Wang Pangbo, Huang Jing, Fang Hongwei, Jia Yong, Xu Liwei, Zhao Jun, Hu Rong
Department of Neurosurgery and State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital; Chongqing Key Laboratory of Precision Neuromedicine and Neuroregenaration, Third Military Medical University (Army Medical University), 400038 Chongqing, China.
Hand and foot microsurgery, NO. 946 Hospital of PLA land Force, 835000 Yining, China.
J Clin Endocrinol Metab. 2025 Jan 9. doi: 10.1210/clinem/dgaf002.
Phthalates, widely used as chemical additives, are often found as mixtures in the environment. However, the combined impact of phthalate exposure on sarcopenia remains unclear.
This study aimed to investigate the relationships between phthalates and sarcopenia in adults.
We analyzed data from 3,536 participants from the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2018.Multivariable logistic regression, restricted cubic splines (RCSs), weighted quantile sum regression (WQS), quantile-based g computation (qgcomp), and Bayesian kernel machine regression (BKMR) models were employed to assess the individual, nonlinear, and combined associations between phthalate metabolites and sarcopenia. In addition, subgroup analyses were performed to elucidate sex- and age-specific differences.
Multivariable logistic regression revealed that MBP, MEP, and MiBP were positively associated with sarcopenia (P < 0.05) after adjusting for several covariates, including age, sex, race/ethnicity, education level, marital status, body mass index (BMI), smoking status, alcohol drinking, hypertension, diabetes, stroke, congestive heart failure, chronic kidney disease, physical activity, protein intake and energy intake. MBP exhibited a nonlinear relationship with sarcopenia in the RCS model. Furthermore, mixed phthalate metabolites were associated with a higher risk of sarcopenia in the WQS and qgcomp models. The BKMR model indicated an increasing trend in sarcopenia risk. Subgroup analyses showed stronger associations among individuals aged 20-40 years. BKMR analyses also revealed potential interaction effects between MCPP, MECPP, MBP, and MEP on sarcopenia risk.
This study provides new evidence that co-exposure to phthalates might increase the risk of sarcopenia. Further research is needed to explore the causal relationship between phthalate metabolites and sarcopenia, as well as to elucidate the underlying mechanisms involved.
邻苯二甲酸盐作为化学添加剂被广泛使用，在环境中常以混合物形式存在。然而，邻苯二甲酸盐暴露对肌肉减少症的综合影响仍不清楚。
本研究旨在调查成年人中邻苯二甲酸盐与肌肉减少症之间的关系。
我们分析了2011年至2018年期间进行的美国国家健康与营养检查调查（NHANES）中3536名参与者的数据。采用多变量逻辑回归、受限立方样条（RCS）、加权分位数和回归（WQS）、基于分位数的g计算（qgcomp）以及贝叶斯核机器回归（BKMR）模型来评估邻苯二甲酸酯代谢物与肌肉减少症之间的个体、非线性和综合关联。此外，进行亚组分析以阐明性别和年龄特异性差异。
多变量逻辑回归显示，在调整了年龄、性别、种族/民族、教育水平、婚姻状况、体重指数（BMI）、吸烟状况、饮酒、高血压、糖尿病、中风、充血性心力衰竭、慢性肾脏病、身体活动、蛋白质摄入量和能量摄入量等多个协变量后，单丁基邻苯二甲酸酯（MBP）、单乙基邻苯二甲酸酯（MEP）和单异丙基邻苯二甲酸酯（MiBP）与肌肉减少症呈正相关（P < 0.05）。在RCS模型中，MBP与肌肉减少症呈现非线性关系。此外，在WQS和qgcomp模型中，混合邻苯二甲酸酯代谢物与肌肉减少症风险较高相关。BKMR模型表明肌肉减少症风险呈上升趋势。亚组分析显示20 - 40岁个体之间的关联更强。BKMR分析还揭示了3 - 氯苯甲酸单乙酯（MCPP）、2 - 氯苯甲酸单乙酯（MECPP）、MBP和MEP对肌肉减少症风险的潜在交互作用。
本研究提供了新的证据，表明同时暴露于邻苯二甲酸盐可能会增加肌肉减少症的风险。需要进一步研究来探索邻苯二甲酸酯代谢物与肌肉减少症之间的因果关系，以及阐明其中涉及的潜在机制。
