National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan; Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
School of Public Health, National Defense Medical Center, Taipei, Taiwan.
Ecotoxicol Environ Saf. 2024 Oct 15;285:117091. doi: 10.1016/j.ecoenv.2024.117091. Epub 2024 Sep 27.
Few studies have investigated the associations between phthalate exposure and kidney function indicators in adults by simultaneously performing covariate-adjusted creatinine standardization, cumulative risk assessment, and mixture analysis. Thus, we applied these methods simultaneously to investigate the aforementioned associations in an adult population. This cross-sectional study analyzed data (N = 839) from a community-based arm of the Taiwan Biobank. The levels of 10 urinary phthalate metabolites were measured and calculated as the sum of the molar concentrations of the dibutyl phthalate metabolite (ΣDBPm) and di(2-ethylhexyl) phthalate (DEHP) metabolite (ΣDEHPm). The hazard index (HI) and daily intake (DI) were estimated by measuring the urinary levels of the phthalate metabolite. Kidney function biomarkers were assessed by measuring the following: blood urea nitrogen (BUN), uric acid, the albumin-to-creatinine ratio (ACR), and the estimated glomerular filtration rate (eGFR). Generalized linear models were implemented to examine the associations between exposure to individual phthalates, HI scores, and kidney function biomarkers. We also employed Bayesian kernel machine regression (BKMR) to analyze the relationships between exposure to various combinations of phthalates and kidney function. ΣDEHPm levels were significantly and positively associated with BUN and ACR levels, and ΣDBPm levels were positively associated with ACR levels. In addition, eGFR was negatively associated with ΣDBPm and ΣDEHPm levels. In the BKMR model, a mixture of 10 phthalate metabolites was significantly associated with BUN, uric acid, ACR, and eGFR results. Higher DI and higher DI values were significantly associated with lower eGFRs and higher ACRs, respectively. Higher DI and DI values were significantly associated with higher uric acid levels. A higher HI was significantly associated with lower eGFRs and higher ACRs. Our results suggest that exposure to environmental phthalates is associated with impaired kidney function in Taiwanese adults.
很少有研究通过同时进行协变量调整的肌酐标准化、累积风险评估和混合物分析来研究邻苯二甲酸酯暴露与成年人肾功能指标之间的关系。因此，我们在成年人人群中同时应用这些方法来研究上述关联。本横断面研究分析了来自台湾生物库社区基础臂的数据（N=839）。测量了 10 种尿邻苯二甲酸酯代谢物的水平，并计算为二丁基邻苯二甲酸酯代谢物（ΣDBPm）和邻苯二甲酸二（2-乙基己基）酯（DEHP）代谢物（ΣDEHPm）的摩尔浓度之和。通过测量尿邻苯二甲酸酯代谢物水平来估计危害指数（HI）和每日摄入量（DI）。通过测量以下指标来评估肾功能生物标志物：血尿素氮（BUN）、尿酸、白蛋白与肌酐比值（ACR）和估算肾小球滤过率（eGFR）。实施广义线性模型来检查个体邻苯二甲酸暴露、HI 评分与肾功能生物标志物之间的关联。我们还采用贝叶斯核机器回归（BKMR）分析了不同组合的邻苯二甲酸暴露与肾功能之间的关系。ΣDEHPm 水平与 BUN 和 ACR 水平呈显著正相关，ΣDBPm 水平与 ACR 水平呈正相关。此外，eGFR 与 ΣDBPm 和 ΣDEHPm 水平呈负相关。在 BKMR 模型中，10 种邻苯二甲酸代谢物的混合物与 BUN、尿酸、ACR 和 eGFR 结果显著相关。较高的 DI 和更高的 DI 值分别与较低的 eGFR 和较高的 ACR 显著相关。较高的 DI 和 DI 值与较高的尿酸水平显著相关。较高的 HI 与较低的 eGFR 和较高的 ACR 显著相关。我们的研究结果表明，暴露于环境邻苯二甲酸酯与台湾成年人肾功能受损有关。
