Department of Urology, The First Affiliated Hospital of Nanjing Medical University, No 300 Guangzhou Road, Nanjing, 210029, China.
Department of Sports Medicine and Joint Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China.
BMC Public Health. 2024 Jul 14;24(1):1873. doi: 10.1186/s12889-024-19414-9.
Organic phosphorus insecticides (OPPs) are a class of environmental pollutants widely used worldwide with potential human health risks. We aimed to assess the association between exposure to OPPs and osteoarthritis (OA) particularly in participants with atherosclerotic cardiovascular disease (ASCVD).
Participants' information was obtained from data in the National Health and Nutrition Examination (NHANES). Weighted logistic regression models were utilized to detect associations between OPPs metabolites and OA. Restricted cubic spline plots (RCS) were drawn to visualize the dose-response relationship between each metabolite and OA prevalence. Weighted quantile sum (WQS) regression and Bayesian kernel-machine regression (BKMR), were applied to investigate the joint effect of mixtures of OPPs on OA.
A total of 6871 samples were included in our study, no significant associations between OPPs exposure and OA incidence were found in whole population. However, in a subset of 475 individuals with ASCVD, significant associations between DMP (odds ratio [OR] as a continuous variable = 1.22, 95% confidence interval [CI]: 1.07,1.28), DEP ((odds ratio [OR] of the highest tertile compared to the lowest = 2.43, 95% confidence interval [CI]: 1.21,4.86), and OA were observed. DMP and DEP showed an increasing dose-response relationship to the prevalence of OA, while DMTP, DETP, DMDTP and DEDTP showed a nonlinear relationship. Multi-contamination modeling revealed a 1.34-fold (95% confidence intervals:0.80, 2.26) higher prevalence of OA in participants with high co-exposure to OPPs compared to those with low co-exposure, with a preponderant weighting (0.87) for the dimethyl dialkyl phosphate metabolites (DMAPs). The BKMR also showed that co-exposure of mixed OPPs was associated with an increased prevalence of OA, with DMP showing a significant dose-response relationship.
High levels of urine dialkyl phosphate metabolites (DAP) of multiple OPPs are associated with an increased prevalence of OA in patients with ASCVD, suggesting the need to prevent exposure to OPPs in ASCVD patients to avoid triggering OA and further avoid the occurrence of cardiovascular events caused by OA.
有机磷杀虫剂（OPPs）是一类在全球范围内广泛使用的环境污染物，具有潜在的人类健康风险。我们旨在评估接触 OPPs 与骨关节炎（OA）之间的关联，特别是在患有动脉粥样硬化性心血管疾病（ASCVD）的参与者中。
参与者的信息来自国家健康和营养检查调查（NHANES）的数据。使用加权逻辑回归模型来检测 OPPs 代谢物与 OA 之间的关联。绘制受限立方样条图（RCS）以直观显示每种代谢物与 OA 患病率之间的剂量-反应关系。加权分位数总和（WQS）回归和贝叶斯核机器回归（BKMR）用于研究 OPPs 混合物对 OA 的联合效应。
本研究共纳入了 6871 个样本，在整个人群中，未发现 OPPs 暴露与 OA 发生率之间存在显著关联。然而，在 ASCVD 的 475 名亚组中，DMP（连续变量的比值比[OR] = 1.22，95%置信区间[CI]：1.07，1.28）、DEP（与最低 tertile 相比最高 tertile 的比值比[OR] = 2.43，95%置信区间[CI]：1.21，4.86）与 OA 之间存在显著关联。DMP 和 DEP 显示出与 OA 患病率的递增剂量-反应关系，而 DMTP、DETP、DMDTP 和 DEDTP 则表现出非线性关系。多污染模型显示，与低 OPPs 共暴露相比，高 OPPs 共暴露的参与者中 OA 的患病率高 1.34 倍（95%置信区间：0.80，2.26），且二甲基二烷基磷酸盐代谢物（DMAPs）的权重较高（0.87）。BKMR 还显示，混合 OPPs 的共暴露与 OA 患病率的增加有关，DMP 显示出显著的剂量-反应关系。
高水平的尿液二烷基磷酸盐代谢物（DAP）与 ASCVD 患者中 OA 的患病率增加有关，这表明需要预防 ASCVD 患者接触 OPPs，以避免引发 OA 并进一步避免由 OA 引起的心血管事件的发生。
