Clinic of Pediatric Metabolic Diseases, Etlik City Hospital, 06170 Ankara, Türkiye.
Division of Social Pediatrics, Department of Pediatrics, Hacettepe University İhsan Doğramacı Children's Hospital, 06230 Ankara, Türkiye.
Nutrients. 2024 Sep 23;16(18):3213. doi: 10.3390/nu16183213.
Phenylketonuria (PKU) is the most common amino acid metabolism disorder. Patients with blood phenylalanine (Phe) levels of ≥6 mg/dL require treatment, and the most definitive treatment is the Phe-restricted diet. Bisphenols and phthalates are widely used endocrine-disrupting chemicals (EDCs) found in personal care products, baby bottles, and food packaging.
In this study, we evaluated the possible routes of exposure to these EDCs in patients diagnosed with PKU (n = 105, 2-6 years of age) and determined the relationship between the plasma levels of bisphenol A (BPA), bisphenol F (BPF), di-butyl phthalate (DBP), di-(2-ethylhexyl) phthalate (DEHP), mono-(2ethylhexyl) phthalate (MEHP), and dietary regimens. Participant characteristics and exposure routes were evaluated according to their dietary treatment status.
Thirty-four of these patients were on a Phe-restricted diet, while the remaining 71 had no dietary restrictions. DBP and DEHP levels were higher in those using plastic tablecloths ( = 0.049 and = 0.04, respectively). In addition, plasma DBP levels were higher in those who used bottled water ( = 0.01). Being under 4 years of age, using plastic food containers, and using plastic shower curtains were characteristics associated with higher MEHP levels ( = 0.027, = 0.019, and = 0.014, respectively). After adjustment for baseline characteristics (Model 1), the odds of having a plasma BPA level in the upper tertile were 3.34 times higher in the free-diet group (95% CI = 1.09-10.25). When we additionally adjusted for plastic exposure (Model 2), the odds ratio was found to be 18.64 (95% CI = 2.09-166.42) for BPA. In the free-diet group, the probability of having plasma DEHP levels in the upper tertile was increased by a relative risk of 3.01 ( = 0.039, 95% CI = 1.06-8.60).
Our results indicate that exposure to bisphenols and phthalates varies with dietary treatment. The difference in sources of exposure to EDCs between the diet and non-diet groups indicates that diet plays an important role in EDC exposure.
苯丙酮尿症（PKU）是最常见的氨基酸代谢紊乱疾病。血苯丙氨酸（Phe）水平≥6mg/dL 的患者需要治疗，最明确的治疗方法是限制 Phe 的饮食。双酚类和邻苯二甲酸酯是广泛存在于个人护理产品、奶瓶和食品包装中的内分泌干扰化学物质（EDC）。
本研究评估了 105 名（2-6 岁）PKU 患者接触这些 EDC 的可能途径，并确定了血浆中双酚 A（BPA）、双酚 F（BPF）、邻苯二甲酸二丁酯（DBP）、邻苯二甲酸二（2-乙基己基）酯（DEHP）、邻苯二甲酸单（2-乙基己基）酯（MEHP）的浓度与饮食方案之间的关系。根据饮食治疗状况评估参与者特征和暴露途径。
34 名患者接受限制 Phe 的饮食，其余 71 名患者无饮食限制。使用塑料桌布的患者 DBP 和 DEHP 水平较高（=0.049 和=0.04）。此外，使用瓶装水的患者血浆 DBP 水平较高（=0.01）。4 岁以下、使用塑料食品容器和使用塑料浴帘是与较高 MEHP 水平相关的特征（=0.027、=0.019 和=0.014）。在调整基线特征后（模型 1），自由饮食组 BPA 血浆水平处于上三分位数的比值比为 3.34（95%CI=1.09-10.25）。当我们进一步调整塑料暴露时（模型 2），BPA 的比值比为 18.64（95%CI=2.09-166.42）。在自由饮食组中，DEHP 血浆水平处于上三分位数的相对风险增加了 3.01（=0.039，95%CI=1.06-8.60）。
我们的结果表明，双酚类和邻苯二甲酸酯的暴露随饮食治疗而变化。饮食组和非饮食组之间 EDC 暴露源的差异表明，饮食在 EDC 暴露中起着重要作用。
