential IBD risk factor. Per- and poly-fluoroalkyl substances (PFASs), a large class of persistent fluorinated organic chemicals used in industrial applications and consumer products such as paints, food packaging, and nonstick cookware, for over 6 decades, may be implicated in IBD etiology. Yet, epidemiological evidence has so far been scarce. Exposures to a few legacy PFASs, including perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorodecanoic (PFDA), and perfluorohexane sulfonate (PFHxS), have been associated with immunotoxicity and increased risk of other immune-mediated diseases,1 but data for their potential association with IBD are conflicting.2,3 Further, the impact of more recently emerging PFAS chemicals on IBD risk has not been studied.
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Affiliation(s)
- Manasi Agrawal
- Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York New York; Center for Molecular Prediction of Inflammatory Bowel Disease, Department of Clinical Medicine, Aalborg University, Copenhagen, Denmark
| | - Vishal Midya
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Amith Maroli
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jared Magee
- Department of Gastroenterology, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Lauren Petrick
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York; Bert Strassburger Metabolic Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Jean-Frederic Colombel
- Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York New York
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Yao J, Zhou F, Ruan L, Liang Y, Zheng Q, Shao J, Cai F, Zhou J, Zhou H. Association between estimated glucose disposal rate control level and stroke incidence in middle-aged and elderly adults. J Diabetes 2024; 16:e13595. [PMID: 39136536 PMCID: PMC11320750 DOI: 10.1111/1753-0407.13595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/06/2024] [Accepted: 06/02/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND To estimate glucose disposal rate (eGDR) as a newly validated surrogate marker of insulin resistance. Few studies have explored the association between changes in eGDR levels and stroke incidence. This study aims to explore the effect of the level of eGDR control on stroke and events. METHODS Data were obtained from the China Longitudinal Study on Health and Retirement (CHARLS). The eGDR control level was classified using K-means cluster analysis. Logistic regression analysis was used to explore the association between different eGDR control levels and incident stroke. Restrictive cubic spline regression was used to test the potential nonlinear association between cumulative eGDR and stroke incidence. RESULTS Of the 4790 participants, 304 (6.3%) had a stroke within 3 years. The odds ratio (OR) was 2.34 (95% confidence interval [CI], 1.42-3.86) for the poorly controlled class 4 and 2.56 (95% CI, 1.53-4.30) for the worst controlled class 5 compared with class 1 with the best controlled eGDR. The OR for well-controlled class 2 was 1.28 (95% CI, 0.79-2.05), and the OR for moderately controlled class 3 was 1.95 (95% CI, 1.14-3.32). In restrictive cubic spline regression analysis, eGDR changes are linearly correlated with stroke occurrence. Weighted quartile and regression analysis identified waist circumference and hypertension as key variables of eGDR for predicting incident stroke. CONCLUSIONS Poorly controlled eGDR level is associated with an increased risk of stroke in middle-aged and elderly people. Monitoring changes in eGDR may help identify individuals at high risk of stroke early.
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Affiliation(s)
- Jiangnan Yao
- College of NursingWenzhou Medical UniversityWenzhouChina
| | - Feng Zhou
- Department of Global Health, School of Public HealthWuhan University of Science and TechnologyWuhanChina
| | - Lingzhi Ruan
- Department of Clinical MedicineWenzhou Medical UniversityWenzhouChina
| | - Yiling Liang
- College of NursingWenzhou Medical UniversityWenzhouChina
| | - Qianrong Zheng
- College of NursingWenzhou Medical UniversityWenzhouChina
| | - Jiaxin Shao
- College of NursingWenzhou Medical UniversityWenzhouChina
| | - Fuman Cai
- College of NursingWenzhou Medical UniversityWenzhouChina
| | - Jianghua Zhou
- Department of CardiologyThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Hao Zhou
- Department of CardiologyThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
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Hu M, Yang M, Tang H, Zhang C. The association between exposure to volatile organic chemicals and serum α-Klotho in USA middle to old aged population: A cross-sectional study from NHANES 2011-2016. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 934:173083. [PMID: 38761942 DOI: 10.1016/j.scitotenv.2024.173083] [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: 01/16/2024] [Revised: 03/30/2024] [Accepted: 05/07/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Volatile Organic Compounds (VOCs) constitute an omnipresent category of environmental contaminants. Numerous studies have identified associations between various VOCs and human diseases. The anti-aging protein α-Klotho has been shown to exert protective influences across a variety of disease origins and progressions. This study aims to explore the relationship between serum α-Klotho levels and exposure to VOCs in humans. METHODS This analysis utilized data from 1672 participants aged from 40 to 79 years in 2011-2016 NHANES. Exposure to VOCs was assessed through measurements of urinary VOC metabolites (mVOCs), with 16 mVOCs selected for analysis. Multivariate generalized linear models (GLM), restricted cubic splines (RCS), weighted quantile sum (WQS) regression models, and Bayesian kernel machine regression (BKMR) models were employed to examine the connection between serum α-Klotho and individual mVOCs and mVOCs mixtures, as well as to identify the primary monomeric mVOCs responsible for these associations. RESULTS Our research revealed that 8 mVOCs exhibited inverse associations with serum α-Klotho levels in GLM and RCS models. Particularly noteworthy, N-Acetyl-S-(2-cyanoethyl)-L-cysteine (CYMA), a metabolite of acrylonitrile, emerged as the most influential mVOC in both WQS and BKMR models. Furthermore, the mVOCs mixture was found to be negatively correlated with serum α-Klotho. The detrimental effects of mVOCs on serum α-Klotho were observed to significantly diminish in individuals with elevated serum vitamin D levels. CONCLUSION Our study highlights a significant inverse relationship between serum α-Klotho and the mixture of mVOCs, indicating that exposure to VOCs may impact the molecular pathways of aging and related diseases by influencing α-Klotho concentrations. Remarkably, the attenuation of this association by high serum vitamin D levels implies potential therapeutic strategies. Our study underscores the importance of minimizing VOCs exposure to mitigate the adverse effects on α-Klotho. Further research is warranted to elucidate the underlying mechanisms of these relationships.
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Affiliation(s)
- Mingcun Hu
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Min Yang
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Hui Tang
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Chun Zhang
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China.
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Renzetti S, van Thriel C, Lucchini RG, Smith DR, Peli M, Borgese L, Cirelli P, Bilo F, Patrono A, Cagna G, Rechtman E, Idili S, Ongaro E, Calza S, Rota M, Wright RO, Claus Henn B, Horton MK, Placidi D. A multi-environmental source approach to explore associations between metals exposure and olfactory identification among school-age children residing in northern Italy. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024; 34:699-708. [PMID: 38802534 DOI: 10.1038/s41370-024-00687-6] [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: 05/08/2023] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Metal exposures can adversely impact olfactory function. Few studies have examined this association in children. Further, metal exposure occurs as a mixture, yet previous studies of metal-associated olfactory dysfunction only examined individual metals. Preventing olfactory dysfunctions can improve quality of life and prevent neurodegenerative diseases with long-term health implications. OBJECTIVE We aimed to test the association between exposure to a mixture of 12 metals measured in environmental sources and olfactory function among children and adolescents residing in the industrialized province of Brescia, Italy. METHODS We enrolled 130 children between 6 and 13 years old (51.5% females) and used the "Sniffin' Sticks" test to measure olfactory performance in identifying smells. We used a portable X-ray fluorescence instrument to determine concentrations of metals (arsenic (As), calcium, cadmium (Cd), chromium, copper, iron, manganese, lead (Pb), antimony, titanium, vanadium and zinc) in outdoor and indoor deposited dust and soil samples collected from participants' households. We used an extension of weighted quantile sum (WQS) regression to test the association between exposure to metal mixtures in multiple environmental media and olfactory function adjusting for age, sex, socio-economic status, intelligence quotient and parents' smoking status. RESULTS A higher multi-source mixture was significantly associated with a reduced Sniffin' Sticks identification score (β = -0.228; 95% CI -0.433, -0.020). Indoor dust concentrations of Pb, Cd and As provided the strongest contributions to this association (13.8%, 13.3% and 10.1%, respectively). The metal mixture in indoor dust contributed more (for 8 metals out of 12) to the association between metals and olfactory function compared to soil or outdoor dust. IMPACT STATEMENT Among a mixture of 12 metals measured in three different environmental sources (soil, outdoor and indoor dust), we identified Pb, Cd and As measured in indoor dust as the main contributors to reduced olfactory function in children and adolescents residing in an industrialized area. Exposure to indoor pollution can be effectively reduced through individual and public health interventions allowing to prevent the deterioration of olfactory functions. Moreover, the identification of the factors that can deteriorate olfactory functions can be a helpful instrument to improve quality of life and prevent neurodegenerative diseases as long-term health implications.
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Affiliation(s)
- Stefano Renzetti
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy.
| | - Christoph van Thriel
- Leibniz Research Centre for Working Environment and Human Factors (IfADo), Neurotoxicology and Chemosensation, TU Dortmund, Dortmund, Germany
| | - Roberto G Lucchini
- Department of Biochemical, Biomedical and Neurosciences, Università degli Studi di Modena e Reggio Emilia, Modena, Italy
- Department of Environmental Health Sciences, School of Public Health, Florida International University, Miami, FL, USA
| | - Donald R Smith
- Department of Microbiology and Environmental Toxicology, University of California, Santa Cruz, CA, USA
| | - Marco Peli
- Department of Civil, Environmental, Architectural Engineering and Mathematics, Università degli Studi di Brescia, Brescia, Italy
| | - Laura Borgese
- Department of Mechanical and Industrial Engineering, Università degli Studi di Brescia, Brescia, Italy
| | - Paola Cirelli
- Department of Mechanical and Industrial Engineering, Università degli Studi di Brescia, Brescia, Italy
| | - Fabjola Bilo
- Department of Mechanical and Industrial Engineering, Università degli Studi di Brescia, Brescia, Italy
| | - Alessandra Patrono
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy
- Department of Molecular and Translational Medicine, Università degli Studi di Brescia, Brescia, Italy
| | - Giuseppa Cagna
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy
| | - Elza Rechtman
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA
| | - Stefania Idili
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy
| | - Elisa Ongaro
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy
| | - Stefano Calza
- Department of Molecular and Translational Medicine, Università degli Studi di Brescia, Brescia, Italy
| | - Matteo Rota
- Department of Molecular and Translational Medicine, Università degli Studi di Brescia, Brescia, Italy
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Megan K Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA
| | - Donatella Placidi
- Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy
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Mérida-Ortega Á, Ugalde-Resano R, Rincón-Rubio A, Flores-Collado G, Flores-García MK, Rangel-Moreno K, Gennings C, López-Carrillo L. Food groups consumption and urinary metal mixtures in women from Northern Mexico. J Trace Elem Med Biol 2024; 84:127428. [PMID: 38484634 DOI: 10.1016/j.jtemb.2024.127428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 03/04/2024] [Accepted: 03/05/2024] [Indexed: 05/27/2024]
Abstract
OBJECTIVE We aimed to evaluate the association between food groups and mixtures of urinary metal concentrations in a sample of women; as well as identify the most important metals within each mixture. METHODS This is a cross-sectional analysis between food groups consumption and mixtures of various metals in urine from 439 women, ≥18 years old, from Northen Mexico. We estimated the dietary intake of 20 food groups through a validated semi-quantitative food frequency questionnaire. Urinary metal concentration of aluminum, antimony, arsenic, barium, cadmium, cesium, chromium, cobalt, copper, lead, manganese, magnesium, molybdenum, nickel, selenium, thallium, tin, vanadium, and zinc, were measured by inductively coupled plasma triple quad. We used weighted quantile sum (WQS) regression with binomial family specification to assess the association of food groups and metal mixtures, as well as to identify the most important ones. RESULTS We identified tin, lead, and antimony as the most important metals, in the metal mixtures that were positively associated with the consumption of eggs, non-starchy vegetables, fruits, seafood, corn, oil seeds, chicken, soda, legumes, red and/or processed meats, as well as negatively with the consumption of alliums, corn tortillas and/or vegetable oils. CONCLUSION Our findings suggest that food consumption is related to more than one metal in the study sample, and highlights the presence of some of them. Further research is required to identify the possible sources of metals in food, as well as the chronic adverse health effects attributed to their simultaneous presence.
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Affiliation(s)
- Ángel Mérida-Ortega
- Instituto Nacional de Salud Pública, Av. Universidad No. 655, Santa María Ahuacatitlán, Cuernavaca, Morelos CP 62100, Mexico
| | - Rodrigo Ugalde-Resano
- Instituto Nacional de Salud Pública, Av. Universidad No. 655, Santa María Ahuacatitlán, Cuernavaca, Morelos CP 62100, Mexico
| | - Alma Rincón-Rubio
- Instituto Nacional de Salud Pública, Av. Universidad No. 655, Santa María Ahuacatitlán, Cuernavaca, Morelos CP 62100, Mexico
| | - Gisela Flores-Collado
- Instituto Nacional de Salud Pública, Av. Universidad No. 655, Santa María Ahuacatitlán, Cuernavaca, Morelos CP 62100, Mexico
| | - M Karen Flores-García
- Instituto Nacional de Salud Pública, Av. Universidad No. 655, Santa María Ahuacatitlán, Cuernavaca, Morelos CP 62100, Mexico
| | - Karla Rangel-Moreno
- Instituto Nacional de Salud Pública, Av. Universidad No. 655, Santa María Ahuacatitlán, Cuernavaca, Morelos CP 62100, Mexico
| | - Chris Gennings
- Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Lizbeth López-Carrillo
- Instituto Nacional de Salud Pública, Av. Universidad No. 655, Santa María Ahuacatitlán, Cuernavaca, Morelos CP 62100, Mexico.
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Amadou A, Giampiccolo C, Bibi Ngaleu F, Praud D, Coudon T, Grassot L, Faure E, Couvidat F, Frenoy P, Severi G, Romana Mancini F, Roy P, Fervers B. Multiple xenoestrogen air pollutants and breast cancer risk: Statistical approaches to investigate combined exposures effect. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 351:124043. [PMID: 38679129 DOI: 10.1016/j.envpol.2024.124043] [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: 08/07/2023] [Revised: 02/10/2024] [Accepted: 04/23/2024] [Indexed: 05/01/2024]
Abstract
Studies suggested that exposure to air pollutants, with endocrine disrupting (ED) properties, have a key role in breast cancer (BC) development. Although the population is exposed simultaneously to a mixture of multiple pollutants and ED pollutants may act via common biological mechanisms leading to synergic effects, epidemiological studies generally evaluate the effect of each pollutant separately. We aimed to assess the complex effect of exposure to a mixture of four xenoestrogen air pollutants (benzo-[a]-pyrene (BaP), cadmium, dioxin (2,3,7,8-Tétrachlorodibenzo-p-dioxin TCDD)), and polychlorinated biphenyl 153 (PCB153)) on the risk of BC, using three recent statistical methods, namely weighted quantile sum (WQS), quantile g-computation (QGC) and Bayesian kernel machine regression (BKMR). The study was conducted on 5222 cases and 5222 matched controls nested within the French prospective E3N cohort initiated in 1990. Annual average exposure estimates to the pollutants were assessed using a chemistry transport model, at the participants' residence address between 1990 and 2011. We found a positive association between the WQS index of the joint effect and the risk of overall BC (adjusted odds ratio (OR) = 1.10, 95% confidence intervals (CI): 1.03-1.19). Similar results were found for QGC (OR = 1.11, 95%CI: 1.03-1.19). Despite the association did not reach statistical significance in the BKMR model, we observed an increasing trend between the joint effect of the four pollutants and the risk of BC, when fixing other chemicals at their median concentrations. BaP, cadmium and PCB153 also showed positive trends in the multi-pollutant mixture, while dioxin showed a modest inverse trend. Despite we found a clear evidence of a positive association between the joint exposure to pollutants and BC risk only from WQS and QGC regression, we observed a similar suggestive trend using BKMR. This study makes a major contribution to the understanding of the joint effects of air pollution.
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Affiliation(s)
- Amina Amadou
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France.
| | - Camille Giampiccolo
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France; Service de Biostatistique-Bioinformatique, Pole Sante Publique, Hospices Civils de Lyon, Lyon, France; Laboratoire de Biometrie Et Biologie Evolutive, CNRS UMR 5558, Villeurbanne, France
| | - Fabiola Bibi Ngaleu
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France
| | - Delphine Praud
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France
| | - Thomas Coudon
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France
| | - Lény Grassot
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France
| | - Elodie Faure
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France
| | - Florian Couvidat
- National Institute for industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France
| | - Pauline Frenoy
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France
| | - Gianluca Severi
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France; Department of Statistics, Computer Science and Applications (DISIA), University of Florence, Italy
| | - Francesca Romana Mancini
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France.
| | - Pascal Roy
- Université Claude Bernard Lyon 1, Lyon, France; Service de Biostatistique-Bioinformatique, Pole Sante Publique, Hospices Civils de Lyon, Lyon, France; Laboratoire de Biometrie Et Biologie Evolutive, CNRS UMR 5558, Villeurbanne, France
| | - Béatrice Fervers
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France.
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14
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Choi JW, Oh J, Bennett DH, Calafat AM, Schmidt RJ, Shin HM. Prenatal exposure to per- and polyfluoroalkyl substances and child behavioral problems. ENVIRONMENTAL RESEARCH 2024; 251:118511. [PMID: 38387490 PMCID: PMC11144101 DOI: 10.1016/j.envres.2024.118511] [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: 10/27/2023] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) may adversely affect child behaviors; however, findings of epidemiologic studies are inconsistent. We examined prenatal PFAS exposure in association with child behavioral problems. METHODS Participants were 177 mother-child pairs from MARBLES (Markers of Autism Risk in Babies - Learning Early Signs), a cohort with elevated familial likelihood of autism spectrum disorder (ASD). We quantified nine PFAS in maternal serum (1-3 samples per mother) collected from the 1st to 3rd trimesters of pregnancy. Child behavioral problems were assessed at 3 years of age using the Child Behavior Checklist (CBCL), developed to test for various behavioral problems of children. We examined associations of the CBCL scores with individual PFAS concentrations and with their mixture using negative binomial regression and weighted quantile sum regression models. RESULTS Higher prenatal perfluorononanoate (PFNA) concentrations were associated with higher scores of externalizing problems [β = 0.16, 95% CI (0.01, 0.32)] and aggressive behavior [β = 0.17 (0.01, 0.32)]. Higher PFNA, perfluorooctane sulfonate (PFOS), and perfluorodecanoate (PFDA) were associated with higher scores of sleep problems [β = 0.34 (0.15, 0.54) for PFNA, β = 0.20 (0.02, 0.37) for PFOS, and β = 0.19 (0.00, 0.37) for PFDA]. No significant associations observed for typically developing children, whereas PFOS, PFNA, and PFDA were associated with several behavioral problems among children diagnosed with ASD or other neurodevelopmental concerns. Exposure to a mixture of PFAS was associated with higher scores of sleep problems and aggressive behavior, mostly contributed by PFNA and PFDA. CONCLUSIONS Our study showed that prenatal exposure to some PFAS could increase child behavioral problems at 3 years of age. However, our results should be interpreted with caution because we relied on data from a cohort with increased familial likelihood of ASD and thereby had more behavioral problems.
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Affiliation(s)
- Jeong Weon Choi
- Department of Environmental Science, Baylor University, Waco, TX, USA.
| | - Jiwon Oh
- Department of Public Health Sciences, University of California, Davis, CA, USA
| | - Deborah H Bennett
- Department of Public Health Sciences, University of California, Davis, CA, USA
| | | | - Rebecca J Schmidt
- Department of Public Health Sciences, University of California, Davis, CA, USA; MIND Institute, Sacramento, CA, USA
| | - Hyeong-Moo Shin
- Department of Environmental Science, Baylor University, Waco, TX, USA
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15
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Zhang D, Yan Z, He J, Yao Y, Liu K. The exposure to volatile organic compounds associate positively with overactive bladder risk in U.S. adults: a cross-sectional study of 2007-2020 NHANES. Front Public Health 2024; 12:1374959. [PMID: 38912261 PMCID: PMC11190323 DOI: 10.3389/fpubh.2024.1374959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/27/2024] [Indexed: 06/25/2024] Open
Abstract
Objective The aim of this study was to comprehensively investigate the potential relationship between blood volatile organic compounds (VOCs) and overactive bladder (OAB) risk. Methods A total of 11,183 participants from the 2007-2020 National Health and Nutrition Examination Survey (NHANES) were included in this cross-sectional study. We used multivariate logistic regression models to investigate the relationship between nine blood VOCs and OAB risk. Restricted cubic spline (RCS) analysis was used to investigate the dose-response relationship between blood VOCs and OAB. In addition, the overall association of blood VOCs with OAB risk was assessed by weighted quantile sum (WQS) regression model. Finally, we conducted subgroup analyses to explore the findings in different high-risk populations. Results After adjusting for potential confounders, logistic regression analysis revealed that blood 2,5-dimethylfuran (aOR = 2.940, 95% CI: 1.096-7.890, P = 0.032), benzene (aOR = 1.460, 95% CI: 1.044-2.043, P = 0.027) and furan (aOR = 9.426, 95% CI: 1.421-62.500, P = 0.020) were positively independent associated with the risk of OAB. And dose-response risk curves indicated that 2,5-dimethylfuran, benzene and furan in the blood were linearly positive associated with OAB risk. WQS regression analysis showed that exposure to mixed blood VOCs increased the risk of OAB (OR = 1.29, 95% CI: 1.11-1.49), with furans having the greatest weight. In subgroup analyses, we found that OAB was more susceptible to blood VOCs in young and middle-aged, male, non-hypertensive, and alcohol-drinking populations. Conclusions The results of this study indicate that high exposure to VOCs is independently and positively associated with OAB risk in U.S. adults, particularly 2,5-dimethylfuran, benzene, and furan. In addition, age, gender, hypertension and alcohol consumption may influence the association. Our study provided novel epidemiologic evidence to explore the potential role of environmental pollutants in OAB.
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Affiliation(s)
| | | | | | - Yunmin Yao
- Department of Urology, The Fifth People's Hospital of Wujiang District, Suzhou, China
| | - Kai Liu
- Department of Urology, The Fifth People's Hospital of Wujiang District, Suzhou, China
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16
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Shi X, Wang X, Zhang J, Dang Y, Ouyang C, Pan J, Yang A, Hu X. Associations of mixed metal exposure with chronic kidney disease from NHANES 2011-2018. Sci Rep 2024; 14:13062. [PMID: 38844557 PMCID: PMC11156859 DOI: 10.1038/s41598-024-63858-3] [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: 01/15/2024] [Accepted: 06/03/2024] [Indexed: 06/09/2024] Open
Abstract
Metals have been proved to be one of risk factors for chronic kidney disease (CKD) and diabetes, but the effect of mixed metal co-exposure and potential interaction between metals are still unclear. We assessed the urine and whole blood levels of cadmium (Cd), manganese (Mn), lead (Pb), mercury (Hg), and renal function in 3080 adults from National Health and Nutrition Survey (NHANES) (2011-2018) to explore the effect of mixed metal exposure on CKD especially in people with type 2 diabetes mellitus (T2DM). Weighted quantile sum regression model and Bayesian Kernel Machine Regression model were used to evaluate the overall exposure impact of metal mixture and potential interaction between metals. The results showed that the exposure to mixed metals was significantly associated with an increased risk of CKD in blood glucose stratification, with the risk of CKD being 1.58 (1.26,1.99) times in urine and 1.67 (1.19,2.34) times in whole blood higher in individuals exposed to high concentrations of the metal mixture compared to those exposed to low concentrations. The effect of urine metal mixture was elevated magnitude in stratified analysis. There were interactions between urine Pb and Cd, Pb and Mn, Pb and Hg, Cd and Mn, Cd and Hg, and blood Pb and Hg, Mn and Cd, Mn and Pb, Mn and Hg on the risk of CKD in patients with T2DM and no significant interaction between metals was observed in non-diabetics. In summary, mixed metal exposure increased the risk of CKD in patients with T2DM, and there were complex interactions between metals. More in-depth studies are needed to explore the mechanism and demonstrate the causal relationship.
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MESH Headings
- Humans
- Renal Insufficiency, Chronic/chemically induced
- Renal Insufficiency, Chronic/blood
- Renal Insufficiency, Chronic/epidemiology
- Renal Insufficiency, Chronic/urine
- Female
- Male
- Middle Aged
- Nutrition Surveys
- Adult
- Environmental Exposure/adverse effects
- Diabetes Mellitus, Type 2/epidemiology
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/complications
- Cadmium/blood
- Cadmium/urine
- Cadmium/adverse effects
- Cadmium/toxicity
- Risk Factors
- Lead/blood
- Lead/urine
- Lead/toxicity
- Metals, Heavy/blood
- Metals, Heavy/urine
- Metals, Heavy/adverse effects
- Metals, Heavy/toxicity
- Aged
- Metals/urine
- Metals/blood
- Metals/adverse effects
- Manganese/urine
- Manganese/blood
- Manganese/adverse effects
- Bayes Theorem
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Affiliation(s)
- Xiaoru Shi
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Xiao Wang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Jia Zhang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Ying Dang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Changping Ouyang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Jinhua Pan
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China
| | - Aimin Yang
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Xiaobin Hu
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, No.199, Donggang West Road, Chengguan District, Lanzhou, 730000, Gansu Province, China.
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17
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Oluyemi K, Rechtman E, Invernizzi A, Gennings C, Renzetti S, Patrono A, Cagna G, Reichenberg A, Smith DR, Lucchini RG, Wright RO, Placidi D, Horton MK. Sex-specific associations between co-exposure to multiple metals and externalizing symptoms in adolescence and young adulthood. ENVIRONMENTAL RESEARCH 2024; 250:118443. [PMID: 38365053 PMCID: PMC11102844 DOI: 10.1016/j.envres.2024.118443] [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: 11/07/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/18/2024]
Abstract
Externalizing disorders, such as attention-deficit/hyperactivity disorder (ADHD), account for the majority of the child/adolescent referrals to mental health services and increase risk for later-life psychopathology. Although the expression of externalizing disorders is more common among males, few studies have addressed how sex modifies associations between metal exposure and adolescent externalizing symptoms. This study aimed to examine sex-specific associations between co-exposure to multiple metals and externalizing symptoms in adolescence and young adulthood. Among 150 adolescents and young adults (55% female, ages: 15-25 years) enrolled in the Public Health Impact of Metals Exposure (PHIME) study in Brescia, Italy, we measured five metals (manganese (Mn), lead (Pb), copper (Cu), chromium (Cr), nickel (Ni)) in four biological matrices (blood, urine, hair, and saliva). Externalizing symptoms were assessed using the Achenbach System of Empirically Based Assessment (ASEBA) Youth Self-Report (YSR) or Adult Self Report (ASR). Using generalized weighted quantile sum (WQS) regression, we investigated the moderating effect of sex (i.e., assigned at birth) on associations between the joint effect of exposure to the metal mixture and externalizing symptoms, adjusting for age and socioeconomic status. We observed that metal mixture exposure was differentially associated with aggressive behavior in males compared to females (β = -0.058, 95% CI [-0.126, -0.009]). In males, exposure was significantly associated with more externalizing problems, and aggressive and intrusive behaviors, driven by Pb, Cu and Cr. In females, exposure was not significantly associated with any externalizing symptoms. These findings suggest that the effect of metal exposure on externalizing symptoms differs in magnitude between the sexes, with males being more vulnerable to increased externalizing symptoms following metal exposure. Furthermore, our findings support the hypothesis that sex-specific vulnerabilities to mixed metal exposure during adolescence/young adulthood may play a role in sex disparities observed in mental health disorders, particularly those characterized by externalizing symptoms.
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Affiliation(s)
- Kristie Oluyemi
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Nash Family Department of Neuroscience Icahn School of Medicine at Mount Sinai, New York NY, USA; The Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Elza Rechtman
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Azzurra Invernizzi
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stefano Renzetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Alessandra Patrono
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Giuseppa Cagna
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Donald R Smith
- Department of Microbiology and Environmental Toxicology, University of California Santa Cruz, Santa Cruz, CA, USA
| | - Roberto G Lucchini
- Department of Environmental Health Sciences, Robert Stempel School of Public Health, Florida International University, Miami, FL, USA; Department of Biomedical, Metabolic Sciences and Neurosciences, University of Modena, Italy
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Donatella Placidi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Megan K Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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18
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Oh J, Schweitzer JB, Buckley JP, Upadhyaya S, Kannan K, Herbstman JB, Ghassabian A, Schmidt RJ, Hertz-Picciotto I, Bennett DH. Early childhood exposures to phthalates in association with attention-deficit/hyperactivity disorder behaviors in middle childhood and adolescence in the ReCHARGE study. Int J Hyg Environ Health 2024; 259:114377. [PMID: 38692176 DOI: 10.1016/j.ijheh.2024.114377] [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: 02/08/2024] [Revised: 03/19/2024] [Accepted: 03/31/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Early-life exposure to phthalates alters behaviors in animals. However, epidemiological evidence on childhood phthalate exposure and attention-deficit/hyperactivity disorder (ADHD) behaviors is limited. METHODS This study included 243 children from the ReCHARGE (Revisiting Childhood Autism Risks from Genetics and Environment) study, who were previously classified as having autism spectrum disorder (ASD), developmental delay, other early concerns, and typical development in the CHARGE case-control study. Twenty phthalate metabolites were measured in spot urine samples collected from children aged 2-5 years. Parents reported on children's ADHD symptoms at ages 8-18 years using Conners-3 Parent Rating Scale. Covariate-adjusted negative binomial generalized linear models were used to investigate associations between individual phthalate metabolite concentrations and raw scores. Weighted quantile sum (WQS) regression with repeated holdout validation was used to examine mixture effects of phthalate metabolites on behavioral scores. Effect modification by child sex was evaluated. RESULTS Among 12 phthalate metabolites detected in >75% of the samples, higher mono-2-heptyl phthalate (MHPP) was associated with higher scores on Inattentive (β per doubling = 0.05, 95% confidence interval [CI]: 0.02, 0.08) and Hyperactive/Impulsive scales (β = 0.04, 95% CI: 0.00, 0.07), especially among children with ASD. Higher mono-carboxy isooctyl phthalate (MCiOP) was associated with higher Hyperactivity/Impulsivity scores (β = 0.07, 95% CI: -0.01, 0.15), especially among typically developing children. The associations of the molar sum of high molecular weight (HMW) phthalate metabolites and a phthalate metabolite mixture with Hyperactivity/Impulsivity scores were modified by sex, showing more pronounced adverse associations among females. CONCLUSION Exposure to phthalates during early childhood may impact ADHD behaviors in middle childhood and adolescence, particularly among females. Although our findings may not be broadly generalizable due to the diverse diagnostic profiles within our study population, our robust findings on sex-specific associations warrant further investigations.
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Affiliation(s)
- Jiwon Oh
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | - Julie B Schweitzer
- Department of Psychiatry and Behavioral Sciences, University of California at Davis, Sacramento, CA, USA; UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA
| | - Jessie P Buckley
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sudhi Upadhyaya
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kurunthachalam Kannan
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany, NY, USA; Department of Environmental Health Sciences, University at Albany, State University of New York, Albany, NY, USA
| | - Julie B Herbstman
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Akhgar Ghassabian
- Department of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Rebecca J Schmidt
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA; UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA; UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA
| | - Deborah H Bennett
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA.
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19
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Gogna P, Borghese MM, Villeneuve PJ, Kumarathasan P, Johnson M, Shutt RH, Ashley-Martin J, Bouchard MF, King WD. A cohort study of the multipollutant effects of PM 2.5, NO 2, and O 3 on C-reactive protein levels during pregnancy. Environ Epidemiol 2024; 8:e308. [PMID: 38799262 PMCID: PMC11115979 DOI: 10.1097/ee9.0000000000000308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 03/18/2024] [Indexed: 05/29/2024] Open
Abstract
Background PM2.5, NO2, and O3 contribute to the development of adverse pregnancy complications. While studies have investigated the independent effects of these exposures, literature on their combined effects is limited. Our objective was to study the multipollutant effects of PM2.5, NO2, and O3 on maternal systemic C-reactive protein (CRP) levels. Methods We used data from 1170 pregnant women enrolled in the Maternal-Infant Research on Environmental Chemicals Study (MIREC) study in Canada. Air pollution exposures were assigned to each participant based on residential location. CRP was measured in third-trimester blood samples. We fit multipollutant linear regression models and evaluated the effects of air pollutant mixtures (14-day averages) using repeated-holdout Weighted Quantile Sum (WQS) regression and by calculating the Air Quality Health Index (AQHI). Results In multipollutant models adjusting for NO2, O3, and green space, each interquartile range (IQR) increase in 14-day average PM2.5 (IQR: 6.9 µg/m3) was associated with 27.1% (95% confidence interval [CI] = 6.2, 50.7) higher CRP. In air pollution mixture models adjusting for green space, each IQR increase in AQHI was associated with 37.7% (95% CI = 13.9, 66.5) higher CRP; and an IQR increase in the WQS index was associated with 78.6% (95% CI = 29.7, 146.0) higher CRP. Conclusion PM2.5 has the strongest relationship of the individual pollutants examined with maternal blood CRP concentrations. Mixtures incorporating all three pollutants, assessed using the AQHI and WQS index, showed stronger relationships with CRP compared with individual pollutants and illustrate the importance of conducting multipollutant analyses.
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Affiliation(s)
- Priyanka Gogna
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Michael M. Borghese
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Paul J. Villeneuve
- School of Mathematics and Statistics, Carleton University, Ottawa, Ontario, Canada
| | | | - Markey Johnson
- Water and Air Quality Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Robin H. Shutt
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Jillian Ashley-Martin
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | | | - Will D. King
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
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20
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Feng C, Yang B, Wang Z, Zhang J, Fu Y, Yu B, Dong S, Ma H, Liu H, Zeng H, Reinhardt JD, Yang S. Relationship of long-term exposure to air pollutant mixture with metabolic-associated fatty liver disease and subtypes: A retrospective cohort study of the employed population of Southwest China. ENVIRONMENT INTERNATIONAL 2024; 188:108734. [PMID: 38744043 DOI: 10.1016/j.envint.2024.108734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND While evidence suggests that PM2.5 is associated with overall prevalence of Metabolic (dysfunction)-Associated Fatty Liver Disease (MAFLD), effects of comprehensive air pollutant mixture on MAFLD and its subtypes remain unclear. OBJECTIVE To investigate individual and joint effects of long-term exposure to comprehensive air pollutant mixture on MAFLD and its subtypes. METHODS Data of 27,699 participants of the Chinese Cohort of Working Adults were analyzed. MAFLD and subtypes, including overweight/obesity, lean, and diabetes MAFLD, were diagnosed according to clinical guidelines. Concentrations of NO3-, SO42-, NH4+, organic matter (OM), black carbon (BC), PM2.5, SO2, NO2, O3 and CO were estimated as a weighted average over participants' residential and work addresses for the three years preceding outcome assessment. Logistic regression and weighted quantile sum regression were used to estimate individual and joint effects of air pollutant mixture on presence of MAFLD. RESULTS Overall prevalence of MAFLD was 26.6 % with overweight/obesity, lean, and diabetes MAFLD accounting for 92.0 %, 6.4 %, and 1.6 %, respectively. Exposure to SO42-, NO3-, NH4+, BC, PM2.5, NO2, O3and CO was significantly associated with overall MAFLD, overweight/obesity MAFLD, or lean MAFLD in single pollutant models. Joint effects of air pollutant mixture were observed for overall MAFLD (OR = 1.10 [95 % CI: 1.03, 1.17]), overweight/obesity (1.09 [1.02, 1.15]), and lean MAFLD (1.63 [1.28, 2.07]). Contributions of individual air pollutants to joint effects were dominated by CO in overall and overweight/obesity MAFLD (Weights were 42.31 % and 45.87 %, respectively), while SO42- (36.34 %), SO2 (21.00 %) and BC (12.38 %) were more important in lean MAFLD. Being male, aged above 45 years and smoking increased joint effects of air pollutant mixture on overall MAFLD. CONCLUSIONS Air pollutant mixture was associated with MAFLD, particularly the lean MAFLD subtype. CO played a pivotal role in both overall and overweight/obesity MAFLD, whereas SO42- were associated with lean MAFLD.
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Affiliation(s)
- Chuanteng Feng
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu 610200, China; West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Bo Yang
- Department of Health Management Center, Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu 610106, China
| | - Zihang Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Jiayi Zhang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yao Fu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Bin Yu
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu 610200, China; West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Shu Dong
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Hua Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Hongyun Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Honglian Zeng
- Department of Health Management Center, Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu 610106, China
| | - Jan D Reinhardt
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu 610200, China; Department of Rehabilitation Medicine, Jiangsu Province Hospital/Nanjing Medical University First Affiliated Hospital, Nanjing 210009, China; Department of Health Sciences and Medicine, University of Lucerne, Lucerne 6002, Switzerland.
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China; Department of Health Management Center, Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu 610106, China; International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan 430079, China.
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21
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Zhu G, Wen Y, Cao K, He S, Wang T. A review of common statistical methods for dealing with multiple pollutant mixtures and multiple exposures. Front Public Health 2024; 12:1377685. [PMID: 38784575 PMCID: PMC11113012 DOI: 10.3389/fpubh.2024.1377685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/15/2024] [Indexed: 05/25/2024] Open
Abstract
Traditional environmental epidemiology has consistently focused on studying the impact of single exposures on specific health outcomes, considering concurrent exposures as variables to be controlled. However, with the continuous changes in environment, humans are increasingly facing more complex exposures to multi-pollutant mixtures. In this context, accurately assessing the impact of multi-pollutant mixtures on health has become a central concern in current environmental research. Simultaneously, the continuous development and optimization of statistical methods offer robust support for handling large datasets, strengthening the capability to conduct in-depth research on the effects of multiple exposures on health. In order to examine complicated exposure mixtures, we introduce commonly used statistical methods and their developments, such as weighted quantile sum, bayesian kernel machine regression, toxic equivalency analysis, and others. Delineating their applications, advantages, weaknesses, and interpretability of results. It also provides guidance for researchers involved in studying multi-pollutant mixtures, aiding them in selecting appropriate statistical methods and utilizing R software for more accurate and comprehensive assessments of the impact of multi-pollutant mixtures on human health.
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Affiliation(s)
- Guiming Zhu
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
- Key Laboratory of Coal Environmental Pathogenicity and Prevention (Shanxi Medical University), Ministry of Education, Taiyuan, China
| | - Yanchao Wen
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
- Key Laboratory of Coal Environmental Pathogenicity and Prevention (Shanxi Medical University), Ministry of Education, Taiyuan, China
| | - Kexin Cao
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
- Key Laboratory of Coal Environmental Pathogenicity and Prevention (Shanxi Medical University), Ministry of Education, Taiyuan, China
| | - Simin He
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
- Key Laboratory of Coal Environmental Pathogenicity and Prevention (Shanxi Medical University), Ministry of Education, Taiyuan, China
| | - Tong Wang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
- Key Laboratory of Coal Environmental Pathogenicity and Prevention (Shanxi Medical University), Ministry of Education, Taiyuan, China
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22
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Park B, Kim B, Kim CH, Oh HJ, Park B. Association between endocrine-disrupting chemical mixtures and non-alcoholic fatty liver disease with metabolic syndrome as a mediator among adults: A population-based study in Korea. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 276:116310. [PMID: 38614002 DOI: 10.1016/j.ecoenv.2024.116310] [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: 02/06/2024] [Revised: 04/03/2024] [Accepted: 04/06/2024] [Indexed: 04/15/2024]
Abstract
Endocrine-disrupting chemicals (EDCs) may play a role in non-alcoholic fatty liver disease (NAFLD); however, studies on the combined effects of EDC mixtures on NAFLD development are limited. Here, we explored the association between exposure to EDC mixtures and NAFLD and investigated the potential mediating role of metabolic syndrome (MetS). We included participants from the Korean National Environmental Health Survey Cycle 4 (2018-2020) and quantified the urinary concentrations of various EDCs-eight phthalate metabolites, three phenols, one antibacterial compound, four parabens, four polycyclic aromatic hydrocarbons, and one pyrethroid pesticide metabolite-as well as serum concentrations of five perfluorinated compounds (PFCs). NAFLD was defined as a hepatic steatosis index (HSI) ≥36 or a fatty liver index (FLI) ≥60. Weighted quantile sum (WQS) regression was employed to evaluate the associations between EDC mixtures and the risk of MetS or NAFLD. Causal mediation analysis was conducted to explore the potential mediating effect of MetS on the association between mixtures of EDCs and NAFLD risk. All estimates were adjusted for age, sex, educational level, physical activity, smoking status, involuntary smoking, and drinking habits. A total of 2942 adults were included in the analysis. Moderate-to-high positive correlations were identified between phthalate metabolites and PFCs. Higher WQS scores were associated with an elevated risk of MetS and NAFLD. The sex-stratified WQS regression model showed that the interactions between the WQS index and sex were significant for MetS and NAFLD. According to the causal mediation analysis, both the direct and indirect effects of EDC mixtures on NAFLD, with MetS as a mediator, were significant in females. Collectively, these findings highlight the need for interventions that could address both EDC mixture exposure and metabolic status to effectively reduce the risks associated with NAFLD and its related complications.
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Affiliation(s)
- Bohyun Park
- National Cancer Control Institute, National Cancer Center, Goyang, the Republic of Korea.
| | - Byungmi Kim
- National Cancer Control Institute, National Cancer Center, Goyang, the Republic of Korea.
| | - Chung Ho Kim
- Department of Preventive Medicine, College of Medicine, Chung-Ang University, Seoul, the Republic of Korea.
| | - Hyun Jin Oh
- Division of Gastroenterology, Department of Internal Medicine, Center for Cancer Prevention and Detection, National Cancer Center, Goyang, the Republic of Korea.
| | - Bomi Park
- Department of Preventive Medicine, College of Medicine, Chung-Ang University, Seoul, the Republic of Korea.
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Svensson K, Gennings C, Lindh C, Kiviranta H, Rantakokko P, Wikström S, Bornehag CG. EDC mixtures during pregnancy and body fat at 7 years of age in a Swedish cohort, the SELMA study. ENVIRONMENTAL RESEARCH 2024; 248:118293. [PMID: 38281561 DOI: 10.1016/j.envres.2024.118293] [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: 09/05/2023] [Revised: 01/19/2024] [Accepted: 01/21/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Some endocrine disrupting chemicals (EDC), are "obesogens" and have been associated with overweight and obesity in children. Daily exposure to different classes of EDCs demands for research with mixtures approach. OBJECTIVES This study evaluates the association, considering sex-specific effects, between prenatal exposure to EDC mixture and children's body fat at seven years of age. METHODS A total of 26 EDCs were assessed in prenatal urine and serum samples from first trimester in pregnancy from 737 mother-child pairs participating in the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy (SELMA) study. An indicator for children's "overall body fat" was calculated, using principal component analysis (PCA), based on BMI, percent body fat, waist, and skinfolds measured at seven years of age. Weighted quantile sum (WQS) regression was used to assess associations between EDC mixture and children's body fat. RESULTS Principal component (PC1) represented 83.6 % of the variance, suitable as indicator for children's "overall body fat", with positive loadings of 0.40-0.42 for each body fat measure. A significant interaction term, WQS*sex, confirmed associations in the opposite direction for boys and girls. Higher prenatal exposure to EDC mixture was borderline significant with more "overall body fat" for boys (Mean β = 0.20; 95 % CI: -0.13, 0.53) and less for girls (Mean β = -0.23; 95 % CI: -0.58, 0.13). Also, higher prenatal exposure to EDC mixture was borderline significant with more percent body fat (standardized score) for boys (Mean β = 0.09; 95 % CI: -0.04, 0.21) and less for girls (Mean β = -0.10 (-0.26, 0.05). The chemicals of concern included bisphenols, phthalates, PFAS, PAH, and pesticides with different patterns for boys and girls. DISCUSSION Borderline significant associations were found between prenatal exposure to a mixture of EDCs and children's body fat. The associations in opposite directions suggests that prenatal exposure to EDCs may present sex-specific effects on children's body fat.
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Affiliation(s)
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christian Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Hannu Kiviranta
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Panu Rantakokko
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Sverre Wikström
- Department of Health Sciences, Karlstad University, Karlstad, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden; Centre for Clinical Research, County Council of Värmland, Sweden
| | - Carl-Gustaf Bornehag
- Department of Health Sciences, Karlstad University, Karlstad, Sweden; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Jang H, Choi KH, Cho YM, Han D, Hong YS. Environmental risk score of multiple pollutants for kidney damage among residents in vulnerable areas by occupational chemical exposure in Korea. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:35938-35951. [PMID: 38743333 PMCID: PMC11136836 DOI: 10.1007/s11356-024-33567-5] [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: 11/17/2023] [Accepted: 04/30/2024] [Indexed: 05/16/2024]
Abstract
This study aimed to develop an environmental risk score (ERS) of multiple pollutants (MP) causing kidney damage (KD) in Korean residents near abandoned metal mines or smelters and evaluate the association between ERS and KD by a history of occupational chemical exposure (OCE). Exposure to MP, consisting of nine metals, four polycyclic aromatic hydrocarbons, and four volatile organic compounds, was measured as urinary metabolites. The study participants were recruited from the Forensic Research via Omics Markers (FROM) study (n = 256). Beta-2-microglobulin (β2-MG), N-acetyl-β-D-glucosaminidase (NAG), and estimated glomerular filtration rate (eGFR) were used as biomarkers of KD. Bayesian kernel machine regression (BKMR) was selected as the optimal ERS model with the best performance and stability of the predicted effect size among the elastic net, adaptive elastic net, weighted quantile sum regression, BKMR, Bayesian additive regression tree, and super learner model. Variable importance was estimated to evaluate the effects of metabolites on KD. When stratified with the history of OCE after adjusting for several confounding factors, the risks for KD were higher in the OCE group than those in the non-OCE group; the odds ratio (OR; 95% CI) for ERS in non-OCE and OCE groups were 2.97 (2.19, 4.02) and 6.43 (2.85, 14.5) for β2-MG, 1.37 (1.01, 1.86) and 4.16 (1.85, 9.39) for NAG, and 4.57 (3.37, 6.19) and 6.44 (2.85, 14.5) for eGFR, respectively. We found that the ERS stratified history of OCE was the most suitable for evaluating the association between MP and KD, and the risks were higher in the OCE group than those in the non-OCE group.
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Affiliation(s)
- Hyuna Jang
- Department of Environmental Science, Baylor University, Waco, TX, USA
| | - Kyung-Hwa Choi
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea.
| | - Yong Min Cho
- Institute of Environmental Health, Seokyeong University, Seoul, Republic of Korea
- Department of Environmental Chemical Engineering, Seokyeong University, Seoul, Republic of Korea
| | - Dahee Han
- Institute of Environmental Health, Seokyeong University, Seoul, Republic of Korea
- Department of Environmental Chemical Engineering, Seokyeong University, Seoul, Republic of Korea
| | - Young Seoub Hong
- Department of Preventive Medicine, Dong-A University College of Medicine, Busan, Republic of Korea
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Qiao JC, Li ZH, Ma YB, Ma HY, Zhang MY, Zhang XJ, Hu CY. Associations of per- and polyfluoroalkyl substances (PFAS) and their mixture with risk of rheumatoid arthritis in the U.S. adult population. Environ Health 2024; 23:38. [PMID: 38609943 PMCID: PMC11015572 DOI: 10.1186/s12940-024-01073-3] [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: 01/04/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) are known environmental contaminants with immunosuppressive properties. Their connection to rheumatoid arthritis (RA), a condition influenced by the immune system, is not well studied. This research explores the association between PFAS exposure and RA prevalence. METHODS This research utilized data from the NHANES, encompassing a sample of 10,496 adults from the 2003-2018 cycles, focusing on serum levels of several PFAS. The presence of RA was determined based on self-reports. This study used multivariable logistic regression to assess the relationship between individual PFAS and RA risk, adjusting for covariates to calculate odds ratios (ORs). The combined effects of PFAS mixtures were evaluated using BKMR, WQS regression, and quantile g-computation. Additionally, sex-specific associations were explored through stratified analysis. RESULTS Higher serum PFOA (OR = 0.88, 95% CI: 0.79, 0.98), PFHxS (OR = 0.91, 95% CI: 0.83, 1.00), PFNA (OR = 0.87, 95% CI: 0.77, 0.98), and PFDA (OR = 0.89, 95% CI: 0.81, 0.99) concentration was related to lower odds of RA. Sex-specific analysis in single chemical models indicated the significant inverse associations were only evident in females. BKMR did not show an obvious pattern of RA estimates across PFAS mixture. The outcomes of sex-stratified quantile g-computation demonstrated that an increase in PFAS mixture was associated with a decreased odds of RA in females (OR: 0.76, 95% CI: 0.62, 0.92). We identified a significant interaction term of the WQS*sex in the 100 repeated hold out WQS analysis. Notably, a higher concentration of the PFAS mixture was significantly associated with reduced odds of RA in females (mean OR = 0.93, 95% CI: 0.88, 0.98). CONCLUSIONS This study indicates potential sex-specific associations of exposure to various individual PFAS and their mixtures with RA. Notably, the observed inverse relationships were statistically significant in females but not in males. These findings contribute to the growing body of evidence indicating that PFAS may have immunosuppressive effects.
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Affiliation(s)
- Jian-Chao Qiao
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Zhen-Hua Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yu-Bo Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Hui-Ya Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
- Management & Checkup Center, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, 230022, China
| | - Meng-Yue Zhang
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xiu-Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei, 230032, China.
| | - Cheng-Yang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei, 230032, China.
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA.
- Department of Humanistic Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
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Zhang X, Colicino E, Cowell W, Enlow MB, Kloog I, Coull BA, Schwartz JD, Wright RO, Wright RJ. Prenatal exposure to air pollution and BWGA Z-score: Modifying effects of placenta leukocyte telomere length and infant sex. ENVIRONMENTAL RESEARCH 2024; 246:117986. [PMID: 38145728 DOI: 10.1016/j.envres.2023.117986] [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: 08/26/2023] [Revised: 12/01/2023] [Accepted: 12/17/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Air pollutants, such as fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3), have been associated with adverse birth outcomes, including low birth weight, often exhibiting sex-specific effects. However, the modifying effect of placental telomere length (TL), reflecting cumulative lifetime oxidative stress in mothers, remains unexplored. METHOD Using data from a Northeastern U.S. birth cohort (n = 306), we employed linear regression and weighted quantile sum models to assess trimester-average air pollution exposures and birth weight for gestational age (BWGA) z-scores. Placental TL, categorized by median split, was considered as an effect modifier. Interactions among air pollutants, placental TL, infant sex, and BWGA z-score were evaluated. RESULTS Without placental TL as a modifier, only 1st trimester O3 was significantly associated with BWGA z-scores (coefficient: 0.33, 95% CI: 0.03, 0.63). In models considering TL interactions, a significant modifying effect was observed between 3rd trimester NO2 and BWGA z-scores (interaction p-value = 0.02). Specifically, a one interquartile range (1-IQR) increase in 3rd trimester NO2 was linked to a 0.28 (95% CI: 0.06, 0.52) change in BWGA z-score among shorter placental TL group, with no significant association among longer TL group. Among male infants, there were significant associations between 3rd trimester PM2.5 exposure and BWGA z-scores in the longer TL group (coefficient: -0.34, 95% CI: -0.61, -0.02), and between 1st trimester O3 exposure and BWGA z-scores among males in the shorter TL group (coefficient: 0.59, 95% CI: 0.06, 1.08). For females, only a negative association in 2nd trimester mixture model was observed within the longer TL group (coefficient: -0.10, 95% CI: -0.21, -0.01). CONCLUSION These findings highlight the need to consider the complex interactions among prenatal air pollutant exposures, placental TL, and fetal sex to better elucidate those at greatest risk for adverse birth outcomes.
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Affiliation(s)
- Xueying Zhang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Whitney Cowell
- Department of Pediatrics, Grossman School of Medicine, New York University, New York, NY, USA
| | - Michelle Bosquet Enlow
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Itai Kloog
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel D Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Akinkugbe AA, Midya V, Duffy J, Landero J, Wright RO, Wright RJ. Metal mixtures and oral health among children and adolescents in the National Health and Nutrition Examination Survey (NHANES), 2017-2020. Int J Hyg Environ Health 2024; 257:114335. [PMID: 38330728 PMCID: PMC10939733 DOI: 10.1016/j.ijheh.2024.114335] [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: 10/23/2023] [Revised: 01/30/2024] [Accepted: 02/04/2024] [Indexed: 02/10/2024]
Abstract
INTRODUCTION Dental caries is the most common non-communicable human disease, yet little is known about the role of environmental metals, despite teeth consisting of a hard matrix of trace elements. We conducted a cross-sectional study of associations between environmental metals and objective assessment of dental caries and subjective assessments of oral health among a representative sample of U.S. children and adolescents. METHODS Data were from the 2017-March 2020 pre-pandemic data file of the National Health and Nutrition Examination Survey (NHANES). To account for metal mixtures, we used weighted quantile sum (WQS) regression to estimate the joint impact of multiple trace elements assessed in blood and urine with oral disease outcomes. RESULTS The blood metal mixture index was associated with a 32% (95% CI: 1.11, 1.56) increased risk of decayed surfaces while the urine metal mixture index was associated with a 106%, RR (95% CI = 2.06 (1.58, 2.70) increased caries risk. For both blood and urine, Mercury (Hg) had the largest contribution to the mixture index followed by Lead (Pb). The WQS blood metal mixture index was also significantly associated with poorer self-rated oral health, although the magnitude of the association was not as strong as for the objective oral disease measures, RR (95% CI) = 1.04 (1.02, 1.07). DISCUSSION Increased exposure to a metal mixture was significantly related to poorer objective and subjective oral health outcomes among U.S. children and adolescents. These are among the first findings showing that metal mixtures are a significant contributor to poor oral health.
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Affiliation(s)
- A A Akinkugbe
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - V Midya
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J Duffy
- Tufts University School of Medicine, Boston, MA, USA
| | - J Landero
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - R O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - R J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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28
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Oh J, Kim K, Kannan K, Parsons PJ, Mlodnicka A, Schmidt RJ, Schweitzer JB, Hertz-Picciotto I, Bennett DH. Early childhood exposure to environmental phenols and parabens, phthalates, organophosphate pesticides, and trace elements in association with attention deficit hyperactivity disorder (ADHD) symptoms in the CHARGE study. Environ Health 2024; 23:27. [PMID: 38486233 PMCID: PMC10938747 DOI: 10.1186/s12940-024-01065-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 02/23/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND A growing body of literature investigated childhood exposure to environmental chemicals in association with attention-deficit/hyperactivity disorder (ADHD) symptoms, but limited studies considered urinary mixtures of multiple chemical classes. This study examined associations of concurrent exposure to non-persistent chemicals with ADHD symptoms in children diagnosed with autism spectrum disorder (ASD), developmental delay (DD), and typical development (TD). METHODS A total of 549 children aged 2-5 years from the Childhood Autism Risks from Genetics and Environment (CHARGE) case-control study were administered the Aberrant Behavior Checklist (ABC). This study focused on the ADHD/noncompliance subscale and its two subdomains (hyperactivity/impulsivity, inattention). Sixty-two chemicals from four classes (phenols/parabens, phthalates, organophosphate pesticides, trace elements) were quantified in child urine samples, and 43 chemicals detected in > 70% samples were used to investigate their associations with ADHD symptoms. Negative binomial regression was used for single-chemical analysis, and weighted quantile sum regression with repeated holdout validation was applied for mixture analysis for each chemical class and all chemicals. The mixture analyses were further stratified by diagnostic group. RESULTS A phthalate metabolite mixture was associated with higher ADHD/noncompliance scores (median count ratio [CR] = 1.10; 2.5th, 97.5th percentile: 1.00, 1.21), especially hyperactivity/impulsivity (median CR = 1.09; 2.5th, 97.5th percentile: 1.00, 1.25). The possible contributors to these mixture effects were di-2-ethylhexyl phthalate (DEHP) metabolites and mono-2-heptyl phthalate (MHPP). These associations were likely driven by children with ASD as these were observed among children with ASD, but not among TD or those with DD. Additionally, among children with ASD, a mixture of all chemicals was associated with ADHD/noncompliance and hyperactivity/impulsivity, and possible contributors were 3,4-dihydroxy benzoic acid, DEHP metabolites, MHPP, mono-n-butyl phthalate, and cadmium. CONCLUSIONS Early childhood exposure to a phthalate mixture was associated with ADHD symptoms, particularly among children with ASD. While the diverse diagnostic profiles limited generalizability, our findings suggest a potential link between phthalate exposure and the comorbidity of ASD and ADHD.
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Affiliation(s)
- Jiwon Oh
- Department of Public Health Sciences, University of California at Davis (UC Davis), Davis, CA, USA.
| | - Kyoungmi Kim
- Department of Public Health Sciences, University of California at Davis (UC Davis), Davis, CA, USA
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA
| | - Kurunthachalam Kannan
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany, NY, USA
- Department of Environmental Health Sciences, University at Albany, State University of New York, Albany, NY, USA
| | - Patrick J Parsons
- Division of Environmental Health Sciences, Wadsworth Center, New York State Department of Health, Albany, NY, USA
- Department of Environmental Health Sciences, University at Albany, State University of New York, Albany, NY, USA
| | - Agnieszka Mlodnicka
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California at Davis (UC Davis), Sacramento, CA, USA
| | - Rebecca J Schmidt
- Department of Public Health Sciences, University of California at Davis (UC Davis), Davis, CA, USA
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA
| | - Julie B Schweitzer
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California at Davis (UC Davis), Sacramento, CA, USA
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California at Davis (UC Davis), Davis, CA, USA
- UC Davis MIND (Medical Investigations of Neurodevelopmental Disorders) Institute, Sacramento, CA, USA
| | - Deborah H Bennett
- Department of Public Health Sciences, University of California at Davis (UC Davis), Davis, CA, USA
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Yin T, Ji D, Su X, Zhou X, Wang X, He S, Jiang T, Yue X, Zhang H, Zhang Y, Peng J, Zou W, Liang D, Liu Y, Du Y, Zhang Z, Liang C, Cao Y. Using Bayesian and weighted regression to evaluate the association of idiopathic oligoastenoteratozoospermia with seminal plasma metal mixtures. CHEMOSPHERE 2024; 351:141202. [PMID: 38237779 DOI: 10.1016/j.chemosphere.2024.141202] [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: 04/06/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 01/28/2024]
Abstract
Idiopathic oligoastenoteratozoospermia (iOAT) affects 30% of infertile men of reproductive age. However, the associations between Cr, Fe, Cu, Se or Co levels and iOAT risk have not been determined. This research aimed to assess the associations between Cr, Fe, Cu, Se and Co levels as well as their mixtures in seminal plasma and the risk of iOAT and severe iOAT. Therefore, a case‒control study including 823 participants (416 iOAT patients and 407 controls) recruited from October 2021 to August 2022 at the reproductive medicine center of the First Affiliated Hospital of Anhui Medical University was conducted in Anhui, China. The concentrations of Cr, Fe, Cu, Se and Co in seminal plasma were detected via inductively coupled plasma‒mass spectrometry. Binary logistic regression models were used to assess the associations between the levels of Cr, Fe, Cu, Se and Co and the risk of iOAT and severe iOAT; additionally, Bayesian kernel machine regression (BKMR) and weighted quantile sum (WQS) regressions were performed to evaluate the joint effect of seminal plasma levels of Cr, Fe, Cu, Se and Co on the risk of iOAT and explore which elements contributed most to the relationship. We found significant associations between the concentrations of Fe, Cu and Se in seminal plasma and iOAT risk after adjusting for covariates (Fe, lowest tertile vs. second tertile: aOR = 1.86, 95% CI = 1.31, 2.64; Cu, lowest tertile vs. second tertile: aOR = 1.95, 95% CI = 1.37, 2.76; Se, lowest tertile vs. second tertile: aOR = 1.65, 95% CI = 1.17, 2.35). A lower Se concentration in seminal plasma (lowest tertile vs. second tertile: aOR = 1.84, 95% CI = 1.10, 3.10) was positively associated with the risk of severe iOAT. Additionally, we also observed an association between the concentration of Cr in seminal plasma and the risk of iOAT before adjusting for covariates (Cr, third tertile vs. lowest tertile: OR=1.44, 95% CI: 1.03, 2.02). According to the BKMR analyses, the risk of iOAT increased when the overall concentrations were less than the 25th percentile. The results from the WQS regression indicated that a negative WQS index was significantly associated with the iOAT risk, while a positive WQS index was not. Se and Fe had significant weights in the negative direction. In conclusion, lower Cu, Fe and Se levels in seminal plasma were positively associated with iOAT risk, while higher Cr levels in seminal plasma were positively associated with iOAT risk according to the single element model, and lower levels of Se were related to a greater risk of severe iOAT; when comprehensively considering all the results from BKMR and WQS regression, Fe, Se and Cr levels contributed most to this relationship.
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Affiliation(s)
- Tao Yin
- Department of Obstetrics and Gynaecology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Dongmei Ji
- Department of Obstetrics and Gynaecology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xun Su
- Department of Obstetrics and Gynaecology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xinyu Zhou
- Department of Obstetrics and Gynaecology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xin Wang
- Department of Obstetrics and Gynaecology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Shitao He
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Tingting Jiang
- School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xinyu Yue
- Department of Obstetrics and Gynaecology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Hua Zhang
- Department of Obstetrics and Gynaecology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Ying Zhang
- Department of Obstetrics and Gynaecology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Jie Peng
- Department of Obstetrics and Gynaecology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Weiwei Zou
- Department of Obstetrics and Gynaecology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Dan Liang
- Department of Obstetrics and Gynaecology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yajing Liu
- Department of Obstetrics and Gynaecology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yinan Du
- School of Basic Medical Sciences, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Zhiguo Zhang
- Department of Obstetrics and Gynaecology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Chunmei Liang
- Department of Obstetrics and Gynaecology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China; School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
| | - Yunxia Cao
- Department of Obstetrics and Gynaecology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
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Wang A, Wan Y, Qi W, Mahai G, Qian X, Zheng T, Li Y, Xu S, Xiao H, Xia W. Urinary biomarkers of exposure to organophosphate, pyrethroid, neonicotinoid insecticides and oxidative stress: A repeated measurement analysis among pregnant women. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169565. [PMID: 38145670 DOI: 10.1016/j.scitotenv.2023.169565] [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: 10/23/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 12/27/2023]
Abstract
Exposure to insecticides may be associated with increased oxidative stress (OS), but few studies have assessed the associations of OS biomarkers (OSBs) with exposure to multiple insecticides and their mixture, especially in pregnant women who are a vulnerable population. In the present study, 1,094 Chinese pregnant women were recruited and a total of 3,282 urine samples were collected at their three trimesters to measure eight metabolites of organophosphates, three metabolites of pyrethroids, nine typical neonicotinoids/their metabolites, and three OSBs of DNA damage (8-OHdG), RNA damage (8-OHG), and lipid peroxidation (HNE-MA). Among the twenty target insecticide metabolites, sixteen of them were frequently detected; thirteen of them were detected in over 86% of all the urine samples except for imidacloprid (IMI, detection frequency: 72.9%), desnitro-imidacloprid (DN-IMI, 70.0%), and clothianidin (CLO, 79.6%). The reproducibility of their concentrations across the three trimesters was poor to fair (intraclass correlation coefficients <0.50). Multiparity and warm season were related to higher urinary levels of some insecticide metabolites, while higher education level and inadequate weight gain during pregnancy were significantly associated with lower concentrations of certain insecticide metabolites. Linear mixed model analyses suggested that almost all the frequently detected insecticide metabolites [other than 3-phenoxybenzoic acid (3-PBA)] were significantly associated with elevated levels of the three OSBs (8-OHdG, 8-OHG, and HNE-MA), where the percent change (Δ%) ranged 8.10-36.0% for 8-OHdG, 8.49-34.7% for 8-OHG, and 5.92-182% for HNE-MA, respectively, with each interquartile ratio (IQR)-fold increase in the concentrations of the individual exposure biomarkers. Weighted quantile sum models demonstrated that the insecticide metabolite mixture was positively associated with the three OSBs. Overall, urinary desmethyl-clothianidin (DM-CLO) and 3,5,6-trichloro-2-pyridinol (TCPy) were the top insecticide exposure biomarkers contributing to the association with 8-OHdG and 8-OHG levels, while PNP contributed the most to the association with HNE-MA levels. These findings suggested that gestational exposure to organophosphates, pyrethroids, neonicotinoids, their transformation products, and their mixture may increase oxidative damage to lipids, RNA, and DNA during pregnancy.
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Affiliation(s)
- Aizhen Wang
- Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University and Technology, Wuhan, Hubei 430016, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China.
| | - Yanjian Wan
- Center for Public Health Laboratory Service, Institute of Environmental Health, Wuhan Centers for Disease Prevention & Control, Wuhan, Hubei 430024, PR China.
| | - Wei Qi
- Wuhan Jinyintan Hospital, Wuhan, Hubei 430040, PR China
| | - Gaga Mahai
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China.
| | - Xi Qian
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China.
| | - Tongzhang Zheng
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02912, United States.
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China.
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China.
| | - Han Xiao
- Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University and Technology, Wuhan, Hubei 430016, PR China.
| | - Wei Xia
- Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University and Technology, Wuhan, Hubei 430016, PR China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China.
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Khorrami Z, Pourkhosravani M, Karamoozian A, Jafari-Khounigh A, Akbari ME, Rezapour M, Khorrami R, Taghavi-Shahri SM, Amini H, Etemad K, Khanjani N. Ambient air pollutants and breast cancer stage in Tehran, Iran. Sci Rep 2024; 14:3873. [PMID: 38365800 PMCID: PMC10873290 DOI: 10.1038/s41598-024-53038-8] [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: 08/01/2023] [Accepted: 01/27/2024] [Indexed: 02/18/2024] Open
Abstract
This study aimed to examine the impacts of single and multiple air pollutants (AP) on the severity of breast cancer (BC). Data of 1148 diagnosed BC cases (2008-2016) were obtained from the Cancer Research Center and private oncologist offices in Tehran, Iran. Ambient PM10, SO2, NO, NO2, NOX, benzene, toluene, ethylbenzene, m-xylene, p-xylene, o-xylene, and BTEX data were obtained from previously developed land use regression models. Associations between pollutants and stage of BC were assessed by multinomial logistic regression models. An increase of 10 μg/m3 in ethylbenzene, o-xylene, m-xylene, and 10 ppb of NO corresponded to 10.41 (95% CI 1.32-82.41), 4.07 (1.46-11.33), 2.89 (1.08-7.73) and 1.08 (1.00-1.15) increase in the odds of stage I versus non-invasive BC, respectively. Benzene (OR, odds ratio = 1.16, 95% CI 1.01-1.33) and o-xylene (OR = 1.18, 1.02-1.38) were associated with increased odds of incidence of BC stages III & IV versus non-invasive stages. BC stage I and stage III&IV in women living in low SES areas was associated with significantly higher levels of benzene, ethylbenzene, o-xylene, and m-xylene. The highest multiple-air-pollutants quartile was associated with a higher odds of stage I BC (OR = 3.16) in patients under 50 years old. This study provides evidence that exposure to AP is associated with increased BC stage at diagnosis, especially under premenopause age.
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Affiliation(s)
- Zahra Khorrami
- Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Pourkhosravani
- Department of Geography and Urban Planning, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Ali Karamoozian
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Jafari-Khounigh
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Maysam Rezapour
- Department of Paramedicine, Amol School of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reihaneh Khorrami
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Heresh Amini
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Koorosh Etemad
- Cancer Research Center (CRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Narges Khanjani
- Department of Medical Education, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA.
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Tang L, Liu M, Tian J. Volatile organic compounds exposure associated with depression among U.S. adults: Results from NHANES 2011-2020. CHEMOSPHERE 2024; 349:140690. [PMID: 37995973 DOI: 10.1016/j.chemosphere.2023.140690] [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: 06/18/2023] [Revised: 10/18/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023]
Abstract
Volatile organic compounds (VOCs) are important contributors to air pollution. VOCs exposure was associated with various human diseases. Depression is one of the most prevalent mental disorders and poses a serious mental health burden. Although VOCs are neurotoxic and can damage the central nervous system, the association between VOCs exposure and depression remains obscure. Based on data from the National Health and Nutrition Examination Survey, we included 5676 adult individuals and 15 major components of urinary volatile organic compound metabolites (mVOCs). We comprehensively evaluated the potential association between each single urinary mVOC exposure and depressive symptoms using binary logistic and restricted cubic spline regression, whereas the weighted quantile sum regression and least absolute shrinkage and selection operator regression model were used to explore the mixture co-exposure association. The results indicated significantly higher mean concentrations of the 11 urinary mVOC components in the depression group than that in the non-depression group. And 12 mVOC components had a significantly positive association with depression. The overall effect of all 15 mVOCs components was also significantly positive. The corresponding odds ratio was 1.56 (95%CI: 1.2-2.03) in the categorical variable model and the regression coefficient was 0.36 (95%CI: 0.12-0.6) in the numerical variable model. Five urinary mVOCs (URXCYM, URXPHG, URX34 M, URXMB3, and URXAMC) were identified as the most relevant components associated with depression, with 89.06% total weights in the categorical variable model and 89.39% in the numerical variable model. The mVOCs were the biomarkers of VOCs, their concentrations in urine could specifically represent the contents of their metabolic parents in the human body. Considering that the metabolic parents of the above five mVOCs were predominantly acrylonitrile, toluene, styrene, acrylamide, 1,3-Butadiene, and xylenes, our results further indicated that exposure to these VOCs was closely related to depression, and more attention should be paid to the mental health risks of VOCs exposure.
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Affiliation(s)
- Liwei Tang
- Shenzhen Key Laboratory of Marine Biotechnology and Ecology, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, Guangdong, 518055, China
| | - Min Liu
- Shenzhen Key Laboratory of Marine Biotechnology and Ecology, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, Guangdong, 518055, China; Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, 518055, China
| | - Jing Tian
- Shenzhen Key Laboratory of Marine Biotechnology and Ecology, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, Guangdong, 518055, China.
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Zhao M, Xiao M, Tan Q, Ji J, Lu F. Cumulative residual cholesterol predicts the risk of cardiovascular disease in the general population aged 45 years and older. Lipids Health Dis 2024; 23:19. [PMID: 38243226 PMCID: PMC10797780 DOI: 10.1186/s12944-023-02000-0] [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: 10/30/2023] [Accepted: 12/31/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Numerous studies have affirmed a robust correlation between residual cholesterol (RC) and the occurrence of cardiovascular disease (CVD). However, the current body of literature fails to adequately address the link between alterations in RC and the occurrence of CVD. Existing studies have focused mainly on individual RC values. Hence, the primary objective of this study is to elucidate the association between the cumulative RC (Cum-RC) and the morbidity of CVD. METHODS The changes in RC were categorized into a high-level fast-growth group (Class 1) and a low-level slow-growth group (Class 2) by K-means cluster analysis. To investigate the relationship between combined exposure to multiple lipids and CVD risk, a weighted quantile sum (WQS) regression analysis was employed. This analysis involved the calculation of weights for total cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL), which were used to effectively elucidate the RC. RESULTS Among the cohort of 5,372 research participants, a considerable proportion of 45.94% consisted of males, with a median age of 58. In the three years of follow-up, 669 participants (12.45%) had CVD. Logistic regression analysis revealed that Class 2 individuals had a significantly reduced risk of developing CVD compared to Class 1. The probability of having CVD increased by 13% for every 1-unit increase in the Cum-RC according to the analysis of continuous variables. The restricted cubic spline (RCS) analysis showed that Cum-RC and CVD risk were linearly related (P for nonlinearity = 0.679). The WQS regression results showed a nonsignificant trend toward an association between the WQS index and CVD incidence but an overall positive trend, with the greatest contribution from TC (weight = 0.652), followed by LDL (weight = 0.348). CONCLUSION Cum-RC was positively and strongly related to CVD risk, suggesting that in addition to focusing on traditional lipid markers, early intervention in patients with increased RC may further reduce the incidence of CVD.
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Affiliation(s)
- Mengjie Zhao
- Xiyuan Hospital, China Academy of Chinese Medicine Sciences, Beijing, 100091, China
- NMPA Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Beijing, 100091, China
- National Clinical Research Center for Chinese Medicine Cardiology, Beijing, 100091, China
| | - Mengli Xiao
- Xiyuan Hospital, China Academy of Chinese Medicine Sciences, Beijing, 100091, China
| | - Qin Tan
- Xiyuan Hospital, China Academy of Chinese Medicine Sciences, Beijing, 100091, China
| | - Jinjin Ji
- Xiyuan Hospital, China Academy of Chinese Medicine Sciences, Beijing, 100091, China
| | - Fang Lu
- Xiyuan Hospital, China Academy of Chinese Medicine Sciences, Beijing, 100091, China.
- NMPA Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Beijing, 100091, China.
- National Clinical Research Center for Chinese Medicine Cardiology, Beijing, 100091, China.
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Duan X, Chen Z, Xia C, Zhong R, Liu L, Long L. Increased Levels of Urine Volatile Organic Compounds Are Associated With Diabetes Risk and Impaired Glucose Homeostasis. J Clin Endocrinol Metab 2024; 109:e531-e542. [PMID: 37793167 DOI: 10.1210/clinem/dgad584] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 10/06/2023]
Abstract
CONTEXT Volatile organic compounds (VOCs) are pervasive environmental pollutants that have been linked to various adverse health effects. However, the effect of ambient VOCs, whether individually or in mixtures, on diabetes remains uncertain and requires further investigation. OBJECTIVE This study investigates the effects of ambient VOCs exposure, whether single or mixed, on diabetes mellitus and glucose homeostasis in the general population. METHODS Urinary concentrations of VOC metabolites were obtained from the National Health and Nutrition Examination Survey. Survey-weighted logistic regression and generalized linear regression were used to explore the associations between individual VOC exposure and diabetes risk and glucose homeostasis indicators, respectively. Weighted quantile sum (WQS) regression models were applied to assess the combined effects of VOC mixtures. RESULTS Out of 8468 participants, 1504 had diabetes mellitus. Eight VOC metabolites showed positive associations with diabetes mellitus (OR, 1.15-1.43; all P < .05), insulin resistance (IR) (OR, 1.02-1.06; P < .05), and other glucose homeostasis indicators (β, 0.04-2.32; all P < .05). Mixed VOC models revealed positive correlations between the WQS indices and diabetes risk (OR = 1.52; 95% CI, 1.29-1.81), IR (OR = 1.36; 95% CI, 1.14-1.62), and other glucose homeostasis indicators (β, 0.17-2.22; all P < .05). CONCLUSION Urinary metabolites of ambient VOCs are significantly associated with an increased diabetes risk and impaired glucose homeostasis. Thus, primary prevention policies aimed at reducing ambient VOCs could attenuate diabetes burden.
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Affiliation(s)
- Xiaoxia Duan
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Zhenhua Chen
- Department of Microbiology Laboratory, Chengdu Municipal Center for Disease Control and Prevention, Chengdu 610031, China
| | - Congying Xia
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Rong Zhong
- Department of Epidemiology and Health Statistics, School of Public Health, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Li Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510310, China
| | - Lu Long
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
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Tao HW, Han WW, Liu YJ, Du HZ, Li ZN, Qin LQ, Chen GC, Chen JS. Association of phthalate exposure with all-cause mortality across renal function status: The U.S. National Health and Nutrition Examination Survey, 2005-2018. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 270:115881. [PMID: 38147775 DOI: 10.1016/j.ecoenv.2023.115881] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/11/2023] [Accepted: 12/21/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND Wide phthalate exposure has been associated with both declines in renal function and an elevated risk of mortality. Whether phthalate-associated risk of premature mortality differs by renal function status remains unclear. METHODS This study included 9605 adults from the U.S. National Health and Nutrition Examination Survey. Urinary concentrations of 11 phthalate metabolites were assessed using high-performance liquid chromatography-electrospray ionization tandem mass spectrometry. According to estimated glomerular filtration rate (eGFR), participants were grouped as having normal or modestly declined renal functions, or chronic kidney disease (CKD). Multivariable Cox regression models estimated all-cause mortality associated with phthalate exposure, overall and by renal function status. RESULTS Overall, Mono-n-butyl phthalate (MnBP), Mono-benzyl phthalate (MBzP), Mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and Mono-(2-ethyl-5-carbox-ypentyl) phthalate (MECPP) were associated with an elevated risk of mortality (P-trend across tertile <0.05). Moreover, significant interactions were observed between eGFR and MEHHP, MEOHP, MECPP, DEHP in the whole population (P for interactions <0.05). After stratification by renal function, total Di (2-ethylhexyl) phthalate (DEHP) was additionally found to be associated with mortality risk in the CKD group (HR = 1.12; 95% CI: 1.01, 1.25). Co-exposure to the 11 phthalate metabolites was associated with a higher risk of all-cause mortality in the CKD (HR = 1.47; 95% CI: 1.18, 1.84) and modestly declined renal function group (HR = 1.25; 95% CI: 1.09, 1.44). CONCLUSIONS The associations between phthalate exposure and risk of all-cause mortality were primarily observed in CKD patients, reinforcing the need for monitoring phthalate exposure in this patient population.
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Affiliation(s)
- Hao-Wei Tao
- Department of Nutrition and Food Hygiene, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Wen-Wen Han
- Department of Nutrition and Food Hygiene, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Yu-Jie Liu
- Department of Nutrition and Food Hygiene, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Hong-Zhen Du
- Department of Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China; Hebei Key Laboratory of Nutrition and Health, Shijiazhuang, Hebei, China
| | - Zeng-Ning Li
- Department of Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China; Hebei Key Laboratory of Nutrition and Health, Shijiazhuang, Hebei, China; Hospital of Stomatology of Hebei Medical University Shijiazhuang, China
| | - Li-Qiang Qin
- Department of Nutrition and Food Hygiene, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Guo-Chong Chen
- Department of Nutrition and Food Hygiene, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China.
| | - Jing-Si Chen
- Department of Nutrition and Food Hygiene, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China.
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Invernizzi A, Renzetti S, Rechtman E, Ambrosi C, Mascaro L, Corbo D, Gasparotti R, Tang CY, Smith DR, Lucchini RG, Wright RO, Placidi D, Horton MK, Curtin P. Neuro-environmental interactions: a time sensitive matter. Front Comput Neurosci 2024; 17:1302010. [PMID: 38260714 PMCID: PMC10800942 DOI: 10.3389/fncom.2023.1302010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction The assessment of resting state (rs) neurophysiological dynamics relies on the control of sensory, perceptual, and behavioral environments to minimize variability and rule-out confounding sources of activation during testing conditions. Here, we investigated how temporally-distal environmental inputs, specifically metal exposures experienced up to several months prior to scanning, affect functional dynamics measured using rs functional magnetic resonance imaging (rs-fMRI). Methods We implemented an interpretable XGBoost-shapley additive explanation (SHAP) model that integrated information from multiple exposure biomarkers to predict rs dynamics in typically developing adolescents. In 124 participants (53% females, ages, 13-25 years) enrolled in the public health impact of metals exposure (PHIME) study, we measured concentrations of six metals (manganese, lead, chromium, copper, nickel, and zinc) in biological matrices (saliva, hair, fingernails, toenails, blood, and urine) and acquired rs-fMRI scans. Using graph theory metrics, we computed global efficiency (GE) in 111 brain areas (Harvard Oxford atlas). We used a predictive model based on ensemble gradient boosting to predict GE from metal biomarkers, adjusting for age and biological sex. Results Model performance was evaluated by comparing predicted versus measured GE. SHAP scores were used to evaluate feature importance. Measured versus predicted rs dynamics from our model utilizing chemical exposures as inputs were significantly correlated (p < 0.001, r = 0.36). Lead, chromium, and copper contributed most to the prediction of GE metrics. Discussion Our results indicate that a significant component of rs dynamics, comprising approximately 13% of observed variability in GE, is driven by recent metal exposures. These findings emphasize the need to estimate and control for the influence of past and current chemical exposures in the assessment and analysis of rs functional connectivity.
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Affiliation(s)
- Azzurra Invernizzi
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Stefano Renzetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Elza Rechtman
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Claudia Ambrosi
- Department of Neuroscience, Neuroradiology Unit, ASST Cremona, Cremona, Italy
| | | | - Daniele Corbo
- Department of Medical Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Roberto Gasparotti
- Department of Medical Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Cheuk Y. Tang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Donald R. Smith
- Department of Microbiology and Environmental Toxicology, University of California Santa Cruz, Santa Cruz, CA, United States
| | - Roberto G. Lucchini
- Department of Neuroscience, Neuroradiology Unit, ASST Cremona, Cremona, Italy
- Department of Environmental Health Sciences, Robert Stempel School of Public Health, Florida International University, Miami, FL, United States
| | - Robert O. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Donatella Placidi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Megan K. Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Merced-Nieves FM, Eitenbichler S, Goldson B, Zhang X, Klein DN, Bosquet Enlow M, Curtin P, Wright RO, Wright RJ. Associations between a metal mixture and infant negative affectivity: Effect modification by prenatal cortisol and infant sex. Child Dev 2024; 95:e47-e59. [PMID: 37610319 PMCID: PMC10840921 DOI: 10.1111/cdev.13997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 05/17/2023] [Accepted: 07/05/2023] [Indexed: 08/24/2023]
Abstract
In-utero exposures interact in complex ways that influence neurodevelopment. Animal research demonstrates that fetal sex moderates the impact of joint exposure to metals and prenatal stress measures, including cortisol, on offspring socioemotional outcomes. Further research is needed in humans. We evaluated the joint association of prenatal exposures to a metal mixture and cortisol with infant negative affectivity, considering sex differences. Analyses included 226 (29% White, Non-Hispanic) mother-infant pairs with data on exposures and negative affectivity assessed using the Infant Behavior Questionnaire-Revised in 6-month-olds. Results showed that girls whose mothers had higher cortisol had significantly higher scores of Fear and Sadness with greater exposure to the mixture. Examining higher-order interactions may better elucidate the effects of prenatal exposure to metals and cortisol on socioemotional functioning.
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Affiliation(s)
- Francheska M Merced-Nieves
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Brandon Goldson
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Xueying Zhang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Daniel N Klein
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Michelle Bosquet Enlow
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Paul Curtin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Ham D, Ha M, Park H, Hong YC, Kim Y, Ha E, Bae S. Association of postnatal exposure to mixture of bisphenol A, Di-n-butyl phthalate and Di-(2-ethylhexyl) phthalate with Children's IQ at 5 Years of age: Mothers and Children's environmental health (MOCEH) study. CHEMOSPHERE 2024; 347:140626. [PMID: 37939933 DOI: 10.1016/j.chemosphere.2023.140626] [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: 07/03/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 11/10/2023]
Abstract
Early childhood is important for neurodevelopment, and exposure to endocrine disruptors such as bisphenol A (BPA) and phthalates in this period may cause neurodevelopmental disorders and delays. The present study examined the association between exposure to mixtures of BPA and three metabolites of phthalates in early childhood and IQ at 5 years of age. The Mother and Children's Environmental Health (MOCEH) study is a prospective birth cohort study conducted in Korea with 1751 pregnant women enrolled from 2006 to 2010. After excluding those without relevant data, 47 children were included in the final analysis. We measured children's urinary concentrations of metabolites of endocrine-disrupting chemicals (Bisphenol A, mono-(2-ethyl-5-oxohexyl) phthalate, mono-(2-ethyl-5-hydroxyhexyl) phthalate and mono-(2-ethyl-5-butyl) phthalate) at ages of 24 and 36 months. We evaluated the children's IQ with the Korean Wechsler Intelligence Test at the age of 5 years. After adjusting for potential confounders, a multiple linear regression was conducted to examine the associations between individual endocrine-disrupting chemicals and the IQ of the children. Weighted Quantile Sum (WQS) regression and quantile-based g-computation were used to assess the association between IQ at age 5 and exposure to mixtures of BPA and phthalates. In the single-chemical analyses, mono-(2-ethyl-5-butyl) phthalate exposure at 36 months was adversely associated with children's IQ (β = -4.93, 95% confidence interval (CI): -9.22, -0.64). In the WQS regression and quantile-based g-computation analyses, exposure to the mixture of BPA and phthalates was associated with lower IQ [β = -9.13 (P-value = 0.05) and β = -9.18 (P-value = 0.05), respectively]. The largest contributor to the overall association was exposure to mono-(2-ethyl-5-butyl) phthalate at 36 months. In the present study, postnatal exposure to mixtures of BPA and three metabolites of phthalates was associated with decreased IQ of children at age 5.
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Affiliation(s)
- Dajeong Ham
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Mina Ha
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Hyesook Park
- Department of Preventive Medicine, College of Medicine, Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Eunhee Ha
- Department of Occupational and Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Sanghyuk Bae
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Environmental Health Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Ryva BA, Pacyga DC, Anderson KY, Calafat AM, Whalen J, Aung MT, Gardiner JC, Braun JM, Schantz SL, Strakovsky RS. Associations of urinary non-persistent endocrine disrupting chemical biomarkers with early-to-mid pregnancy plasma sex-steroid and thyroid hormones. ENVIRONMENT INTERNATIONAL 2024; 183:108433. [PMID: 38219543 PMCID: PMC10858740 DOI: 10.1016/j.envint.2024.108433] [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: 09/01/2023] [Revised: 11/22/2023] [Accepted: 01/06/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND/OBJECTIVES Pregnant women are exposed to numerous endocrine disrupting chemicals (EDCs) that can affect hormonal pathways regulating pregnancy outcomes and fetal development. Thus, we evaluated overall and fetal sex-specific associations of phthalate/replacement, paraben, and phenol biomarkers with sex-steroid and thyroid hormones. METHODS Illinois women (n = 302) provided plasma for progesterone, estradiol, testosterone, free T4 (FT4), total T4 (TT4), and thyroid stimulating hormone (TSH) at median 17 weeks gestation. Women also provided up-to-five first-morning urine samples monthly across pregnancy (8-40 weeks), which we pooled to measure 19 phthalate/replacement metabolites (reflecting ten parent compounds), three parabens, and six phenols. We used linear regression to evaluate overall and fetal sex-specific associations of biomarkers with hormones, as well as weighted quantile sum and Bayesian kernel machine regression (BKMR) to assess cumulative associations, non-linearities, and chemical interactions. RESULTS In women of relatively high socioeconomic status, several EDC biomarkers were associated with select hormones, without cumulative or non-linear associations with progesterone, FT4, or TT4. The biomarker mixture was negatively associated with estradiol (only at higher biomarker concentrations using BKMR), testosterone, and TSH, where each 10% mixture increase was associated with -5.65% (95% CI: -9.79, -1.28) lower testosterone and -0.09 μIU/mL (95% CI: -0.20, 0.00) lower TSH. Associations with progesterone, testosterone, and FT4 did not differ by fetal sex. However, in women carrying females, we identified an inverted u-shaped relationship of the mixture with estradiol. Additionally, in women carrying females, each 10% increase in the mixture was associated with 1.50% (95% CI: -0.15, 3.18) higher TT4, whereas in women carrying males, the mixture was associated with -1.77% (95% CI: -4.08, 0.58) lower TT4 and -0.18 μIU/mL (95% CI: -0.33, -0.03) lower TSH. We also identified select chemical interactions. CONCLUSION Some biomarkers were associated with early-to-mid pregnancy hormones. There were some sex-specific and non-linear associations. Future studies could consider how these findings relate to pregnancy/birth outcomes.
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Affiliation(s)
- Brad A Ryva
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI 48824, United States; College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824, United States; Institute for Integrative Toxicology, Michigan State University, East Lansing, MI 48824, United States
| | - Diana C Pacyga
- Institute for Integrative Toxicology, Michigan State University, East Lansing, MI 48824, United States; Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, United States
| | - Kaitlyn Y Anderson
- College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824, United States
| | - Antonia M Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, United States
| | - Jason Whalen
- Michigan Diabetes Research Center Chemistry Laboratory, University of Michigan, Ann Arbor, MI 48109, United States
| | - Max T Aung
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, United States
| | - Joseph C Gardiner
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48824, United States
| | - Joseph M Braun
- Department of Epidemiology, Brown University, Providence, RI 02912, United States
| | - Susan L Schantz
- The Beckman Institute, University of Illinois, Urbana-Champaign, IL 61801, United States; Department of Comparative Biosciences, University of Illinois, Urbana-Champaign, IL 61802, United States
| | - Rita S Strakovsky
- Institute for Integrative Toxicology, Michigan State University, East Lansing, MI 48824, United States; Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, United States.
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Midya V, Alcala CS, Rechtman E, Gregory JK, Kannan K, Hertz-Picciotto I, Teitelbaum SL, Gennings C, Rosa MJ, Valvi D. Machine Learning Assisted Discovery of Interactions between Pesticides, Phthalates, Phenols, and Trace Elements in Child Neurodevelopment. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:18139-18150. [PMID: 37595051 PMCID: PMC10666542 DOI: 10.1021/acs.est.3c00848] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 08/10/2023] [Accepted: 08/10/2023] [Indexed: 08/20/2023]
Abstract
A growing body of literature suggests that developmental exposure to individual or mixtures of environmental chemicals (ECs) is associated with autism spectrum disorder (ASD). However, investigating the effect of interactions among these ECs can be challenging. We introduced a combination of the classical exposure-mixture Weighted Quantile Sum (WQS) regression and a machine-learning method termed Signed iterative Random Forest (SiRF) to discover synergistic interactions between ECs that are (1) associated with higher odds of ASD diagnosis, (2) mimic toxicological interactions, and (3) are present only in a subset of the sample whose chemical concentrations are higher than certain thresholds. In a case-control Childhood Autism Risks from Genetics and Environment (CHARGE) study, we evaluated multiordered synergistic interactions among 62 ECs measured in the urine samples of 479 children in association with increased odds for ASD diagnosis (yes vs no). WQS-SiRF identified two synergistic two-ordered interactions between (1) trace-element cadmium (Cd) and the organophosphate pesticide metabolite diethyl-phosphate (DEP); and (2) 2,4,6-trichlorophenol (TCP-246) and DEP. Both interactions were suggestively associated with increased odds of ASD diagnosis in the subset of children with urinary concentrations of Cd, DEP, and TCP-246 above the 75th percentile. This study demonstrates a novel method that combines the inferential power of WQS and the predictive accuracy of machine-learning algorithms to discover potentially biologically relevant chemical-chemical interactions associated with ASD.
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Affiliation(s)
- Vishal Midya
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Cecilia Sara Alcala
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Elza Rechtman
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Jill K. Gregory
- Instructional
Technology Group,Icahn School of Medicine
at Mount Sinai, New York, New York 10029, United States
| | - Kurunthachalam Kannan
- Department
of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, New York 10016, United States
| | - Irva Hertz-Picciotto
- Department
of Public Health Sciences, School of Medicine, University of California at Davis, Davis, California 95616, United States
- UC
Davis MIND (Medical Investigations of Neurodevelopmental Disorders)
Institute, University of California at Davis, Sacramento, California 95817, United States
| | - Susan L. Teitelbaum
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Chris Gennings
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Maria J. Rosa
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Damaskini Valvi
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
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Song X, Wang C, He H, Peng M, Hu Q, Wang B, Tang L, Yu F. Association of phthalate exposure with pulmonary function in adults: NHANES 2007-2012. ENVIRONMENTAL RESEARCH 2023; 237:116902. [PMID: 37625539 DOI: 10.1016/j.envres.2023.116902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 07/03/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Epidemiological evidence for the adverse effect of phthalate exposure on respiratory health is on the rise, but cross-sectional studies regarding its effects on lung function are limited and contradictory, especially in adults. OBJECTIVE To assess the associations between individual and a mixture of urinary phthalate metabolites and adult pulmonary function in the United States, and to identify which ones were primarily responsible for impaired respiratory function. METHODS We obtained a cross-sectional data on 3788 adults aged 20 years and older from the National Health and Nutrition Examination Survey (2007-2012). Respiratory function was evaluated using spirometry, and phthalate exposure was assessed by measuring the levels of ten urinary phthalate metabolites. The effects of individual and mixed phthalate metabolites exposure on lung function were assessed using multivariate linear regression models and the repeated holdout weighted quantile sum (WQS) regression models, respectively, after adjusting for potential confounders including age, gender, family poverty income ratio, body mass index, and serum cotinine. RESULTS When modeled as continuous variables or quantiles, urinary phthalate metabolites, including mono-ethyl phthalate (MEP), mono-n-butyl phthalate, mono-iso-butyl phthalate, mono-benzyl phthalate, mono-(2-ethyl-5-oxohexyl) phthalate, mono-(2-ethyl-5-hydroxyhexyl) phthalate, mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), mono-(3-carboxypropyl) phthalate, and mono-carboxyoctyl phthalate, were identified to be negatively associated with forced vital capacity in percent predicted values (ppFVC) and forced expiratory volume in the first second in percent predicted values (ppFEV1). In addition, per each decile increase in the WQS index, ppFVC (β = -2.87, 95% CI: -3.56, -2.08) and ppFEV1 (β = -2.53, 95% CI: -3.47, -1.54) declined significantly, primarily due to the contribution of MEP and MECPP. Furthermore, there were no significant interactions between co-exposure to urinary phthalate metabolites and each covariate. CONCLUSION Our findings reveal that urinary phthalate metabolites are significantly associated with adult respiratory decrements, with diethyl and di-(2-ethylhexyl) phthalate contributing the most to the impaired lung function.
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Affiliation(s)
- Xinli Song
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China; National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Cheng Wang
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Hao He
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Muyun Peng
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qikang Hu
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Bin Wang
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lei Tang
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Fenglei Yu
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China.
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Midya V, Lane JM, Gennings C, Torres-Olascoaga LA, Gregory JK, Wright RO, Arora M, Téllez-Rojo MM, Eggers S. Prenatal Lead Exposure Is Associated with Reduced Abundance of Beneficial Gut Microbial Cliques in Late Childhood: An Investigation Using Microbial Co-Occurrence Analysis (MiCA). ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:16800-16810. [PMID: 37878664 PMCID: PMC10634322 DOI: 10.1021/acs.est.3c04346] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 10/27/2023]
Abstract
Many analytical methods used in gut microbiome research focus on either single bacterial taxa or the whole microbiome, ignoring multibacteria relationships (microbial cliques). We present a novel analytical approach to identify microbial cliques within the gut microbiome of children at 9-11 years associated with prenatal lead (Pb) exposure. Data came from a subset of participants (n = 123) in the Programming Research in Obesity, Growth, Environment and Social Stressors cohort. Pb concentrations were measured in maternal whole blood from the second and third trimesters of pregnancy. Stool samples collected at 9-11 years old underwent metagenomic sequencing to assess the gut microbiome. Using a novel analytical approach, Microbial Co-occurrence Analysis (MiCA), we paired a machine learning algorithm with randomization-based inference to first identify microbial cliques that were predictive of prenatal Pb exposure and then estimate the association between prenatal Pb exposure and microbial clique abundance. With second-trimester Pb exposure, we identified a two-taxa microbial clique that included Bifidobacterium adolescentis and Ruminococcus callidus and a three-taxa clique that also included Prevotella clara. Increasing second-trimester Pb exposure was associated with significantly increased odds of having the two-taxa microbial clique below the median relative abundance (odds ratio (OR) = 1.03, 95% confidence interval (CI) [1.01-1.05]). Using a novel combination of machine learning and causal inference, MiCA identified a significant association between second-trimester Pb exposure and the reduced abundance of a probiotic microbial clique within the gut microbiome in late childhood.
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Affiliation(s)
- Vishal Midya
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Jamil M. Lane
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Chris Gennings
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Libni A. Torres-Olascoaga
- Center
for Research on Nutrition and Health, National
Institute of Public Health, Cuernavaca 62100, Mexico
| | - Jill K. Gregory
- Instructional
Technology Group, Icahn School of Medicine
at Mount Sinai, New York, New York 10029, United States
| | - Robert O. Wright
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Manish Arora
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
| | - Martha Maria Téllez-Rojo
- Center
for Research on Nutrition and Health, National
Institute of Public Health, Cuernavaca 62100, Mexico
| | - Shoshannah Eggers
- Department
of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York 10029, United States
- Department
of Epidemiology, University of Iowa College
of Public Health, Iowa City, Iowa 52242, United States
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Wang A, Wan Y, Mahai G, Qian X, Li Y, Xu S, Xia W. Association of Prenatal Exposure to Organophosphate, Pyrethroid, and Neonicotinoid Insecticides with Child Neurodevelopment at 2 Years of Age: A Prospective Cohort Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:107011. [PMID: 37856202 PMCID: PMC10586492 DOI: 10.1289/ehp12097] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Widespread insecticide exposure might be a risk factor for neurodevelopment of our children, but few studies examined the mixture effect of maternal coexposure to organophosphate insecticides (OPPs), pyrethroids (PYRs), and neonicotinoid insecticides (NNIs) during pregnancy on child neurodevelopment, and critical windows of exposure are unknown. OBJECTIVES We aimed to evaluate the association of prenatal exposure to multiple insecticides with children's neurodevelopment and to identify critical windows of the exposure. METHODS Pregnant women were recruited into a prospective birth cohort study in Wuhan, China, from 2014-2017. Eight metabolites of OPPs (mOPPs), three metabolites of PYRs (mPYRs), and nine metabolites of NNIs (mNNIs) were measured in 3,123 urine samples collected at their first, second, and third trimesters. Children's neurodevelopment [mental development index (MDI) and psychomotor development index (PDI)] was assessed using the Bayley Scales of Infant Development at 2 years of age (N = 1,041 ). Multivariate linear regression models, generalized estimating equation models, and weighted quantile sum (WQS) regression were used to estimate the association between the insecticide metabolites and Bayley scores. Potential sex-specific associations were also examined. RESULTS Single chemical analysis suggested higher urinary concentrations of some insecticide metabolites at the first trimester were significantly associated with lower MDI and PDI scores, and the associations were more prominent among boys. Each 1-unit increase in ln-transformed urinary concentrations of two mOPPs, 3,5,6-trichloro-2-pyridinol and 4-nitrophenol, was associated with a decrease of 3.16 points [95% confidence interval (CI): - 5.59 , - 0.74 ] and 3.06 points (95% CI: - 5.45 , - 0.68 ) respectively in boys' MDI scores. Each 1-unit increase in that of trans-3-(2,2-dichloroethenyl)-2,2-dimethylcyclopropanecarboxylic acid (trans-DCCA; an mPYR) was significantly associated with a decrease of 2.24 points (95% CI: - 3.89 , - 0.58 ) in boys' MDI scores and 1.90 points (95% CI: - 3.16 , - 0.64 ) in boys' PDI scores, respectively. Significantly positive associations of maternal urinary biomarker concentrations [e.g., dimethyl phosphate (a nonspecific mOPP) and desmethyl-clothianidin (a relatively specific mNNI)] with child neurodevelopment were also observed. Using repeated holdout validation, a 1-quartile increase in the WQS index of the insecticide mixture (in the negative direction) at the first trimester was significantly associated with a decrease of 3.02 points (95% CI: - 5.47 , - 0.57 ) in MDI scores among the boys, and trans-DCCA contributed the most to the association (18%). CONCLUSIONS Prenatal exposure to higher levels of certain insecticides and their mixture were associated with lower Bayley scores in children, particularly in boys. Early pregnancy may be a sensitive window for such an effect. Future studies are needed to confirm our findings. https://doi.org/10.1289/EHP12097.
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Affiliation(s)
- Aizhen Wang
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yanjian Wan
- Center for Public Health Laboratory Service, Institute of Environmental Health, Wuhan Centers for Disease Prevention & Control, Wuhan, Hubei, PR China
| | - Gaga Mahai
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Xi Qian
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
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Huo RR, Zhai L, Liao Q, You XM. Changes in the triglyceride glucose-body mass index estimate the risk of stroke in middle-aged and older Chinese adults: a nationwide prospective cohort study. Cardiovasc Diabetol 2023; 22:254. [PMID: 37716947 PMCID: PMC10505325 DOI: 10.1186/s12933-023-01983-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/05/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Stroke was reported to be highly correlated with the triglyceride glucose-body mass index (TyG-BMI). Nevertheless, literature exploring the association between changes in the TyG-BMI and stroke incidence is scant, with most studies focusing on individual values of the TyG-BMI. We aimed to investigate whether changes in the TyG-BMI were associated with stroke incidence. METHODS Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS), which is an ongoing nationally representative prospective cohort study. The exposures were changes in the TyG-BMI and cumulative TyG-BMI from 2012 to 2015. Changes in the TyG-BMI were classified using K-means clustering analysis, and the cumulative TyG-BMI was calculated as follows: (TyG-BMI2012 + TyG-BMI2015)/2 × time (2015-2012). Logistic regressions were used to determine the association between different TyG-BMI change classes and stroke incidence. Meanwhile, restricted cubic spline regression was applied to examine the potential nonlinear association of the cumulative TyG-BMI and stroke incidence. Weighted quantile sum regression was used to provide a comprehensive explanation of the TyG-BMI by calculating the weights of FBG, triglyceride-glucose (TG), and BMI. RESULTS Of the 4583 participants (mean [SD] age at baseline, 58.68 [9.51] years), 2026 (44.9%) were men. During the 3 years of follow-up, 277 (6.0%) incident stroke cases were identified. After adjusting for potential confounders, compared to the participants with a consistently low TyG-BMI, the OR for a moderate TyG-BMI with a slow rising trend was 1.01 (95% CI 0.65-1.57), the OR for a high TyG-BMI with a slow rising trend was 1.62 (95% CI 1.11-2.32), and the OR for the highest TyG-BMI with a slow declining trend was 1.71 (95% CI 1.01-2.89). The association between the cumulative TyG-BMI and stroke risk was nonlinear (Passociation = 0.017; Pnonlinearity = 0.012). TG emerged as the primary contributor when the weights were assigned to the constituent elements of the TyG-BMI (weight2012 = 0.466; weight2015 = 0.530). CONCLUSIONS Substantial changes in the TyG-BMI are independently associated with the risk of stroke in middle-aged and older adults. Monitoring long-term changes in the TyG-BMI may assist with the early identification of individuals at high risk of stroke.
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Affiliation(s)
- Rong-Rui Huo
- Department of Experimental Research, Guangxi Medical University Cancer Hospital, He Di Rd. #71, Nanning, 530021, China
| | - Lu Zhai
- Department of Smart Health Elderly Care Services and Management, School of Nursing, Guangxi Health Science College, Nanning, China
| | - Qian Liao
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Xue-Mei You
- Department of Experimental Research, Guangxi Medical University Cancer Hospital, He Di Rd. #71, Nanning, 530021, China.
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumour (Guangxi Medical University), Ministry of Education, Nanning, 530021, China.
- Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumour, Nanning, 530021, China.
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Chiu YHM, Wilson A, Hsu HHL, Jamal H, Mathews N, Kloog I, Schwartz J, Bellinger DC, Xhani N, Wright RO, Coull BA, Wright RJ. Prenatal ambient air pollutant mixture exposure and neurodevelopment in urban children in the Northeastern United States. ENVIRONMENTAL RESEARCH 2023; 233:116394. [PMID: 37315758 PMCID: PMC10528414 DOI: 10.1016/j.envres.2023.116394] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/22/2023] [Accepted: 06/09/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Studies of prenatal air pollution (AP) exposure on child neurodevelopment have mostly focused on a single pollutant. We leveraged daily exposure data and implemented novel data-driven statistical approaches to assess effects of prenatal exposure to a mixture of seven air pollutants on cognitive functioning in school-age children from an urban pregnancy cohort. METHODS Analyses included 236 children born at ≥37 weeks gestation. Maternal prenatal daily exposure levels for nitrogen dioxide (NO2), ozone (O3), and constituents of fine particles [elemental carbon (EC), organic carbon (OC), nitrate (NO3-), sulfate (SO42-), ammonium (NH4+)] were estimated based on residential addresses using validated satellite-based hybrid models or global 3-D chemical-transport models. Children completed Wide Range Assessment of Memory and Learning (WRAML-2) and Conners' Continuous Performance Test (CPT-II) at 6.5 ± 0.9 years of age. Time-weighted levels for mixture pollutants were estimated using Bayesian Kernel Machine Regression Distributed Lag Models (BKMR-DLMs), with which we also explored the interactions in the exposure-response functions among pollutants. Resulting time-weighted exposure levels were used in Weighted Quantile Sum (WQS) regressions to examine AP mixture effects on outcomes, adjusted for maternal age, education, child sex, and prenatal temperature. RESULTS Mothers were primarily ethnic minorities (81% Hispanic and/or black) reporting ≤12 years of education (68%). Prenatal AP mixture (per unit increase in WQS estimated AP index) was associated with decreased WRAML-2 general memory (GM; β = -0.64, 95%CI = -1.40, 0.00) and memory-related attention/concentration (AC; β = -1.03, 95%CI = -1.78, -0.27) indices, indicating poorer memory functioning, as well as increased CPT-II omission errors (OE; β = 1.55, 95%CI = 0.34, 2.77), indicating increased attention problems. When stratified by sex, association with AC index was significant among girls, while association with OE was significant among boys. Traffic-related pollutants (NO2, OC, EC) and SO42- were major contributors to these associations. There was no significant evidence of interactions among mixture components. CONCLUSIONS Prenatal exposure to an AP mixture was associated with child neurocognitive outcomes in a sex- and domain-specific manner.
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Affiliation(s)
- Yueh-Hsiu Mathilda Chiu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ander Wilson
- Department of Statistics, Colorado State University, Fort Collins, CO, USA
| | - Hsiao-Hsien Leon Hsu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Harris Jamal
- Augusta University/University of Georgia Medical Partnership, Medical College of Georgia, Athens, GA, USA
| | - Nicole Mathews
- The Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Itai Kloog
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - David C Bellinger
- Departments of Neurology and Psychiatry, Boston Children's Hospital, Boston, MA, USA; Departments of Neurology and Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Naim Xhani
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brent A Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Pan X, Hong F, Li S, Wu J, Xu H, Yang S, Chen K, Baima K, Nima Q, Meng Q, Xia J, Xu J, Guo B, Lin H, Xie L, Zhang J, Zhao X. Long-term exposure to ambient PM 2.5 constituents is associated with dyslipidemia in Chinese adults. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 263:115384. [PMID: 37603926 DOI: 10.1016/j.ecoenv.2023.115384] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Ambient particulate matter with aerodynamic diameter ≤ 2.5 µm (PM2.5) consists of various toxic constituents. However, the health effect of PM2.5 may differ depending on its constituents, but the joint effect of PM2.5 constituents remains incompletely understood. OBJECTIVE Our goal was to evaluate the joint effect of long-term PM2.5 constituent exposures on dyslipidemia and identify the most hazardous chemical constituent. METHODS This study included 67,015 participants from the China Multi-Ethnic Cohort study. The average yearly levels of PM2.5 constituents for all individuals at their residences were assessed through satellite remote sensing and chemical transport modeling. Dyslipidemia was defined as one or more following abnormal blood lipid concentrations: total cholesterol (TC) ≥ 6.22 mmol/L, triglycerides (TG) ≥ 2.26 mmol/L, high-density lipoprotein cholesterol (HDL-C) < 1.04 mmol/L, and low-density lipoprotein cholesterol (LDL-C) ≥ 4.14 mmol/L. The logistic regression model was utilized to examine the single effect of PM2.5 constituents on dyslipidemia, while the weighted quantile sum regression model for the joint effect. RESULTS The odds ratio with a 95 % confidence interval for dyslipidemia positively related to per-SD increase in the three-year average was 1.29 (1.20-1.38) for PM2.5 mass, 1.25 (1.17-1.34) for black carbon, 1.24 (1.16-1.33) for ammonium, 1.33 (1.24-1.43) for nitrate, 1.34 (1.25-1.44) for organic matter, 1.15 (1.08-1.23) for sulfate, 1.30 (1.22-1.38) for soil particles, and 1.12 (1.05-1.92) for sea salt. Stronger associations were observed in individuals < 65 years of age, males, and those with low physical activity. Joint exposure to PM2.5 constituents was positively related to dyslipidemia (OR: 1.09, 95 %CI: 1.05-1.14). Nitrate was identified as the constituent with the largest weight (weighted at 0.387). CONCLUSIONS Long-term exposure to PM2.5 constituents poses a significant risk to dyslipidemia and nitrate might be the most responsible for the risk. These findings indicate that reducing PM2.5 constituent exposures, especially nitrate, could be beneficial to alleviate the burden of disease attributed to PM2.5-related dyslipidemia.
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Affiliation(s)
- Xianmou Pan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Feng Hong
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Sicheng Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jialong Wu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Huan Xu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China; Institute for Disaster Management and Reconstruction, Sichuan University-The Hongkong Polytechnic University, Chengdu, Sichuan, China
| | - Shaokun Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kejun Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kangzhuo Baima
- School of Medicine, Tibet University, Lhasa, Tibet, China
| | - Qucuo Nima
- Tibet Center for Disease Control and Prevention, Lhasa, Tibet, China
| | - Qiong Meng
- Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Jinjie Xia
- Chengdu Center for Disease Control & Prevention, China
| | - Jingru Xu
- Chongqing Municipal Center for Disease Control and Prevention, China
| | - Bing Guo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Linshen Xie
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Juying Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
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Drago G, Ruggieri S, Sprovieri M, Rizzo G, Colombo P, Giosuè C, Quinci E, Traina A, Gastaldelli A, Cibella F, Panunzi S. Exposure profiles in pregnant women from a birth cohort in a highly contaminated area of southern Italy. Sci Rep 2023; 13:14815. [PMID: 37684286 PMCID: PMC10491776 DOI: 10.1038/s41598-023-41865-0] [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: 04/05/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
Protecting the health of pregnant women from environmental stressors is crucial for reducing the burden of non-communicable diseases. In industrially contaminated sites, this action is particularly challenging due to the heterogeneous pollutant mixtures in environmental matrices. The aim of this study was to evaluate distribution patterns of mercury, hexachlorobenzene and polychlorobiphenyls in the serum of 161 pregnant women recruited in the framework of the Neonatal Environment and Health Outcomes (NEHO) cohort and living both inside and outside the National Priority Contaminated Site (NPCS) of Priolo. Food macro-categories were determined, and serum levels of contaminants were used to perform k-means cluster analysis and identify the role of food in pollutant transfer from the environment. Two groups of mothers with high and low measured pollutant levels were distinguished. Concentrations in mothers in the high-exposure cluster were at least twofold for all the evaluated pollutants (p < 0.0001) and included mothers living inside and outside NPCS, with a predominance of individuals from the NPCS (p = 0.045). Fish consumption was higher in the high-exposure cluster (p = 0.019). These findings suggest a link between contamination of environmental matrices such as sediment with maternal exposure, through the intake of local food. Such consideration appears poorly investigated in the context of contaminated sites.
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Affiliation(s)
- Gaspare Drago
- Institute for Biomedical Research and Innovation, National Research Council of Italy, Via Ugo La Malfa 153, 90146, Palermo, Italy
| | - Silvia Ruggieri
- Institute for Biomedical Research and Innovation, National Research Council of Italy, Via Ugo La Malfa 153, 90146, Palermo, Italy.
| | - Mario Sprovieri
- Institute of Marine Sciences, National Research Council of Italy, Arsenale-Tesa 104, Castello 2737/F, 30122, Venice, Italy
| | - Giulia Rizzo
- Institute for Biomedical Research and Innovation, National Research Council of Italy, Via Ugo La Malfa 153, 90146, Palermo, Italy
| | - Paolo Colombo
- Institute for Biomedical Research and Innovation, National Research Council of Italy, Via Ugo La Malfa 153, 90146, Palermo, Italy
| | - Cristina Giosuè
- Institute of Anthropic Impacts and Sustainability in Marine Environment, National Research Council of Italy, Lungomare Cristoforo Colombo 4521, 90149, Palermo, Italy
| | - Enza Quinci
- Institute of Anthropic Impacts and Sustainability in Marine Environment, National Research Council of Italy, Via del Mare 3, Torretta Granitola, 91021, Trapani, Italy
| | - Anna Traina
- Institute of Anthropic Impacts and Sustainability in Marine Environment, National Research Council of Italy, Lungomare Cristoforo Colombo 4521, 90149, Palermo, Italy
| | - Amalia Gastaldelli
- Institute of Clinical Physiology, National Research Council of Italy, Via Giuseppe Moruzzi 1, 56124, Pisa, Italy
| | - Fabio Cibella
- Institute for Biomedical Research and Innovation, National Research Council of Italy, Via Ugo La Malfa 153, 90146, Palermo, Italy
| | - Simona Panunzi
- Institute for System Analysis and Computer Science-BioMatLab, National Research Council of Italy, Via dei Taurini 19, 00168, Rome, Italy
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Mérida-Ortega Á, Pérez-Saldivar ML, Espinoza-Hernández LE, Dorantes-Acosta EM, Torres-Nava JR, Solís-Labastida KA, Paredes-Aguilera R, Velázquez-Aviña MM, Espinosa-Elizondo RM, Miranda-Madrazo MR, González-Ávila AI, Rodríguez-Villalobos LR, Dosta-Herrera JJ, Mondragón-García JA, Castañeda-Echevarría A, López-Caballero MG, Martínez-Silva SI, Rivera-González J, Hernández-Pineda NA, Flores-Botello J, Pérez-Gómez JA, Rodríguez-Vázquez MA, Torres-Valle D, Olvera-Durán JÁ, Martínez-Ríos A, García‐Cortés LR, Almeida-Hernández C, Flores-Lujano J, Núñez-Enríquez JC, Mata-Rocha M, Rosas-Vargas H, Duarte-Rodríguez DA, Jiménez-Morales S, Mejía-Arangure JM, López-Carrillo L. A protective maternal nutrient concomitant intake associated with acute leukemia might be modified by sex, in children under 2 years. Front Oncol 2023; 13:1239147. [PMID: 37746300 PMCID: PMC10514356 DOI: 10.3389/fonc.2023.1239147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Maternal dietary consumption during pregnancy has been inconclusively associated with acute leukemia (AL) in infants, probably because epidemiological evidence has emerged mainly from the analysis of one-by-one nutrient, which is not a real-life scenario. Our objective was to evaluate the association between AL in Mexican children under 2 years of age and their mothers' nutrients concomitant intake during pregnancy, as well as to explore whether there are differences between girls and boys. Methods We conducted a study of 110 cases of AL and 252 hospital-based controls in the Mexico City Metropolitan area from 2010 to 2019. We obtained information on maternal intake of 32 nutrients by a food frequency questionnaire and used weighted quantile sum regression to identify nutrient concomitant intakes. Results We found a concomitant intake of nutrients negatively associated with AL (OR 0.17; CI95% 0.03,0.88) only among girls; and we did not find a nutrient concomitant intake positively associated with AL. Discussion This is the first study that suggests nutrients that have been individually associated with AL are not necessarily the same in the presence of other nutrients (concomitant intake); as well as that maternal diet might reduce AL risk only in girls.
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Affiliation(s)
- Ángel Mérida-Ortega
- Center of Population Health Research, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Mexico
| | - María Luisa Pérez-Saldivar
- Unidad de Investigación Médica en Epidemiología Clínica, Hospital de Pediatría, Centro Médico Nacional (CMN) Siglo-XXI, Instituto Mexicano del Seguro Social (IMSS), México City, Mexico
| | - Laura E. Espinoza-Hernández
- Servicio de Hematología Pediátrica, Hospital General “Gaudencio González Garza”, CMN “La Raza”, IMSS, Mexico City, Mexico
| | - Elisa M. Dorantes-Acosta
- Departamento de Hemato-Oncología, Hospital Infantil de México Federico Gómez, Secretaria de Salud (SSA), Mexico City, Mexico
| | - José Refugio Torres-Nava
- Servicio de Oncología, Hospital Pediátrico Moctezuma, Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | | | | | | | | | - M. Raquel Miranda-Madrazo
- Servicio de Hematología Pediátrica, CMN”20 de Noviembre”, Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | - Ana Itamar González-Ávila
- Servicio de Hematología Pediátrica, HGR No. 1 “Dr. Carlos Mac Gregor Sánchez Navarro” IMSS, Mexico City, Mexico
| | | | - Juan José Dosta-Herrera
- Servicio de Cirugía Pediátrica, Hospital General “Gaudencio González Garza”, CMN “La Raza”, IMSS, Mexico City, Mexico
| | - Javier A. Mondragón-García
- Servicio de Cirugía Pediátrica, Hospital General Regional (HGR) No. 1 “Dr. Carlos Mac Gregor Sánchez Navarro” IMSS, Mexico City, Mexico
| | | | | | | | - Juan Rivera-González
- Hospital General Dr. “Gustavo Baz Prada”, Instituto de Salud del Estado de México (ISEM), State of Mexico, Mexico
| | | | - Jesús Flores-Botello
- Coordinación Clínica y Pediatría, Hospital General “La Perla” ISEM, Nezahualcóyotl, State of Mexico, Mexico
| | - Jessica Arleet Pérez-Gómez
- Coordinación Clínica y Pediatría, HGR No. 72 “Dr. Vicente Santos Guajardo”, IMSS, Tlalnepantla de Baz, State of Mexico, Mexico
| | | | - Delfino Torres-Valle
- Coordinación Clínica y Pediatría del Hospital General de Zona 71, IMSS, Chalco de Díaz Covarrubias, State of Mexico, Mexico
| | | | | | - Luis R. García‐Cortés
- Delegación Regional Estado de México Oriente, IMSS, Naucalpan de Juárez, State of Mexico, Mexico
| | | | - Janet Flores-Lujano
- Unidad de Investigación Médica en Epidemiología Clínica, Hospital de Pediatría, Centro Médico Nacional (CMN) Siglo-XXI, Instituto Mexicano del Seguro Social (IMSS), México City, Mexico
| | - Juan Carlos Núñez-Enríquez
- Unidad de Investigación Médica en Epidemiología Clínica, Hospital de Pediatría, Centro Médico Nacional (CMN) Siglo-XXI, Instituto Mexicano del Seguro Social (IMSS), México City, Mexico
| | - Minerva Mata-Rocha
- Laboratorio de Biología Molecular de las Leucemias, Unidad de Investigación en Genética Humana, UMAE, Hospital de Pediatría, CMN “Siglo XXI”, IMSS, Mexico City, Mexico
| | - Haydeé Rosas-Vargas
- Laboratorio de Genética, Hospital de Pediatría, Centro Médico Nacional (CMN) Siglo-XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - David Aldebarán Duarte-Rodríguez
- Unidad de Investigación Médica en Epidemiología Clínica, Hospital de Pediatría, Centro Médico Nacional (CMN) Siglo-XXI, Instituto Mexicano del Seguro Social (IMSS), México City, Mexico
| | - Silvia Jiménez-Morales
- Laboratorio de Innovación y Medicina de Precisión, Núcleo A, Instituto Nacional de Medicina Genómica (INMEGEN), México City, Mexico
| | - Juan Manuel Mejía-Arangure
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica (INMEGEN), México City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), México City, Mexico
| | - Lizbeth López-Carrillo
- Center of Population Health Research, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Mexico
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49
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Svensson K, Gennings C, Lindh C, Kiviranta H, Rantakokko P, Wikström S, Bornehag CG. Prenatal exposures to mixtures of endocrine disrupting chemicals and sex-specific associations with children's BMI and overweight at 5.5 years of age in the SELMA study. ENVIRONMENT INTERNATIONAL 2023; 179:108176. [PMID: 37672941 DOI: 10.1016/j.envint.2023.108176] [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: 05/29/2023] [Revised: 08/18/2023] [Accepted: 08/28/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Prenatal exposure to mixtures of endocrine disrupting chemicals (EDC) has the potential to disrupt human metabolism. Prenatal periods are especially sensitive as many developmental processes are regulated by hormones. Prenatal exposure to EDCs has inconsistently been associated with children's body mass index (BMI) and obesity. The objective of this study was to investigate if prenatal exposure to a mixture of EDCs was associated with children's BMI and overweight (ISO-BMI ≥ 25) at 5.5 years of age, and if there were sex-specific effects. METHODS A total of 1,105 mother-child pairs with complete data on prenatal EDCs concentrations (e.g., phthalates, non-phthalate plasticizers, phenols, PAH, pesticides, PFAS, organochlorine pesticides, and PCBs), children's measured height and weight, and selected covariates in the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy (SELMA) study were included in this analysis. The mixture effect of EDCs with children's BMI and overweight was assessed using WQS regression with 100 repeated holdouts. A positively associated WQS index with higher BMI and odds of overweight was derived. Models with interaction term and stratified weights by sex was applied in order to evaluate sex-specific associations. RESULTS A significant WQS*sex interaction term was identified and associations for boys and girls were in opposite directions. Higher prenatal exposure to a mixture of EDCs was associated with lower BMI (Mean β = -0.19, 95%CI: -0.40, 0.01) and lower odds of overweight (Mean OR = 0.72, 95%CI: 0.48, 1.04) among girls with borderline significance. However, the association among boys did not reach statistical significance. Among girls, the possible chemicals of concern were MEP, 2-OHPH, BPF, BPS, DPP and PFNA. CONCLUSION Prenatal exposure to a mixture of EDCs was associated with lower BMI and overweight among girls, and non-significant associations among boys. Chemicals of concern for girls included phthalates, non-phthalate plasticizers, bisphenols, PAHs, and PFAS.
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Affiliation(s)
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christian Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Hannu Kiviranta
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Panu Rantakokko
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Sverre Wikström
- Department of Health Sciences, Karlstad University, Karlstad, Sweden; Centre for Clinical Research and Education, County Council of Värmland, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Carl-Gustaf Bornehag
- Department of Health Sciences, Karlstad University, Karlstad, Sweden; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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50
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Wang D, Li Y, Duan H, Zhang S, Liu L, He Y, Chen X, Jiang Y, Ma Q, Yu G, Liu S, Yao N, Liang Y, Lin X, Liu L, Wan H, Shen J. Associations between blood essential metal mixture and serum uric acid: a cross-sectional study. Front Public Health 2023; 11:1182127. [PMID: 37670835 PMCID: PMC10476669 DOI: 10.3389/fpubh.2023.1182127] [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: 03/08/2023] [Accepted: 08/02/2023] [Indexed: 09/07/2023] Open
Abstract
Introduction Although several studies have explored the associations between single essential metals and serum uric acid (SUA), the study about the essential metal mixture and the interactions of metals for hyperuricemia remains unclear. Methods We performed a cross-sectional study to explore the association of the SUA levels with the blood essential metal mixture, including magnesium (Mg), calcium (Ca), iron (Fe), copper (Cu), zinc (Zn), manganese (Mn) in Chinese community-dwelling adults (n=1039). The multivariable linear regression, the weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) were conducted to estimate the associations of blood essential metals with SUA levels and the BKMR model was also conducted to estimate the interactions of the essential metals on SUA. Results In the multivariable linear regression, the association of blood Mg, Mn, and Cu with SUA was statistically significant, both in considering multiple metals and a single metal. In WQS regression [β=13.59 (95%CI: 5.57, 21.60)] and BKMR models, a positive association was found between the mixture of essential metals in blood and SUA. Specifically, blood Mg and Cu showed a positive association with SUA, while blood Mn showed a negative association. Additionally, no interactions between individual metals on SUA were observed. Discussion In conclusion, further attention should be paid to the relationship between the mixture of essential metals in blood and SUA. However, more studies are needed to confirm these findings.
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Affiliation(s)
- Dongmei Wang
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Yue Li
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Hualin Duan
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Shuting Zhang
- Department of Endocrinology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Lingling Liu
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Yajun He
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Xingying Chen
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Yuqi Jiang
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Qintao Ma
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Genfeng Yu
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Siyang Liu
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Nanfang Yao
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Yongqian Liang
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Xu Lin
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Lan Liu
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Heng Wan
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
| | - Jie Shen
- Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, China
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