Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China.
Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China.
Environ Res. 2022 Nov;214(Pt 3):113962. doi: 10.1016/j.envres.2022.113962. Epub 2022 Aug 5.
The effects of environmental endocrine-disrupting chemicals (EDCs) (e.g., phthalates) on fractional exhaled nitric oxide (FeNO) in children have received much attention. However, few studies evaluated this relationship in adults, and the previous studies have considered only a unitary exposure or a set of similar exposures instead of mixed exposures, which contain complicated interactions. We aimed to evaluate simultaneously the relationship between three types of EDCs (six phthalate metabolites and two parabens in urine, two heavy metals in blood) and FeNO (as a continuous variable) in adults. Data of adults aged ≥20 years from the National Health and Nutrition Examination Survey (NHANES, 2007-2012) were collected and analyzed. The generalized linear (GLM) regression model was used to explore the association of chemicals with FeNO. The combined effect of 10 chemicals on the overall association with FeNO was evaluated by the weighted quantile sum regression (WQS) model. In addition, The Bayesian kernel machine regression (BKMR) model was explored to investigate the interaction and joint effects of multiple chemicals with FeNO. Of the 3296 study participants ultimately included, among the GLMs, we found that mercury (Hg) (β = 0.84, 95%CI:0.32-1.36, FDR = 0.01) and methyl paraben (MPB) (β = 0.47, 95%CI:0.16-0.78, FDR = 0.015) were positively correlated with FeNO. In the WQS model, the combined effect of chemicals almost had a significantly positive association with FeNO and the top three contributors to the WQS index were Hg (40.2%), MECPP (22.1%), and MPB (19.3%). BKMR analysis showed that there may be interactions between MPB and Hg, Mono (carboxyoctyl) phthalate (MCOP) and Hg and the overall effect of the mixture showed a positive correlation with FeNO. In conclusion, our study strengthens the credibility of the view that EDCs can affect respiratory health. In the future, we should be particularly careful with products containing Hg, MECPP, MPB, and MEHP for the prevention of respiratory diseases.
环境内分泌干扰化学物质(EDCs)(如邻苯二甲酸酯)对儿童呼出气一氧化氮(FeNO)的影响备受关注。然而,很少有研究评估成人中这种关系,并且之前的研究仅考虑单一暴露或一组类似暴露,而不是混合暴露,其中包含复杂的相互作用。我们旨在同时评估三种类型的 EDC(尿液中的六种邻苯二甲酸酯代谢物和两种对羟基苯甲酸酯、血液中的两种重金属)与成人 FeNO(作为连续变量)之间的关系。从国家健康和营养检查调查(NHANES,2007-2012 年)中收集并分析了 20 岁及以上成年人的数据。使用广义线性(GLM)回归模型来探讨化学物质与 FeNO 的关联。通过加权分位数总和回归(WQS)模型评估 10 种化学物质对整体与 FeNO 关联的综合影响。此外,还探索了贝叶斯核机器回归(BKMR)模型,以研究多种化学物质与 FeNO 之间的相互作用和联合作用。在最终纳入的 3296 名研究参与者中,在 GLM 中,我们发现汞(Hg)(β=0.84,95%CI:0.32-1.36,FDR=0.01)和甲基对羟基苯甲酸酯(MPB)(β=0.47,95%CI:0.16-0.78,FDR=0.015)与 FeNO 呈正相关。在 WQS 模型中,化学物质的综合效应几乎与 FeNO 呈显著正相关,WQS 指数的前三个主要贡献者是 Hg(40.2%)、MECPP(22.1%)和 MPB(19.3%)。BKMR 分析表明,MPB 和 Hg、Mono(carboxyoctyl)邻苯二甲酸酯(MCOP)和 Hg 之间可能存在相互作用,混合物的整体效应与 FeNO 呈正相关。总之,我们的研究加强了 EDC 会影响呼吸健康的观点的可信度。在未来,我们应该特别注意含有 Hg、MECPP、MPB 和 MEHP 的产品,以预防呼吸道疾病。