Kim Kyoung-Nam, Choi Yoon-Hyeong, Lim Youn-Hee, Hong Yun-Chul
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Preventive Medicine, Gachon University Graduate School of Medicine, Incheon, Republic of Korea.
Environ Res. 2016 Feb;145:61-67. doi: 10.1016/j.envres.2015.11.021. Epub 2015 Dec 6.
Previous animal studies have demonstrated that phthalate exposure is associated with depression-like behaviors. However, no human study has explored this relationship. We explored the association between urinary phthalate metabolite concentrations and depression in a nationally representative sample of the U.S. elderly population. We analyzed 2030 participants aged 60 years or older with available data on phthalates and depression from the 2005 to 2012 National Health and Nutrition Examination Survey (NHANES). We selected 10 urinary phthalate metabolites with a weighted detection rate >60%. Depression was defined as a 9-item Patient Health Questionnaire score ≥10. The models were adjusted for age, sex, race/ethnicity, education level, income-to-poverty ratio, health insurance coverage, marital status, smoking status, alcohol consumption, moderate physical activity, body mass index, comorbidity status, NHANEs cycle, and urinary creatinine levels. One-unit increases in log-transformed mono-(3-carboxypropyl) phthalate (MCPP) (odds ratio [OR]=1.24, 95% confidence interval [CI]=1.02-1.52) and mono(carboxynonyl) phthalate (MCNP) (OR=1.42, 95% CI=1.15-1.75) were positively associated with depression. When we stratified the urinary phthalate metabolites into quartiles, the highest quartiles (Q4) of MCNP (OR=2.57, 95% CI=1.25-5.27) and mono-n-butyl phthalate (MBP) (OR=2.40, 95% CI=1.10-5.22) were associated with depression compared with the lowest quartiles (Q1). Concentrations of urinary phthalate metabolites MCPP, MCNP, and MBP were positively associated with the risk of depression in a representative sample of the U.S. elderly population. However, the present cross-sectional study is hypothesis generating and the associations need to be investigated through further longitudinal studies.
以往的动物研究表明，接触邻苯二甲酸盐与类似抑郁的行为有关。然而，尚无人体研究探讨这种关系。我们在美国老年人群具有全国代表性的样本中，探究了尿中邻苯二甲酸酯代谢物浓度与抑郁症之间的关联。我们分析了2030名年龄在60岁及以上的参与者，他们来自2005年至2012年的全国健康与营养检查调查（NHANES），拥有邻苯二甲酸盐和抑郁症的相关可用数据。我们选取了加权检出率>60%的10种尿中邻苯二甲酸酯代谢物。抑郁症定义为9项患者健康问卷评分≥10。模型针对年龄、性别、种族/民族、教育水平、收入与贫困比率、医疗保险覆盖情况、婚姻状况、吸烟状况、饮酒量、适度体育活动、体重指数、合并症状况、NHANES周期以及尿肌酐水平进行了调整。对数转换后的单（3-羧丙基）邻苯二甲酸酯（MCPP）每增加一个单位（优势比[OR]=1.24，95%置信区间[CI]=1.02 - 1.52）以及单（羧壬基）邻苯二甲酸酯（MCNP）（OR=1.42，95% CI=1.15 - 1.75）与抑郁症呈正相关。当我们将尿中邻苯二甲酸酯代谢物分层为四分位数时，与最低四分位数（Q1）相比，MCNP的最高四分位数（Q4）（OR=2.57，95% CI=1.25 - 5.27）和单正丁基邻苯二甲酸酯（MBP）（OR=2.40，95% CI=1.10 - 5.22）与抑郁症相关。在美国老年人群的代表性样本中，尿中邻苯二甲酸酯代谢物MCPP、MCNP和MBP的浓度与抑郁症风险呈正相关。然而，目前的横断面研究只是提出假设，这些关联需要通过进一步的纵向研究来调查。
