Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Department of Gynaecology and Obstetrics, People's Hospital of Pingfang District, Harbin, China.
Environ Sci Pollut Res Int. 2023 Nov;30(55):117715-117728. doi: 10.1007/s11356-023-30545-1. Epub 2023 Oct 23.
To explore the association between exposure to polycyclic aromatic hydrocarbons (PAHs) and endometriosis risk. Data were obtained from the 2003-2006 National Health and Nutrition Examination Survey database. Urinary concentrations of PAHs were divided into quartiles, and weighted multivariate logistic regression, restricted cubic spline, and subgroup analyses were performed. An extreme gradient boosting (XGBoost) algorithm was used to screen the most important PAHs. After multivariable adjustments, 9-fluorene, 1-phenanthrene, 2-phenanthrene, and 4-phenanthrene exposure were significantly associated with a risk of endometriosis. Specifically, compared with the reference group, the odds ratios (ORs) of endometriosis for the fourth quartile were 3.52 (95% confidence interval (CI): 1.15, 10.77), 3.10 (95% CI: 1.37, 6.97), 4.86 (95% CI: 1.93, 12.21), and 2.67 (95% CI: 1.02, 7.01) for 9-fluorene, 1-phenanthrene, 2-phenanthrene, and 4-phenanthrene, respectively. In terms of continuous exposure, each one-standard-deviation increase in the urinary concentration of 9-fluorene, 1-phenanthrene, 2-phenanthrene, and 4-phenanthrene was independently associated with a 66% (OR: 1.66, 95% CI: 1.15, 2.40), 62% (OR:1.62, 95% CI: 1.19, 2.20), 68% (OR: 1.68, 95% CI: 1.24, 2.28), and 56% (OR: 1.56, 95% CI: 1.11, 2.19) increase in the risk of endometriosis, respectively, in the fully adjusted model. A significant association between the urinary concentration of 9-fluorene and the risk of endometriosis was also observed in participants who had a high body-mass index (≥25 kg/m), with a corresponding OR of 2.61 (95% CI: 1.37, 5.00; P for interaction = 0.006). Our findings show that high urinary concentrations of PAHs were associated with a high risk of endometriosis in participants and that the urinary concentration of 9-fluorene was related with a high susceptibility of endometriosis in participants with overweight.
探讨多环芳烃（PAHs）暴露与子宫内膜异位症风险之间的关联。数据来自 2003-2006 年国家健康与营养调查数据库。将 PAHs 的尿浓度分为四分位，并进行加权多变量逻辑回归、限制立方样条和亚组分析。使用极端梯度提升（XGBoost）算法筛选最重要的 PAHs。经过多变量调整后，9-芴、1-菲、2-菲和 4-菲的暴露与子宫内膜异位症风险显著相关。具体而言，与参考组相比，第四四分位数的子宫内膜异位症比值比（OR）分别为 3.52（95%置信区间（CI）：1.15，10.77）、3.10（95%CI：1.37，6.97）、4.86（95%CI：1.93，12.21）和 2.67（95%CI：1.02，7.01）。对于 9-芴、1-菲、2-菲和 4-菲，连续暴露时，尿中 9-芴、1-菲、2-菲和 4-菲的浓度每增加一个标准差，与子宫内膜异位症风险的独立相关性分别为 66%（OR：1.66，95%CI：1.15，2.40）、62%（OR：1.62，95%CI：1.19，2.20）、68%（OR：1.68，95%CI：1.24，2.28）和 56%（OR：1.56，95%CI：1.11，2.19）。在完全调整模型中，在体重指数（BMI）较高（≥25kg/m）的参与者中，9-芴尿浓度与子宫内膜异位症风险之间也存在显著关联，相应的 OR 为 2.61（95%CI：1.37，5.00；P 交互=0.006）。我们的研究结果表明，较高的尿 PAHs 浓度与参与者中子宫内膜异位症的高风险相关，而 9-芴的尿浓度与超重参与者中子宫内膜异位症的高易感性相关。
