Urinary phthalate metabolites concentrations and symptoms of depression in an elderly population

Association between environmental phthalates exposure and gut microbiota and metabolome in dementia with Lewy bodies

BACKGROUND

Emerging evidence has shown the potential involvement of phthalates (PAEs) exposure in the development of dementia with Lewy bodies (DLB). Metabolomics can reflect endogenous metabolites variation in the progress of disease after chemicals exposure. However, little is known about the association between PAEs, gut microbiota and metabolome in DLB.

OBJECTIVE

We aim to explore the intricate relationship among urinary PAEs metabolites (mPAEs), dysbiosis of gut bacteria, and metabolite profiles in DLB.

METHODS

A total of 43 DLB patients and 45 normal subjects were included in this study. Liquid chromatography was used to analyze the levels of mPAEs in the urine of the two populations. High-throughput sequencing and liquid chromatography-mass spectrometry were used to analyze gut microbiota and the profile of gut metabolome, respectively. The fecal microbiota transplantation (FMT) experiment was performed to verify the potential role of mPAEs on gut dysbiosis contribute to aggravating cognitive dysfunction in α-synuclein tg DLB/PD mice.

RESULTS

The DLB patients had higher DEHP metabolites (MEOHP, MEHHP and MEHP), MMP and MnBP, lower MBP and MBzP than the control group and different microbiota. A significantly higher abundance of Ruminococcus gnavus and lower Prevotella copri, Prevotella stercorea and Bifidobacterium were observed in DLB. Higher 3 DEHP metabolites, MMP, MnBP and lower MBP and MBzP were significantly negatively associated with Prevotella copri, Prevotella stercorea and Bifidobacterium. Additionally, using metabolomics, we found that altered bile acids, short-chain fatty acids and amino acids metabolism are linked to these mPAEs. We further found that FMT of fecal microbiota from highest DEHP metabolites donors significantly impaired cognitive function in the germ-free DLB/PD mice.

CONCLUSION

Our study suggested that PAEs exposure may alter the microbiota-gut-brain axis and providing novel insights into the interactions among environmental perturbations and microbiome-host in pathogenesis of DLB.

The association of ultra-processed food consumption with adult mental health disorders: a systematic review and dose-response meta-analysis of 260,385 participants

OBJECTIVE

We aimed to conduct a systematic review and meta-analysis of observational studies examining the relationship between ultra-processed food (UPF) consumption and the risk of mental health disorders.

METHODS

The ISI Web of Science, PubMed/MEDLINE, and Scopus databases were searched without date restriction until 28 December 2021. Data were extracted from 26 studies, including 260,385 participants from twelve countries. Risk ratios for mental health disorders were pooled by a random-effects model.

RESULTS

Meta-analyses suggested that UPF consumption was associated with an increased risk of depression (RR = 1.28; 95% CI: 1.19, 1.38; I2 = 61.8%; p = 0.022) but not anxiety (RR = 1.35; 95% CI: 0.86, 2.11; I2 =  77.8%; p = 0.198). However, when analyzed for the dietary assessment method, UPF consumption was significantly associated with an enhanced risk of depression among studies utilizing food frequency questionnaires (RR = 1.31; 95% CI: 1.21, 1.41; I2 = 60.0%; p < 0.001) as opposed to other forms of dietary recall approaches. Additionally, for every 10% increase in UPF consumption per daily calorie intake, 11% higher risk of depression (RR = 1.11; 95% CI: 1.01, 1.17; I2 = 88.9%; p < 0.001) was observed among adults. Dose-response analysis further emphasized a positive linear association between UPF consumption with depression risk (p-nonlinearity = 0.819, p-dose-response = p < 0.001).

CONCLUSION

Our findings indicate that UPF consumption is related to an enhanced depressive mental health status risk. There may be different causes for this increased risk, and further studies are needed to investigate if there is a causal relationship between consumption of UPF and mental health.

Associations between urinary phthalate metabolite concentrations and rheumatoid arthritis in the U.S. adult population

Phthalates are ubiquitous environmental contaminants. Nevertheless, limited data is available about the impacts of phthalates on rheumatoid arthritis (RA). The purpose of this study was to use National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2018 to assess the individual and combined effects of exposure to phthalate mixtures on RA in adults. A total of 8240 participants with complete data participated in the study, of whom 645 had RA. The levels of ten phthalate metabolites were detected in urine samples. In the single-pollutant models, independent associations were identified between urinary mono-(carboxyoctyl) phthalate (MCOP), mono-(3-carboxylpropyl) phthalate (MCPP), mono-isobutyl phthalate (MiBP) and mono-benzyl phthalate (MBzP) with the incidence of RA. The results of multi-pollutant models, including weighted quantile sum (WQS) regression, quantile-based g computation (qgcomp), and Bayesian kernel machine regression (BKMR) approaches consistently revealed that co-exposure to phthalates was positively associated with RA incidence. Such association was more pronounced in adults over 60 years of age, where MCOP was identified as the dominant positive driver. Overall, our findings add novel evidence that co-exposures to phthalates might be positively associated with RA incidence. Given the limitations of the NHANES study, well-designed longitudinal studies are required to verify or disprove these results.

Racial differences in the associations of urinary phthalate metabolites with depression risk

OBJECTIVE

This study aimed to investigate the composite effects of different kinds of phthalates on depression risk in the U.S population.

METHODS

11731 participants were included from the National Health and Nutrition Examination Survey (NHANES), a national cross-sectional survey. Twelve urinary phthalate metabolites were used to evaluate the level of phthalates exposure. Phthalates levels were devided into four quartiles. High phthalate was defined as having values in the highest quartile.

RESULTS

Urinary mono-isobutyl phthalate (MiBP) and mono-benzyl phthalate (MBzP) were estimated as the independent risk factors for depression by mutivariate logistic regression analyses. Compared with the lowest quartile group of MiBP or MBzP, an incrementally higher risk of depression and moderate/severe depression was observed in the highest quartile (all P_trend <0.05). It was observed that incrementally higher risk of depression and moderate/severe depression were associated with more numbers of high phthalates parameter (P_trend <0.001 and P_trend = 0.003, respectively). A significant interaction between race (Non-Hispanic Black vs. Mexican American) and 2 parameters (having value in the highest quartile of both MiBP and MBzP) was detected for depression (P_interaction = 0.023) and moderate/severe depression (P_interaction = 0.029).

CONCLUSION

Individuals with more numbers of high phthalates parameter were at higher risk of depression and moderate/severe depression. Non-Hispanic Black participants were more likely to be affected by high levels of MiBP and MBzP exposure than Mexican American participants.

Association between phthalate exposure and the risk of depressive symptoms in the adult population of the United States

Previous research has suggested an association between phthalate exposure and depressive symptoms, but the evidence is limited. Our study aimed to examine the association between phthalate exposure and the risk of depressive symptoms in the US adult population. We used data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 to analyze the association between urinary phthalates and depressive symptoms. We included 11 urinary phthalate metabolites in our analysis and used the 9-item Patient Health Questionnaire (PHQ-9) to assess the presence of depression among study participants. Participants were divided into quartiles for each urinary phthalate metabolite, and we evaluated the association using a generalized linear mixed model with a logit link and binary distribution. A total of 7340 participants were included in the final analysis. After controlling for potential confounders, we found a positive association between the molar sum of di (2-ethylhexyl) phthalate (DEHP) metabolites and depressive symptoms, with an odds ratio of 1.30 (95% CI = 1.02-1.66) for the highest compared to the lowest quartile. In addition, we found positive associations of mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and mono (2-ethyl-5-carboxypentyl) phthalate (MECPP) with depressive symptoms, with odds ratios of 1.43 (95% CI = 1.12-1.81, p for trend = 0.02) and 1.44 (95% CI = 1.13-1.84, p for trend = 0.02), respectively, for the highest compared to the lowest quartile. In conclusion, this study is the first to identify a positive association between DEHP metabolites and the risk of depressive symptoms in the general adult population in the United States.

The Role of the Gut Microbiome in Bipolar Disorder and its Common Comorbidities

Bipolar disorder is a decidedly heterogeneous and multifactorial disease, with significant psychosocial and medical disease burden. Much difficulty has been encountered in developing novel therapeutics and objective biomarkers for clinical use in this population. In that regard, gut-microbial homeostasis appears to modulate several key pathways relevant to a variety of psychiatric, metabolic, and inflammatory disorders. Microbial impact on immune, endocrine, endocannabinoid, kynurenine, and other pathways are discussed throughout this review. Emphasis is placed on this system's relevance to current pharmacology, diet, and comorbid illness in bipolar disorder. Despite the high level of optimism promoted in many reviews on this topic, substantial obstacles exist before any microbiome-related findings can provide meaningful clinical utility. Beyond a comprehensive overview of pathophysiology, this review hopes to highlight several key areas where progress is needed. As well, novel microbiome-associated suggestions are presented for future research.

Long-term exposure changes the environmentally relevant bis(2-ethylhexyl) phthalate to be a neuro-hazardous substance disrupting neural homeostasis in emotional and cognitive functions

Bis(2-ethylhexyl) phthalate (DEHP) is the most used member of the phthalate class of compounds. Extensive use of this plasticizer allows daily exposure to humans via various routes. A positive relationship between DEHP exposure and neurobehavioral disorders is suspected. But, there are insufficient data on the harmfulness of neurobehavioral disorders caused by DEHP exposure, particularly at daily exposure levels. In this study, we assessed the consequences of daily DEHP ingestion (2 and 20 mg/kg diets) in male mice for at least 100 days and examined its effects on neuronal functions associated with neurobehavioral disorders, such as depression and cognitive decline. We found the marked depressive behaviors and reduced learning and memory function in the DEHP-ingestion groups, and that biomarkers related to chronic stress were increased in plasma and brain tissues. Long-term DEHP ingestion induced collapse of glutamate (Glu) and glutamine (Gln) homeostasis as a result of disruption of the Glu-Gln cycle in the medial prefrontal cortex and hippocampus. The reduced glutamatergic neurotransmission activity caused by DEHP ingestion was demonstrated using an electrophysiological method. This study revealed that long-term exposure to DEHP is hazardous and can cause neurobehavioral disorders, even at daily exposure levels.

Urinary Phthalate Metabolites and Slow Walking Speed in the Korean Elderly Environmental Panel II Study

BACKGROUND

Previous epidemiological studies have suggested that phthalate exposure may contribute to neurocognitive and neurobehavioral disorders and decreased muscle strength and bone mass, all of which may be associated with reduced physical performance. Walking speed is a reliable assessment tool for measuring physical performance in adults age 60 y and older.

OBJECTIVE

We investigated associations between urinary phthalate metabolites and slowness of walking speed in community-dwelling adults ages 60-98 y.

METHODS

We analyzed 1,190 older adults [range, 60-98 y of age; mean±standard deviation (SD) , 74.81±5.99] from the Korean Elderly Environmental Panel II study and measured repeatedly up to three times between 2012 and 2014. Phthalate exposure was estimated using the following phthalate metabolites in urine samples: mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono-n-butyl phthalate (MnBP), mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), and mono-benzyl phthalate (MBzP). Slowness was defined as a walking speed of <1.0meter/second. We used logistic and linear regression models to evaluate the association between each urinary phthalate metabolite and slowness or walking-speed change. We also used Bayesian kernel machine regression (BKMR) to examine overall mixture effects on walking speed.

RESULTS

At enrollment, MBzP levels were associated with an increased odds of slowness [odds ratio (OR) per doubling increase: 1.15, 95% confidence interval (CI): 1.02, 1.30; OR for the highest vs. lowest quartile: 2.20 (95% CI: 1.12, 4.35) with p-trend across quartiles=0.031]. In longitudinal analyses, MEHHP levels showed an increased risk of slowness [OR per doubling increase: 1.15 (95% CI: 1.02, 1.29), OR for the highest vs. lowest quartile: 1.47 (95% CI: 1.04, 2.06), p- trend=0.035]; whereas those with higher MnBP showed a reduced risk of slowness [OR per doubling increase: 0.84 (95% CI: 0.74, 0.96), OR in the highest (vs. lowest) quartile: 0.64 (95% CI: 0.47, 0.87), p-trend=0.006]. For linear regression models, MBzP quartiles were associated with slower walking speed (p-trend=0.048) at enrollment, whereas MEHHP quartiles were associated with slower walking speed, and MnBP quartiles were associated with faster walking speed in longitudinal analysis (p-trend=0.026 and <0.001, respectively). Further, the BKMR analysis revealed negative overall trends between the phthalate metabolite mixtures and walking speed and DEHP group (MEHHP, MEOHP, and MECPP) had the main effect of the overall mixture.

DISCUSSION

Urinary concentrations of prevalent phthalates exhibited significant associations with slow walking speed in adults ages 60-98 y. https://doi.org/10.1289/EHP10549.

"Oxidative stress induced by phthalates in mammals: State of the art and potential biomarkers"

BACKGROUND

Phthalates, plasticizers that are widely used in consumer products including toys, cosmetics, and food containers, have negative effects in liver, kidney, brain, lung and reproductive system of humans and other mammals.

OBJECTIVES

To summarize, describe and discuss the available information on the effects of phthalate exposure in mammals, with emphasis on oxidative stress, and to suggest potential biomarkers of the health risks associated with phthalate exposure.

METHODS

An assessment of scientific journals was performed using the PRISMA model for systematic reviews. Manuscripts reporting effects of phthalate exposure on mammalian health published in the last decade were selected according to originality, content, and association to health hazards.

RESULTS AND DISCUSSION

We identified 25 peer-reviewed articles published between January 1st, 2010 and June 1st, 2021 that fit the aims and selection criteria. Phthalates induce oxidative stress and cell degenerative processes by increasing intracellular reactive species. Antioxidant cytoprotective systems decrease with time of exposure; conversely, oxidative damage markers, including thiobarbituric acid-reactive substances (TBARS), 8-hydroxy-2'-desoxyguanosine (8-OHdG) and malondialdehyde (MDA), increase. Phthalates were associated with endocrine system disfunction, metabolic disorders, infertility, nonviable pregnancy, cell degeneration, growth impairment, tumor development, and cognitive disorders. Phthalates can also aggravate health conditions such as asthma, hepatitis, diabetes, allergies, chronic liver and kidney diseases. Among humans, the more vulnerable subjects to phthalate exposure effects were children and individuals with a prior health condition.

CONCLUSION

Chronic exposure to phthalates induces oxidative stress in mammals with concomitant adverse effects in reproductive, respiratory, endocrine, circulatory, and central nervous systems in both in vitro and in vivo trials. Oxidative damage markers and phthalate metabolites levels were the most common biomarkers of phthalate exposure effects. Studies in free-ranging and wild mammals are nil. Further studies on the pathways that lead to metabolic disruption are needed to identify potential treatments against phthalate-induced detrimental effects.

Chronic inflammation as a potential mediator between phthalate exposure and depressive symptoms

BACKGROUND

A few studies have reported phthalate exposure as a risk factor for depressive symptoms, but the results have been inconsistent. Whether chronic inflammation mediates the relationship between phthalates (PAEs) and depressive symptoms remains unclear. In this study, we establish mediating models of inflammatory factors and explore the mediating role of chronic inflammation in the association between PAEs exposure and depressive symptoms.

METHODS

The sample included 989 participants from the Study on Health and Environment of the Elderly in Lu'an City, Anhui Province. Geriatric depression scale (GDS-30) was used to screen depressive symptoms of the elderly. The levels of seven kinds of PAEs in urine samples and four inflammatory factors in serum of the elderly were measured. To establish the mediating effect of inflammatory factors to explore the potential effect of PAEs exposure on the increased odds of depressive symptoms.

RESULTS

Adjusted for multiple variables, the highest tertiles of Mono (2-ethylhexyl) phthalate (MEHP) (95%CI = 1.051-2.112), Mono benzyl phthalate (MBzP) (95%CI = 1.016-2.082) and Mono butyl phthalate (MBP) (95%CI = 1.102-2.262) were positively correlated with depressive symptoms. The mediating effect of IL-6 and generalized inflammation factor between MEHP exposure and depressive symptoms were 15.96% (95%CI=0.0288-0.1971) and 14.25% (95%CI = 0.0167-0.1899).

CONCLUSIONS

High levels of MEHP, MBzP and MBP increased the odds of depressive symptoms in the elderly, and chronic inflammation had a partial mediating effect on the increased odds of depressive symptoms due to MEHP exposure.

Ingestion of Bis(2-ethylhexyl) phthalate (DEHP) during adolescence causes depressive-like behaviors through hypoactive glutamatergic signaling in the medial prefrontal cortex

Over the past decades, the production and use of hazardous chemicals has increased worldwide, and the incidence of neurological diseases is increasing proportionately. Among these chemicals, Bis(2-ethylhexyl) phthalate (DEHP) is the most common member of the phthalate family used as a plasticizer. The present study assessed the consequences of daily DEHP ingestion and its effects on brain functions related to depressive-like behaviors. Adolescent C57BL/6 male mice ingested different concentrations of DEHP in their diet (2, 20, and 200 mg/kg of diet), and behavioral changes in anxiety, despair, anhedonia, and sociality were investigated. DEHP exposure evoked depressive-like behaviors in a dose-dependent manner for each symptom. The levels of corticosterone and reactive oxygen species/reactive nitrogen species increased in DEHP-exposed groups, suggesting chronic stress-like responses. In the medial prefrontal cortex (mPFC), glutamate and glutamine were decreased, and glutamine synthetase showed lower activity compared to the control group, suggesting imbalanced glutamatergic signaling. Measuring the spontaneous excitatory postsynaptic current of glutamatergic neurons, we found that DEHP ingestion resulted in hypoactive glutamatergic signaling in the mPFC.

Is the Exposome Involved in Brain Disorders through the Serotoninergic System?

Serotonin (5-hydroxytryptamine, 5-HT) is a biogenic monoamine acting as a neurotransmitter in the central nervous system (CNS), local mediator in the gut, and vasoactive agent in the blood. It has been linked to a variety of CNS functions and is implicated in many CNS and psychiatric disorders. The high comorbidity between some neuropathies can be partially understood by the fact that these diseases share a common etiology involving the serotoninergic system. In addition to its well-known functions, serotonin has been shown to be a mitogenic factor for a wide range of normal and tumor cells, including glioma cells, in vitro. The developing CNS of fetus and newborn is particularly susceptible to the deleterious effects of neurotoxic substances in our environment, and perinatal exposure could result in the later development of diseases, a hypothesis known as the developmental origin of health and disease. Some of these substances affect the serotoninergic system and could therefore be the source of a silent pandemic of neurodevelopmental toxicity. This review presents the available data that are contributing to the appreciation of the effects of the exposome on the serotoninergic system and their potential link with brain pathologies (neurodevelopmental, neurodegenerative, neurobehavioral disorders, and glioblastoma).

Chemo Proling and Simultaneous Analysis of Different Combinations of Sinomenii Caulis and Ramulus Cinnamomi Using UHPLC-Q-TOF-MS, GC-MS and HPLC Methods

OBJECTIVE

Sinomenii Caulis (QingFengTeng) and Ramulus Cinnamomi (GuiZhi) are traditional Chinese drugs that have been used for anti-inflammation. In this study, the team plans to find out the material basis of a Chinese herb combination composed of the two herbs with different ratios.

METHODS

The extracts of the herbal compound with various ratios obtained from ethanol extraction were analyzed by ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF-MS) and gas chromatography coupled mass spectrometry to identify the basic chemical compounds. Simultaneously, the contents of the eight main components (sinomenine, magnoflorine, laurifoline, dauricine, coumarin, cinnamyl alcohol, cinnamic acid and cinnamaldehyde) from herb formula were determined by gradient elution by high-performance liquid chromatography. Furthermore, the content of sinomenine and cinnamaldehyde were determined by isocratic elution, respectively.

RESULTS

Eighteen compounds in the herb formula were identified by UHPLC-Q-TOF-MS. The components in the GuiZhi are mostly volatile oils and the kinds of compounds isolated from the formula in the ratio of 4:1 were the most. Wherein eight compounds were identified as the main detection targets in the content determination.

CONCLUSION

The extraction rate of sinomenine in QingFengTeng was related to the proportion of GuiZhi in the drug pairs. Synchronously, the addition of sinomenine in different proportions also had some influence on the extraction of cinnamaldehyde in GuiZhi. Furthermore, the series of methods was successfully applied to the simultaneous determination of chemical compounds in different samples of QingFengTeng-GuiZhi decoction.

Urinary phthalate metabolite concentrations and hot flashes in women from an urban convenience sample of midlife women

CONTEXT

Phthalate exposure is associated with altered reproductive function, but little is known about associations of phthalate exposure with risk of hot flashes.

OBJECTIVE

To investigate associations of urinary phthalate metabolite levels with four hot flash outcomes in midlife women.

DESIGN

A cross-sectional study of the first year of a prospective cohort of midlife women, the Midlife Women's Health Study (2006-2015), a convenience sample from an urban setting.

PARTICIPANTS

728 multi-racial/ethnic pre- and perimenopausal women aged 45-54 years.

OUTCOME MEASURES

Women completed questionnaires about hot flash experience and provided 1-4 urine samples over four consecutive weeks that were pooled for analysis. Phthalate metabolites were assessed individually and as molar sums representative of common compounds (all phthalates: ƩPhthalates; DEHP: ƩDEHP), exposure sources (plastics: ƩPlastic; personal care products: ƩPCP), and modes of action (anti-androgenic: ƩAA). Covariate-adjusted logistic regression models were used to assess associations of continuous natural log-transformed phthalate metabolite concentrations with hot flash outcomes. Analyses were conducted to explore whether associations differed by menopause status, body mass index (BMI), race/ethnicity, and depressive symptoms.

RESULTS

Overall, 45% of women reported a history of hot flashes. Compared to women who never experienced hot flashes, every two-fold increase in ƩPlastic was associated with 18% (OR: 1.18; 95%CI: 0.98, 1.43) and 38% (OR: 1.38; 95%CI: 1.11, 1.70) higher odds of experiencing hot flashes in the past 30 days and experiencing daily/weekly hot flashes, respectively. Some associations of phthalates with certain hot flash outcomes differed by menopause status, BMI, race/ethnicity, and depressive symptoms.

CONCLUSIONS

This study suggests that phthalates are associated with hot flash experience and may impact hot flash risk in women who are susceptible to experiencing hot flashes.

Association of phthalate exposure and endogenous hormones with self-reported sleep disruptions: results from the Midlife Women's Health Study

OBJECTIVE

Follicle-stimulating hormone and estradiol (E2) have been associated with sleep in midlife women, however, few studies have examined the association of other hormones or environmental chemical exposure such as phthalates, with self-reported sleep quality. We assessed the relationship of self-reported sleep with hormones and phthalates.

METHODS

In total, 762 women (aged 45-54 y, 459 premenopausal, and 303 perimenopausal) from the Midlife Women's Health Study answered self-reported questions regarding the frequency of sleep disturbances, insomnia, and restless sleep. Serum E2, progesterone, testosterone, serum hormone binding globulin, free E2 index, free testosterone index, E2:progesterone, and E2:testosterone were measured. Summary measures of phthalate mixtures, including the phthalates from plastic sources (sumPLASTIC), personal care products (sumPCP), di-(2-ethyhexyl) phthalate (sumDEHP), anti-androgenic phthalates (sumAA), and all phthalate metabolites measured (sumALL), were calculated from urinary phthalate metabolites. Ordinal logistic regression was used to fit each outcome sleep measure with all hormones and summary phthalates.

RESULTS

Progesterone and testosterone were significantly negatively associated with the frequency of sleep disturbances and insomnia. Free testosterone index was also negatively associated with insomnia frequency. E2:progesterone was positively associated with frequency of sleep disturbances and restless sleep in self-reported nonsmokers. SumPCP and sumALL were significantly negatively associated with frequency of sleep disturbances, insomnia, and restless sleep. SumDEHP and sumPLASTIC were negatively associated with insomnia frequency. Further, the direction of association between phthalates and sleep appears to be dependent on the quartile of phthalate exposure. All significant associations between phthalates and sleep were in self-reported nonsmokers or former smokers.

CONCLUSIONS

Our study supports previous literature that hormones beyond follicle-stimulating hormone and E2 are associated with sleep disruptions in menopause. Further, we are among the first to show that phthalate exposure is associated with sleep disruptions in midlife women.

Impact of Endocrine-Disrupting Chemicals in Breast Milk on Postpartum Depression in Korean Mothers

Previous human and animal studies have reported an association between endocrine-disrupting chemicals (EDCs) and anxiety/depression. This study aimed to determine how the concentrations of phthalate metabolites, bisphenol A, triclosan, and parabens in breast milk are associated with the risk of developing postpartum depression (PPD) in Korean mothers. We recruited 221 mothers who were receiving lactation coaching at breastfeeding clinics between July and September 2018. The breast milk samples were collected along with responses to the Edinburgh Postnatal Depression Scale. The multivariable logistic regression results revealed that the phthalate, bisphenol A, parabens, and triclosan levels in the breast milk were not significantly associated with the risk of PPD. This study was the first attempt to analyze the association between the levels of EDCs in breast milk and the risk of PPD. Considering that PPD is a condition that affects not only the women diagnosed with it, but also their children and families, the results of this study may have great relevance to populations in environmentally sensitive periods.

Moderating effects of plastic packaged food on association of urinary phthalate metabolites with emotional symptoms in Chinese adolescents

Previous research reports that diet is the main source of phthalate exposure to adolescents, and phthalate is associated with adolescent mental and behavioral problems. However, no study has explored the moderating effects of eating behavior in this association. This study aimed to analyze the moderating effects of plastic packaged food consumption in the longitudinal association between phthalate metabolite concentration and emotional symptoms in adolescents. This school-based survey was carried out among adolescents in two Chinese provinces. We conducted a baseline and follow-up surveys for 893 freshmen using the purposive sampling method from December 2018 to November 2019. We used food frequency questionnaire to assess eating behavior. The Chinese version of 21-item Depression Anxiety Stress Scales was used to assess emotional symptoms, and high-performance liquid chromatography-tandem mass spectrometry was used to analyze the concentration of six urine phthalate metabolites. The results of latent moderation model indicated that plastic packaged food consumption moderated the association of low molecular weight phthalate (LMWP) with depressive symptoms (β = 0.27, P = 0.002), anxiety symptoms (β = 0.89, P < 0.01), and stress symptoms (β = 0.23, P = 0.019). The moderating effects were significant at the higher scores (β = 0.14-0.35, P < 0.05) and/or the lower scores (β = -0.35 to -0.12, P < 0.05) of plastic packaged food consumption. The results suggest that plastic packaged food consumption to some extent moderates the longitudinal association of phthalate exposure with emotional symptoms in adolescents.

Levels and determinants of urinary phthalate metabolites in Chinese community-dwelling older adults

BACKGROUND

Biomonitoring studies have demonstrated extensive exposure of infants, children, and pregnant women to phthalates, but data on phthalate exposure and their determinants in Chinese older adults remain insufficient. This study aims to assess urinary phthalate metabolite levels, individual and cumulative exposure risk, and their determinants in Chinese community-dwelling older adults.

METHODS

A total of 987 individuals aged 60 years or over were included in this study. The urinary levels of seven phthalate metabolites were measured using high-performance liquid chromatography-tandem mass spectrometry. The estimated daily intake (EDI), hazard quotient (HQ), and hazard index (HI) of phthalates were calculated based on urinary metabolite levels. The associations between phthalate metabolite levels and potential determinants were examined using multiple linear regressions.

RESULTS

Detection rates of seven phthalate metabolites from the study population ranged from 63.83% to 99.39%. The highest median concentration was 43.64 μg/L (42.59 μg/g creatinine) for mono-butyl phthalate (MBP). The highest median EDI was 1.55 μg/kg-bw/day for diethyl phthalate (DBP). Nearly 5% of participants had high HI values exceeding 1, mainly attributed to DBP and di-2-ethylhexyl phthalate (DEHP). Furthermore, we found that females, higher body mass index (BMI), smoking, having two or more chronic diseases, and vegetable-based diets were significantly associated with higher levels of parts of phthalate metabolites. More interestingly, higher urine levels of high-molecular-weight (HMW) phthalate metabolites and lower urine levels of low-molecular-weight (LMW) phthalate metabolites were found in rural older adults than in urban older adults.

CONCLUSIONS

Chinese community-dwelling older adults are extensively exposed to phthalates, especially to DBP and DEHP. More attention should be paid to urban-rural differences in exposure to HMW and LMW phthalates and to phthalate exposure among older adults with overweight/obesity, females, and individuals who are current heavy smokers, have two or more chronic diseases, and consume vegetable-based diets.

Association between Phthalate Exposure and Frailty among Community-Dwelling Older Adults: A Repeated Panel Data Study

Only a few studies have examined the impacts of environmental exposure on frailty. This study investigated the association between phthalates and frailty among community-dwelling older adults. The Korean Elderly Environmental Panel II (KEEP II) study is a repeated panel data study of 800 community-dwelling older adults in South Korea. Frailty was measured with five items defined by Fried and colleagues. Environmental pollutants in the form of two types of metabolites for Di-ethylhexyl phthalate (DEHPs)-Mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and Mono (2-ethyl-5-oxohexyl) phthalate (MEOHP)-were obtained from urine specimens. Analyses were performed using repeated linear mixed models. The concentration levels of both MEOHP and MEHHP in urine were significantly higher in the pre-frail or frail group than its counterparts. While adjusting for covariates, MEOHP level was positively associated with the likelihood of being pre-frail or frail in both males and females; the concentration level of MEHHP also had a positive impact on the likelihood of being pre-frail or frail in females. The DEHP metabolite concentrations were significantly lower among adults with daily fruit consumption in both males and females. DEHPs, measured by metabolite concentrations, may increase the risk of frailty among older men and women; further studies are necessary. The preventive effects of nutrition on DEHP risk should also be further investigated.

Brain Disorders and Chemical Pollutants: A Gap Junction Link?

The incidence of brain pathologies has increased during last decades. Better diagnosis (autism spectrum disorders) and longer life expectancy (Parkinson's disease, Alzheimer's disease) partly explain this increase, while emerging data suggest pollutant exposures as a possible but still underestimated cause of major brain disorders. Taking into account that the brain parenchyma is rich in gap junctions and that most pollutants inhibit their function; brain disorders might be the consequence of gap-junctional alterations due to long-term exposures to pollutants. In this article, this hypothesis is addressed through three complementary aspects: (1) the gap-junctional organization and connexin expression in brain parenchyma and their function; (2) the effect of major pollutants (pesticides, bisphenol A, phthalates, heavy metals, airborne particles, etc.) on gap-junctional and connexin functions; (3) a description of the major brain disorders categorized as neurodevelopmental (autism spectrum disorders, attention deficit hyperactivity disorders, epilepsy), neurobehavioral (migraines, major depressive disorders), neurodegenerative (Parkinson's and Alzheimer's diseases) and cancers (glioma), in which both connexin dysfunction and pollutant involvement have been described. Based on these different aspects, the possible involvement of pollutant-inhibited gap junctions in brain disorders is discussed for prenatal and postnatal exposures.

A Scoping Review of Non-Occupational Exposures to Environmental Pollutants and Adult Depression, Anxiety, and Suicide

PURPOSE OF REVIEW

Despite a call for better understanding of the role of environmental pollutant influences on mental health and the tremendous public health burden of mental health, this issue receives far less attention than many other effects of pollutants. Here we summarize the body of literature on non-occupational environmental pollutant exposures and adult depression, anxiety, and suicide-in PubMed, Embase, Web of Science, and PsychINFO through the end of year 2018.

RECENT FINDINGS

One hundred twelve articles met our criteria for further review. Of these, we found 88 articles on depression, 33 on anxiety, and 22 on suicide (31 articles covered multiple outcomes). The earliest article was published in 1976, and the most frequent exposure of interest was air pollution (n = 33), followed by secondhand smoke (n = 20), metals (n = 18), noise (n = 17), and pesticides (n = 10). Other exposures studied less frequently included radiation, magnetic fields, persistent organic pollutants (POPs), volatile organic compounds, solvents, and reactive sulfur compounds. The current literature, although limited, clearly suggests many kinds of environmental exposures may be risk factors for depression, anxiety, and suicide. For several pollutants, important limitations exist with many of the studies. Gaps in the body of research include a need for more longitudinal, life-course studies, studies that can measure cumulative exposures as well as shorter-term exposures, studies that reduce the possibility of reverse causation, and mechanistic studies focused on neurotoxic exposures.

Investigation of phthalate metabolites in urine and daily phthalate intakes among three age groups in Beijing, China

Phthalates are widely used as binders and plasticizers in industrial and consumer products but show diverse toxicity. We investigated the level of human exposure to phthalates in Beijing, one of the most densely populated cities in the world. In this study, 12 metabolites of phthalates were measured in 70 spot urine samples collected from Beijing residents from August 2017 to April 2018 using ultra high-performance liquid chromatography tandem mass spectrometry. We found that metabolites of phthalates were ubiquitous in all urine samples. Total concentrations of phthalate metabolites ranged from 39.6 to 1931 ng mL^-1, with median concentrations were in decreasing order of children (371 ng mL^-1)> younger adults (332 ng mL^-1)> older adults (276 ng mL^-1). Mono-n-butyl phthalate (MnBP) was the predominant compound, and occurred at concentrations greater than those reported for people in other countries. The mean values of estimated daily intakes (EDIs) of ∑phthalate were 35.2, 10.3 and 10.9 ng (kg-bm)^-1 d^-1 for children, younger adults and older adults, respectively. EDIs of di-n-butyl phthalate (DnBP), di-iso-butyl phthalate (DiBP) and di-(2-ethylhexyl) phthalate (DEHP) exceeded reference values suggested by the US Environmental Protection Agency and the European Food Safety Authority. When concentrations were normalized to volume or creatinine-adjusted, hazard quotients (HQs) for 40 of 70 participants exhibited larger HQs >1 for individual phthalates, which was indicative of potential for adverse effects. Thus, exposure to phthalates might be a critical factor contributing to adverse health effects in Beijing residents. To the best of our knowledge, this is the first study to establish a pre-baseline level of urinary phthalate metabolites among residents in Beijing.

Environmental Exposures and Depression: Biological Mechanisms and Epidemiological Evidence

Mental health and well-being are consistently influenced—directly or indirectly—by multiple environmental exposures. In this review, we have attempted to address some of the most common exposures of the biophysical environment, with a goal of demonstrating how those factors interact with central structures and functions of the brain and thus influence the neurobiology of depression. We emphasize biochemical mechanisms, observational evidence, and areas for future research. Finally, we include aspects of contextual environments—city living, nature, natural disasters, and climate change—and call for improved integration of environmental issues in public health science, policies, and activities. This integration is necessary for reducing the global pandemic of depression.

Migration and potential risk of trace phthalates in bottled water: A global situation

Increasing attention has been dedicated to trace phthalates in bottled water due to the serious concerns on public health, while there is still a lack of systematic analysis and assessment of current global situation. Through analyzing five representative phthalates in bottled water over 20 countries, this work clearly revealed the phthalates-associated potential risks in both human daily intake and estrogenic effect. In the risk assessment, the kinetic models were also developed to describe and predict phthalates migration. In more than three hundred brands of bottled waters from twenty one countries, the detection frequency of the five targeted phthalates was found to be in the order of dibutyl phthalate (DBP, 67.6%), di-2-(ethyl hexyl) phthalate (DEHP, 61.7%), diethyl phthalate (DEP, 47.1%), benzyl butyl phthalate (BBP, 36.9%), and dimethyl phthalate (DMP, 30.1%). Among the countries studied relating concentrations of DEHP in bottled waters, the top five countries ranked in the order of high to low were Thailand, Croatia, Czech Republic, Saudi Arabia and China with an average level of 61.1, 8.8, 6.3, 6.2 and 6.1 μg/L, respectively. The average levels of BBP, DBP, DMP and DEP in bottled water from Pakistan were high, in which DEP and DMP were ranked 1st among all countries with the average levels of 22.4 and 50.2 μg/L, while BBP and DBP were ranked 2nd and 3rd with the average levels of 7.5 and 17.8 μg/L, respectively. The human daily intake-based risk assessment revealed that phthalates in bottled waters studied would not pose a serious concern on public health. However, the adverse estrogenic effects of phthalates in bottled water from some countries appeared to be significant. This study just shed light on global situation of phthalates in bottled water, and more efforts should be needed to systematically examine the phthalates-related safety of bottled water.