School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, 200032, China.
Chemical Laboratory, Jing'an District Center for Disease Control and Prevention, Shanghai, 200041, China.
Environ Res. 2022 Oct;213:113733. doi: 10.1016/j.envres.2022.113733. Epub 2022 Jun 22.
The association between phthalates and early renal injury is largely unknown in adults. We aim to explore the associations of phthalates and hypertension with early renal injury, and the interactive effects of phthalate and hypertension on the early renal injury. This study enrolled 3283 U.S. adults from NHANES 2001-2004. We detected nine phthalate metabolites in spot urine. We also measured the multiple indicators of early renal injury, including albumin-to-creatinine (Cr) ratio (ACR), β2-microglobulin (B2M), cystatin C (CYST), and calculated the estimated glomerular filtration rate (eGFR), including Cr-based eGFR, CYST-based eGFR, and Cr-CYST-based eGFR. Multiple linear regression and multivariable logistic regression were used to explore the associations among urinary phthalate metabolites, hypertension, and the indicators of early renal injury. The results showed that monobenzyl phthalate (MBzP), mono (3-carboxypropyl) phthalate (MCPP), and mono (2-ethylhexyl) phthalate (MEHP) were positively associated with ACR, B2M, CYST and negatively associated with three eGFR. Mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) was positively associated with ACR, with a β value of 0.099 (95% CI: 0.046, 0.152). Meanwhile, MEHP was associated with a higher risk of ACR abnormality, with an OR value of 1.258 (95% CI: 1.067, 1.482). MBzP, MCPP, and MEOHP increased the risks of ACR, B2M, CYST, and eGFR abnormality. Hypertension was positively associated with ACR, with a β value of 0.460 (95% CI: 0.360, 0.561). We also found interactive effects of monoethyl phthalate (MEP), MCPP, MBzP, monobutyl phthalate (MnBP), and hypertension on B2M, CYST, and three kinds of eGFR. Our results indicated that certain phthalate metabolites might contribute to increased risks of early renal injury. The hypertension population may be more sensitive to the early renal injury caused by phthalates exposure than the non-hypertension population.
邻苯二甲酸酯与早期肾损伤之间的关联在成年人中很大程度上尚不清楚。我们旨在探讨邻苯二甲酸酯和高血压与早期肾损伤的关联，以及邻苯二甲酸酯和高血压对早期肾损伤的交互作用。本研究纳入了来自 NHANES 2001-2004 年的 3283 名美国成年人。我们检测了尿液中 9 种邻苯二甲酸代谢物。我们还测量了早期肾损伤的多个指标，包括白蛋白与肌酐（Cr）比值（ACR）、β2-微球蛋白（B2M）、胱抑素 C（CYST），并计算了基于 Cr、CYST 和 Cr-CYST 的估计肾小球滤过率（eGFR）。我们使用多元线性回归和多变量逻辑回归来探讨尿液中邻苯二甲酸代谢物、高血压与早期肾损伤指标之间的关联。结果表明，单苄基邻苯二甲酸酯（MBzP）、单（3-羧基丙基）邻苯二甲酸酯（MCPP）和单（2-乙基己基）邻苯二甲酸酯（MEHP）与 ACR、B2M、CYST 呈正相关，与三种 eGFR 呈负相关。单（2-乙基-5-氧代己基）邻苯二甲酸酯（MEOHP）与 ACR 呈正相关，β 值为 0.099（95%CI：0.046，0.152）。同时，MEHP 与 ACR 异常的风险增加相关，OR 值为 1.258（95%CI：1.067，1.482）。MBzP、MCPP 和 MEOHP 增加了 ACR、B2M、CYST 和 eGFR 异常的风险。高血压与 ACR 呈正相关，β 值为 0.460（95%CI：0.360，0.561）。我们还发现，邻苯二甲酸二甲酯（MEP）、MCPP、MBzP、单丁基邻苯二甲酸酯（MnBP）和高血压对 B2M、CYST 和三种 eGFR 有交互作用。我们的结果表明，某些邻苯二甲酸酯代谢物可能会增加早期肾损伤的风险。与非高血压人群相比，高血压人群可能对邻苯二甲酸酯暴露引起的早期肾损伤更为敏感。
