Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 88 South Keyuan Road, Chengdu, 610041, People's Republic of China.
Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, 610041, China.
Environ Sci Pollut Res Int. 2022 Sep;29(43):64692-64703. doi: 10.1007/s11356-022-20307-w. Epub 2022 Apr 27.
The aim of this study is to investigate the associations between phthalate exposure and UI in a nationally representative sample of US adults. Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) database was used for analysis. In total, 2,818 participants with measurements for phthalate metabolites and complete UI questionnaire data were enrolled in our study. Furthermore, seven phthalate metabolites were measured, which were obtained from urine samples and creatinine-standardized in the subsequent analyses. After dividing these phthalate metabolites into three groups, multivariable regression models were performed to evaluate the association between phthalate metabolites and UI rates. Moreover, interaction analyses and subgroup analyses stratified by gender were performed. In these seven phthalate metabolites, high level of mono-carboxynonyl phthalate (MCNP), mono-carboxyoctyl phthalate (MCOP), mono-isobutyl phthalate (MiBP), mono-n-butyl phthalate (MBP), and mono-3-carboxypropyl phthalate (MCPP) showed increased risk of UI (odds ratio (OR) = 1.52, 1.42, 1.43, 1.50, 1.51, respectively, all p value < 0.05). Trend test showed that incidence of UI increased significantly with concentration. A higher incidence of UI among participants was observed in the maximal tertile of phthalate when comparing with the lowest tertile. Subgroup analysis found that different phthalates have varying influence for different types of UI. Moreover, the analyses stratified for sex indicated that the high concentrations of MCNP and median concentrations of MCCP were associated with increase of the odds of UI in women and in men, respectively. Overall, the exposure to phthalates was positively associated with UI among US adults. Notably, different phthalates have varying influence for different types of UI, and male and female exposure to phthalate could result in the different prevalence of UI.
本研究旨在调查美国成年人中邻苯二甲酸酯暴露与 UI 之间的关联。分析使用了来自国家健康和营养检查调查（NHANES）数据库的横断面数据。共有 2818 名参与者接受了邻苯二甲酸酯代谢物测量和完整的 UI 问卷数据。此外，还测量了 7 种邻苯二甲酸酯代谢物，这些代谢物从尿液样本中获得，并在后续分析中用肌酐标准化。将这些邻苯二甲酸酯代谢物分为三组后，进行多变量回归模型来评估邻苯二甲酸酯代谢物与 UI 发生率之间的关系。此外，还进行了交互分析和按性别分层的亚组分析。在这 7 种邻苯二甲酸酯代谢物中，高水平的单羧酸壬基邻苯二甲酸酯（MCNP）、单羧酸辛基邻苯二甲酸酯（MCOP）、单异丁基邻苯二甲酸酯（MiBP）、单正丁基邻苯二甲酸酯（MBP）和单-3-羧基丙基邻苯二甲酸酯（MCPP）与 UI 风险增加有关（比值比（OR）分别为 1.52、1.42、1.43、1.50、1.51，均 P 值<0.05）。趋势检验显示，UI 的发生率随着浓度的增加而显著增加。与最低三分位相比，在最高三分位的邻苯二甲酸盐中，参与者的 UI 发生率更高。亚组分析发现，不同的邻苯二甲酸酯对不同类型的 UI 有不同的影响。此外，按性别分层的分析表明，MCNP 浓度较高和 MCCP 中位数浓度与女性和男性 UI 几率的增加相关。总的来说，美国成年人中邻苯二甲酸酯的暴露与 UI 呈正相关。值得注意的是，不同的邻苯二甲酸酯对不同类型的 UI 有不同的影响，男性和女性暴露于邻苯二甲酸酯可能导致 UI 的不同患病率。
