Peng Yuhe, Zhang Lan, Chen Shuqing, Tian Yuchen, Xia Qin, Yin Ping
Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Geriatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Am Med Dir Assoc. 2025 Sep 1;26(10):105823. doi: 10.1016/j.jamda.2025.105823.
Ambient contamination may contribute to low muscle mass development, yet evidence regarding the detrimental impacts of phthalate metabolites on muscle wasting is scarce. This study aimed to investigate the relationship between individual and collective phthalate metabolite exposures and low muscle mass occurrence and assess the mediating role of body mass index (BMI).
Cross-sectional study.
Data from 3028 individuals (aged ≥20 years) who participated in the National Health and Nutrition Examination Survey (2011-2018) were examined.
All participants provided data regarding 9 urinary phthalate metabolites, urinary creatinine levels, BMI, dual-energy X-ray absorptiometry measurements, and other pertinent covariates. Survey-weighted logistic regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) models were used to investigate the relationships between individual and collective chemical exposures and low muscle mass. Mediation analysis was conducted to examine the potential mediating effect of BMI in these associations.
Among the participants, 7.8% exhibited low muscle mass. A strong correlation was observed between monoethyl phthalate (MEP) and low muscle mass occurrence, with significant associations in the highest quartile for MEP and mono-n-butyl phthalate (MnBP). The WQS index was significantly linked to low muscle mass incidence, with MEP, MnBP, and monobenzyl phthalate (MBzP) emerging as the predominant contributors. The BKMR model revealed a positive overall trend between co-exposure to multiple phthalates and low muscle mass risk. Mediation analysis indicated that BMI accounted for 26.11% of the total effect between MBzP and low muscle mass.
Exposure to various phthalate metabolite combinations appears to elevate the risk of low muscle mass, and this association is partially mediated by BMI. These findings warrant further investigation to confirm their validity. Understanding the biological mechanisms through which these compounds operate is essential to clarify their role in the progression of low muscle mass.
环境污染物可能导致肌肉量减少，但关于邻苯二甲酸酯代谢物对肌肉萎缩有害影响的证据很少。本研究旨在调查个体和集体邻苯二甲酸酯代谢物暴露与低肌肉量发生之间的关系，并评估体重指数（BMI）的中介作用。
横断面研究。
对参与国家健康与营养检查调查（2011 - 2018年）的3028名年龄≥20岁的个体的数据进行了检查。
所有参与者提供了有关9种尿邻苯二甲酸酯代谢物、尿肌酐水平、BMI、双能X线吸收法测量值以及其他相关协变量的数据。使用调查加权逻辑回归、加权分位数和（WQS）回归以及贝叶斯核机器回归（BKMR）模型来研究个体和集体化学暴露与低肌肉量之间的关系。进行中介分析以检验BMI在这些关联中的潜在中介作用。
在参与者中，7.8%表现出低肌肉量。观察到邻苯二甲酸单乙酯（MEP）与低肌肉量发生之间存在强相关性，MEP和邻苯二甲酸单正丁酯（MnBP）的最高四分位数存在显著关联。WQS指数与低肌肉量发生率显著相关，MEP、MnBP和邻苯二甲酸单苄酯（MBzP）是主要贡献者。BKMR模型显示多种邻苯二甲酸酯共同暴露与低肌肉量风险之间存在总体正相关趋势。中介分析表明，BMI占MBzP与低肌肉量之间总效应的26.11%。
接触各种邻苯二甲酸酯代谢物组合似乎会增加低肌肉量的风险，并且这种关联部分由BMI介导。这些发现需要进一步研究以确认其有效性。了解这些化合物发挥作用的生物学机制对于阐明它们在低肌肉量进展中的作用至关重要。
