Zhang Duo, Liu Xiang, Tu Jiazichao, Xiao Qinru, Han Linjiang, Fu Jinfeng, Bian Junye, Zhang Ruyue, Chen Jimei, Shao Yijia, Lu Shaoyou
School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China.
Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
Environ Health (Wash). 2024 Feb 5;2(3):170-179. doi: 10.1021/envhealth.3c00155. eCollection 2024 Mar 15.
There is a lack of human evidence concerning the cardiovascular effects of combined exposure to endocrine disruptors. This case-control study sought to investigate coronary heart disease (CHD) associations with exposure to organophosphate flame retardants (OFRs), phthalates (PAEs), and polycyclic aromatic hydrocarbons (PAHs) among 148 adults with coronary-angiography-diagnosed CHD and 320 healthy adults from southern China. The mediating role of glucose-lipid metabolism was also explored. Bayesian kernel machine regression suggested that when exposure status was fixed to the 75th percentile with the median value as the reference, exposure to OFRs, PAEs, and PAHs was associated with an 84% (95% CI: 36%-134%), 132% (12%-252%), and 214% (89%-331%) increased risk of developing CHD, respectively. Weighted quantile sum regression indicated urinary bis(2-butoxyethyl) phosphate (BBOEP), dibutyl phosphate (DBP), monoisononyl phthalate (miNP), and metabolites of phenanthrene may be major contributors to the overall effect of mixtures. In further analyses on identified chemical risk factors, mediation analyses suggested exposure to phenanthrene may increase the risk of CHD via elevating total cholesterol and blood glucose, while exposure to DiNP mainly associates with serum lipids. Besides, we observed a slight mediation effect of oxidative DNA damage between urinary BBOEP and risk of CHD. These results provide potential direction for further experimental studies. Longitudinal evidence is needed to clarify the causation of the results.
关于内分泌干扰物联合暴露对心血管系统影响的人体证据尚不充分。这项病例对照研究旨在调查148名经冠状动脉造影诊断为冠心病的成年人以及320名来自中国南方的健康成年人中，冠心病与有机磷酸酯阻燃剂（OFRs）、邻苯二甲酸酯（PAEs）和多环芳烃（PAHs）暴露之间的关联。同时还探讨了糖脂代谢的中介作用。贝叶斯核机器回归分析表明，当将暴露状态固定在第75百分位数，并以中位数作为参考时，暴露于OFRs、PAEs和PAHs会使患冠心病的风险分别增加84%（95%置信区间：36%-134%）、132%（12%-252%）和214%（89%-331%）。加权分位数和回归分析表明，尿中双（2-丁氧基乙基）磷酸酯（BBOEP）、磷酸二丁酯（DBP）、单异壬基邻苯二甲酸酯（miNP）和菲的代谢物可能是混合物总体效应的主要贡献因素。在对已确定的化学风险因素进行的进一步分析中，中介分析表明，暴露于菲可能通过升高总胆固醇和血糖来增加患冠心病的风险，而暴露于邻苯二甲酸二异壬酯（DiNP）主要与血脂相关。此外，我们观察到尿中BBOEP与冠心病风险之间存在轻微的氧化DNA损伤中介效应。这些结果为进一步的实验研究提供了潜在方向。需要纵向证据来阐明这些结果的因果关系。
