Moccia Chiara, Pizzi Costanza, Moirano Giovenale, Popovic Maja, Zugna Daniela, d'Errico Antonio, Isaevska Elena, Fossati Serena, Nieuwenhuijsen Mark J, Fariselli Piero, Sanavia Tiziana, Richiardi Lorenzo, Maule Milena
Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy.
Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy.
Environ Int. 2023 Mar;173:107864. doi: 10.1016/j.envint.2023.107864. Epub 2023 Mar 7.
The exposome drivers are less studied than its consequences but may be crucial in identifying population subgroups with unfavourable exposures.
We used three approaches to study the socioeconomic position (SEP) as a driver of the early-life exposome in Turin children of the NINFEA cohort (Italy).
Forty-two environmental exposures, collected at 18 months of age (N = 1989), were classified in 5 groups (lifestyle, diet, meteoclimatic, traffic-related, built environment). We performed cluster analysis to identify subjects sharing similar exposures, and intra-exposome-group Principal Component Analysis (PCA) to reduce the dimensionality. SEP at childbirth was measured through the Equivalised Household Income Indicator. SEP-exposome association was evaluated using: 1) an Exposome Wide Association Study (ExWAS), a one-exposure (SEP) one-outcome (exposome) approach; 2) multinomial regression of cluster membership on SEP; 3) regressions of each intra-exposome-group PC on SEP.
In the ExWAS, medium/low SEP children were more exposed to greenness, pet ownership, passive smoking, TV screen and sugar; less exposed to NO, NO, PM, humidity, built environment, traffic load, unhealthy food facilities, fruit, vegetables, eggs, grain products, and childcare than high SEP children. Medium/low SEP children were more likely to belong to a cluster with poor diet, less air pollution, and to live in the suburbs than high SEP children. Medium/low SEP children were more exposed to lifestyle PC1 (unhealthy lifestyle) and diet PC2 (unhealthy diet), and less exposed to PC1s of the built environment (urbanization factors), diet (mixed diet), and traffic (air pollution) than high SEP children.
The three approaches provided consistent and complementary results, suggesting that children with lower SEP are less exposed to urbanization factors and more exposed to unhealthy lifestyles and diet. The simplest method, the ExWAS, conveys most of the information and is more replicable in other populations. Clustering and PCA may facilitate results interpretation and communication.
与暴露组的后果相比，对其驱动因素的研究较少，但这可能对识别暴露不利的人群亚组至关重要。
我们采用三种方法研究社会经济地位（SEP）作为意大利NINFEA队列中都灵儿童早期暴露组的驱动因素。
在18个月大时收集的42种环境暴露因素（N = 1989）被分为5组（生活方式、饮食、气象气候、交通相关、建筑环境）。我们进行聚类分析以识别暴露情况相似的受试者，并进行暴露组内主成分分析（PCA）以降低维度。分娩时的SEP通过等效家庭收入指标来衡量。SEP与暴露组的关联通过以下方式评估：1）全暴露组关联研究（ExWAS），一种单暴露（SEP）单结果（暴露组）的方法；2）聚类成员身份对SEP的多项回归；3）每个暴露组内主成分对SEP的回归。
在ExWAS中，与高SEP儿童相比，中/低SEP儿童更多地暴露于绿地、养宠物、被动吸烟、电视屏幕和糖分；更少暴露于一氧化氮、二氧化氮、颗粒物、湿度、建筑环境、交通负荷、不健康食品设施、水果、蔬菜、鸡蛋、谷物产品和儿童保育。与高SEP儿童相比，中/低SEP儿童更有可能属于饮食较差、空气污染较少且居住在郊区的聚类。与高SEP儿童相比，中/低SEP儿童更多地暴露于生活方式主成分1（不健康生活方式）和饮食主成分2（不健康饮食），而较少暴露于建筑环境（城市化因素）、饮食（混合饮食）和交通（空气污染）的主成分1。
这三种方法提供了一致且互补的结果，表明SEP较低的儿童较少暴露于城市化因素，而更多地暴露于不健康的生活方式和饮食。最简单的方法ExWAS传达了大部分信息，并且在其他人群中更具可重复性。聚类和PCA可能有助于结果的解释和交流。
