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Day DB, Melough MM, Flynn JT, Zhu H, Kannan K, Ruzinski J, de Boer IH, Sathyanarayana S. Environmental exposure to melamine and its derivatives and kidney outcomes in children. ENVIRONMENTAL RESEARCH 2024; 252:118789. [PMID: 38555096 PMCID: PMC11156556 DOI: 10.1016/j.envres.2024.118789] [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: 01/26/2024] [Revised: 03/18/2024] [Accepted: 03/23/2024] [Indexed: 04/02/2024]
Abstract
Melamine caused acute nephrotoxicity in a past food adulteration incident, but it is unclear whether and how widespread ambient exposure to melamine and related compounds might affect pediatric kidney health. We assessed cross-sectional associations between childhood exposure to melamine and its derivatives and biomarkers of kidney injury and health and explored potential heterogeneity by sex suggested by sex-dependent differences in renal physiology. We measured melamine and its derivatives ammeline, ammelide, and cyanuric acid (CYA) in spot urine samples collected from 192 children from an urban site (Seattle, WA) and 187 children from a rural site (Yakima, WA) aged 4-8 years in the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) Study. In addition, biomarkers of kidney injury were measured in the same urine samples, including albumin, total protein, KIM-1, NAG, NGAL, and EGF. We utilized linear regressions to examine associations between individual chemical exposures and kidney biomarkers. Interaction terms examined association modification by sex, as well as potential interactions between melamine and CYA. Despite comparable exposures, girls had higher levels of many kidney injury biomarkers compared to boys. A ten-fold higher melamine concentration was associated with a 18% (95% CI: 5.6%, 31%) higher EGF in the full sample, while ten-fold higher melamine was associated with a 76% (14.1%, 173%) higher KIM-1 in boys but not in girls (-10.1% (-40.6%, 36.1%), interaction p = 0.026). Melamine exhibited significant negative interactions with CYA in association with total protein and NAG that appeared to be specific to girls. Our results suggest possible associations between melamine exposure and markers of kidney injury that may be more pronounced in boys. These findings provide novel insights into melamine and related derivative compound health effects at low levels of exposure in children and emphasize the role of sex in mediating the relationship between nephrotoxicant exposure and kidney injury.
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Affiliation(s)
- Drew B Day
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA.
| | - Melissa M Melough
- Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, DE, 19713, USA.
| | - Joseph T Flynn
- Division of Nephrology, Seattle Children's Hospital, 4800 Sand Point NE, Seattle, WA, 98105, USA; Department of Pediatrics, University of Washington, 1959 Northeast Pacific Street, Seattle, WA, 98195, USA.
| | - Hongkai Zhu
- Department of Environmental Medicine, Nankai University, No. 38 Tongyan Road, Jinnan District, Tianjin, 300350, China.
| | | | - John Ruzinski
- Kidney Research Institute, Department of Nephrology, University of Washington, 908 Jefferson St, Seattle, WA, 98104, USA.
| | - Ian H de Boer
- Kidney Research Institute, Department of Nephrology, University of Washington, 908 Jefferson St, Seattle, WA, 98104, USA.
| | - Sheela Sathyanarayana
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA; Department of Pediatrics, University of Washington, 1959 Northeast Pacific Street, Seattle, WA, 98195, USA.
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Choi G, Kuiper JR, Bennett DH, Barrett ES, Bastain TM, Breton CV, Chinthakindi S, Dunlop AL, Farzan SF, Herbstman JB, Karagas MR, Marsit CJ, Meeker JD, Morello-Frosch R, O'Connor TG, Pellizzari ED, Romano ME, Sathyanarayana S, Schantz S, Schmidt RJ, Watkins DJ, Zhu H, Kannan K, Buckley JP, Woodruff TJ. Exposure to melamine and its derivatives and aromatic amines among pregnant women in the United States: The ECHO Program. CHEMOSPHERE 2022; 307:135599. [PMID: 36055588 PMCID: PMC9748524 DOI: 10.1016/j.chemosphere.2022.135599] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/24/2022] [Accepted: 07/01/2022] [Indexed: 05/09/2023]
Abstract
BACKGROUND Melamine, melamine derivatives, and aromatic amines are nitrogen-containing compounds with known toxicity and widespread commercial uses. Nevertheless, biomonitoring of these chemicals is lacking, particularly during pregnancy, a period of increased susceptibility to adverse health effects. OBJECTIVES We aimed to measure melamine, melamine derivatives, and aromatic amine exposure in pregnant women across the United States (U.S.) and evaluate associations with participant and urine sample collection characteristics. METHODS We measured 43 analytes, representing 45 chemicals (i.e., melamine, three melamine derivatives, and 41 aromatic amines), in urine from pregnant women in nine diverse ECHO cohorts during 2008-2020 (N = 171). To assess relations with participant and urine sample collection characteristics, we used generalized estimating equations to estimate prevalence ratios (PRs) for analytes dichotomized at the detection limit, % differences (%Δ) for continuous analytes, and 95% confidence intervals. Multivariable models included age, race/ethnicity, marital status, urinary cotinine, and year of sample collection. RESULTS Twelve chemicals were detected in >60% of samples, with near ubiquitous detection of cyanuric acid, melamine, aniline, 4,4'-methylenedianiline, and a composite of o-toluidine and m-toluidine (99-100%). In multivariable adjusted models, most chemicals were associated with higher exposures among Hispanic and non-Hispanic Black participants. For example, concentrations of 3,4-dichloroaniline were higher among Hispanic (%Δ: +149, 95% CI: +17, +431) and non-Hispanic Black (%Δ: +136, 95% CI: +35, +311) women compared with non-Hispanic White women. We observed similar results for ammelide, o-/m-toluidine, 4,4'-methylenedianiline, and 4-chloroaniline. Most chemicals were positively associated with urinary cotinine, with strongest associations observed for o-/m-toluidine (%Δ: +23; 95% CI: +16, +31) and 3,4-dichloroaniline (%Δ: +25; 95% CI: +17, +33). Some chemicals exhibited annual trends (e.g., %Δ in melamine per year: -11; 95% CI: -19, -1) or time of day, seasonal, and geographic variability. DISCUSSION Exposure to melamine, cyanuric acid, and some aromatic amines was ubiquitous in this first investigation of these analytes in pregnant women. Future research should expand biomonitoring, identify sources of exposure disparities by race/ethnicity, and evaluate potential adverse health effects.
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Affiliation(s)
- Giehae Choi
- Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Jordan R Kuiper
- Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Deborah H Bennett
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Carrie V Breton
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Sridhar Chinthakindi
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Anne L Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Julie B Herbstman
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA
| | - Margaret R Karagas
- Department of Epidemiology, Dartmouth Geisel School of Medicine, Lebanon, NH, USA
| | - Carmen J Marsit
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, CA, USA
| | - Thomas G O'Connor
- Department of Psychiatry, University of Rochester, Rochester, NY, USA
| | | | - Megan E Romano
- Department of Epidemiology, Dartmouth Geisel School of Medicine, Lebanon, NH, USA
| | - Sheela Sathyanarayana
- Department of Pediatrics, University of Washington, Seattle Children's Research Institute, Seattle, WA, USA; Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Susan Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Rebecca J Schmidt
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | - Deborah J Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Hongkai Zhu
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Jessie P Buckley
- Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Tracey J Woodruff
- Department of Obstetrics, Gynecology, and Reproductive Sciences and the Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA.
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