Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Sci Total Environ. 2024 Jan 10;907:167915. doi: 10.1016/j.scitotenv.2023.167915. Epub 2023 Oct 18.
Environmental exposure to volatile organic compounds (VOCs) is ubiquitous, and this study explored whether exposure to VOCs is associated with the risk of kidney stones. We performed a nationally representative US cross-sectional study using data from five survey cycles (2011-2020) of the National Health and Nutrition Examination Survey (NHANES) program. Exposure to VOCs was determined by urine creatinine-corrected metabolites of VOCs (mVOCs). In total 5505 participants and 15 urine mVOCs were included for analysis, and the prevalence of kidney stones was 9.57 % (527/5505). Multivariable logistic regression showed that urine AMCC (parent VOCs (pVOCs): N, N-Dimethylformamide), 3,4-MHA (pVOCs: xylene), MA (pVOCs: ethylbenzene; styrene), DHBMA (pVOCs: 1,3-butadiene), HMPMA (pVOCs: crotonaldehyde) and 2HPMA (pVOCs: propylene oxide) were significantly associated with an increased risk of kidney stones in US general population. Sub-analysis revealed that there was a more pronounced association in women and the overweight/obesity group (body mass index ≥ 25). Moreover, the weighted quantile sum (WQS) regression model and the Bayesian kernel machine regression (BKMR) model consistently identified a positive association between co-exposure to VOCs and the risk of kidney stones, in which AMCC played the most important role among the 15 mVOCs. Mediation analysis further identified serum high-density lipoprotein cholesterol (HDL) as a mediator of the association between VOC co-exposure and kidney stones. Our study draws attention to the previously unknown positive associations between non-occupational VOC exposure and the risk of kidney stones in the general population. However, further studies are required to clarify the existence of such causation.
环境暴露于挥发性有机化合物（VOCs）是普遍存在的，本研究探讨了暴露于 VOCs 是否与肾结石风险相关。我们使用国家健康和营养检查调查（NHANES）计划五个调查周期（2011-2020 年）的数据进行了一项具有全国代表性的美国横断面研究。VOCs 的暴露通过尿液肌酸酐校正的 VOCs 代谢物（mVOCs）来确定。共有 5505 名参与者和 15 种尿液 mVOCs 纳入分析，肾结石的患病率为 9.57%（527/5505）。多变量逻辑回归显示，尿液 AMCC（母体 VOCs（pVOCs）：N，N-二甲基甲酰胺）、3,4-MHA（pVOCs：二甲苯）、MA（pVOCs：乙苯；苯乙烯）、DHBMA（pVOCs：1,3-丁二烯）、HMPMA（pVOCs：丙烯醛）和 2HPMA（pVOCs：环氧丙烷）与美国普通人群肾结石风险增加显著相关。亚分析显示，在女性和超重/肥胖人群（体重指数≥25）中，这种关联更为明显。此外，加权分位数总和（WQS）回归模型和贝叶斯核机器回归（BKMR）模型一致地确定了 VOC 共暴露与肾结石风险之间存在正相关，其中 AMCC 在 15 种 mVOCs 中发挥了最重要的作用。中介分析进一步确定血清高密度脂蛋白胆固醇（HDL）是 VOC 共暴露与肾结石之间关联的中介。我们的研究引起了人们对先前未知的非职业性 VOC 暴露与普通人群肾结石风险之间的正相关的关注。然而，需要进一步的研究来阐明这种因果关系的存在。
