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尿酚类化合物、炎症性肠病与慢性腹泻症状之间的关联:来自美国国家健康与营养检查调查的证据。

Association of urinary phenolic compounds, inflammatory bowel disease and chronic diarrheal symptoms: Evidence from the National Health and Nutrition Examination Survey.

作者信息

de Silva Punyanganie S, Yang Xuan, Korzenik Joshua R, Goldman Rose H, Arheart Kristopher L, Caban-Martinez Alberto J

机构信息

Division of Gastroenterology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.

Division of Environment and Public Health of the Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL 33136, United States.

出版信息

Environ Pollut. 2017 Oct;229:621-626. doi: 10.1016/j.envpol.2017.06.023.

Abstract

Endocrine disruptors such as phenolic compounds and parabens may be involved in chronic non-infective disease. While products incorporating these compounds are extensively utilized in consumer and personal products, little is known about their effect on bowel health. Inflammatory bowel disease (IBD) - consisting of the diseases ulcerative colitis and Crohn's disease - and irritable bowel syndrome are common chronic non-infectious diarrheal diseases. Despite limited knowledge on the etiology of IBD, these diseases have increased prevalence in industrialized countries and cause significant impairment to quality of life. In the present study we examine relationships between urinary environmental phenolic compounds, chronic diarrhea and inflammatory bowel disease. Data was obtained from the 2005-2010 US National Health and Nutrition Examination Survey (NHANES) including demographics, lifestyle factors, self-reported health conditions, inflammatory markers and urinary phenolic chemical concentrations. Only participants with complete environmental phenols & parabens component were included in our analysis. Chronic diarrheal symptoms were determined by using the 2009-2010 NHANES questionnaire which included questions pertaining to bowel health. We utilized chronic bowel leakage symptoms as a surrogate marker for chronic diarrhea. The presence of IBD was also analyzed from 2009 to 2010 NHANES data, as a sub-analysis for arthropathy directly querying the presence or absence of IBD. Among the subset of 5218 American adults aged 20-80 years in the NHANES study period who completed environmental phenols & parabens component, 25.5% reported chronic diarrheal symptoms. Abnormal markers of inflammation were present in 2200 (42.2%) of respondents. For IBD, 19 individuals with arthropathy confirmed a diagnosis of ulcerative colitis, and 1 person confirmed a Crohn's diagnosis. After adjustment for demographics, inflammatory and subsample weighing; lower paraben levels were associated with chronic bowel leakage (diarrheal) symptoms. Higher 4-tert-octylphenol levels was significantly associated with ulcerative colitis. Further study of underlying mechanisms should be considered.

摘要

酚类化合物和对羟基苯甲酸酯等内分泌干扰物可能与慢性非感染性疾病有关。虽然含有这些化合物的产品广泛应用于消费品和个人护理产品中,但人们对它们对肠道健康的影响知之甚少。炎症性肠病(IBD)——包括溃疡性结肠炎和克罗恩病——以及肠易激综合征是常见的慢性非感染性腹泻疾病。尽管对IBD的病因了解有限,但这些疾病在工业化国家的患病率有所上升,并对生活质量造成严重损害。在本研究中,我们研究了尿中环境酚类化合物、慢性腹泻和炎症性肠病之间的关系。数据来自2005 - 2010年美国国家健康与营养检查调查(NHANES),包括人口统计学、生活方式因素、自我报告的健康状况、炎症标志物和尿中酚类化学物质浓度。我们的分析仅纳入了环境酚类和对羟基苯甲酸酯成分完整的参与者。慢性腹泻症状通过使用2009 - 2010年NHANES问卷来确定,该问卷包含与肠道健康相关的问题。我们将慢性肠道渗漏症状用作慢性腹泻的替代指标。IBD的存在情况也从2009年至2010年的NHANES数据中进行分析,作为对关节炎的子分析,直接询问IBD的存在与否。在NHANES研究期间完成环境酚类和对羟基苯甲酸酯成分的5218名20 - 80岁美国成年人子集中,25.5%报告有慢性腹泻症状。2200名(42.2%)受访者存在炎症异常标志物。对于IBD,19名有关节炎的个体确诊为溃疡性结肠炎,1人确诊为克罗恩病。在对人口统计学、炎症和子样本权重进行调整后,较低的对羟基苯甲酸酯水平与慢性肠道渗漏(腹泻)症状相关。较高的4 - 叔辛基苯酚水平与溃疡性结肠炎显著相关。应考虑对潜在机制进行进一步研究。

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