Deng Chenyuan, Jiang Yu, Lin Yuechun, Liang Hengrui, Wang Wei, Huang Ying, He Jianxing
Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China.
Ecotoxicol Environ Saf. 2025 Sep 1;302:118701. doi: 10.1016/j.ecoenv.2025.118701. Epub 2025 Jul 21.
Evidence from prior studies indicates that certain endocrine-disrupting chemicals (EDCs), such as phenols and phthalates, may serve as environmental risk factors for chronic obstructive pulmonary disease (COPD). However, no studies have examined the potential associations between EDCs and preserved ratio impaired spirometry (PRISm), a precursor to COPD.
Data from 1363 participants in the NHANES 2007-2012 dataset were analyzed. Multiple logistic regression was employed to investigate the associations between individual EDCs and PRISm. The mixed effects of multiple EDCs on PRISm were assessed using three mixture analysis models: weighted quantile sum (WQS) regression, quantile g-computation (Qgcomp), and Bayesian kernel machine regression (BKMR). Additionally, the mediating roles of uric acid and SII were examined. Furthermore, an innovative identification model for PRISm was developed using participants' demographic information and EDC exposure levels.
WQS regression and Qgcomp demonstrated that each index rise in the EDC-mixture index increased the odds of PRISm by 63 % (OR=1.63, 95 % CI: 1.25-2.13, P < 0.001) and 41 % (OR=1.41, 95 % CI: 1.15-1.72, P < 0.001), and BKMR model confirmed the same positive direction. The overall mixture effect was primarily attributable to mono-isobutyl phthalate (MIBP), which also yielded the largest single-chemical odds ratio in multivariable logistic regression (OR=2.29, 95 % CI: 1.71-3.07, P < 0.001). Mediation analysis showed that SII and uric acid mediated 15.8 % and 15.6 % of the association between mixed EDCs and PRISm, respectively. The results of SHAP interpretability analysis based CatBoost model further highlighted MIBP as the most informative environmental predictor.
These findings suggest that exposure to EDCs may be linked to the prevalence of PRISm. These results provide novel epidemiological evidence for PRISm.
先前研究的证据表明，某些内分泌干扰化学物质（EDCs），如酚类和邻苯二甲酸盐，可能是慢性阻塞性肺疾病（COPD）的环境风险因素。然而，尚无研究探讨EDCs与COPD前期的保留比值受损肺活量测定法（PRISm）之间的潜在关联。
分析了2007 - 2012年美国国家健康与营养检查调查（NHANES）数据集中1363名参与者的数据。采用多元逻辑回归研究个体EDCs与PRISm之间的关联。使用三种混合分析模型评估多种EDCs对PRISm的混合效应：加权分位数和（WQS）回归、分位数g计算（Qgcomp）和贝叶斯核机器回归（BKMR）。此外，还研究了尿酸和系统性免疫炎症指标（SII）的中介作用。此外，利用参与者的人口统计学信息和EDCs暴露水平开发了一种创新的PRISm识别模型。
WQS回归和Qgcomp表明，EDC混合指数每增加一个单位分别使PRISm的比值比增加63%（OR = 1.63，95%CI：1.25 - 2.13，P < 0.001）和41%（OR = 1.41，95%CI：1.15 - 1.72，P < 0.001），BKMR模型也证实了相同的正向关联。总体混合效应主要归因于单异丁基邻苯二甲酸酯（MIBP），其在多变量逻辑回归中也产生了最大的单化学物质比值比（OR = 2.29，95%CI：1.71 - 3.07，P < 0.001）。中介分析表明，SII和尿酸分别介导了混合EDCs与PRISm之间关联的15.8%和15.6%。基于CatBoost模型的SHAP可解释性分析结果进一步突出了MIBP是最具信息量的环境预测因子。
这些发现表明，暴露于EDCs可能与PRISm的患病率有关。这些结果为PRISm提供了新的流行病学证据。
