A cross sectional pilot study to assess the role of phthalates on respiratory morbidity among patients with chronic obstructive pulmonary disease.
A cross sectional pilot study to assess the role of phthalates on respiratory morbidity among patients with chronic obstructive pulmonary disease.
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DOI：
10.1016/j.envres.2023.115622
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发表时间：
2023-03
影响因子：
8.3
通讯作者：
L. Quirós-Alcalá;D. Belz;H. Woo;W. Lorizio;N. Putcha;K. Koehler;M. McCormack;N. Hansel
中科院分区：
文献类型：
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作者：
L. Quirós-Alcalá;D. Belz;H. Woo;W. Lorizio;N. Putcha;K. Koehler;M. McCormack;N. Hansel
背景慢性阻塞性肺疾病（COPD）影响着1600万美国成年人。邻苯二甲酸酯，消费品中的合成化学物质，可能会对肺功能和气道炎症产生不利影响，但是，他们对COPD发病率的作用仍然是未知的。我们研究了邻苯二甲酸酯暴露和呼吸系统发病率之间的关联40 COPD患者谁是前smokers.MethodsWe量化11邻苯二甲酸酯生物标志物在基线收集的尿液样本在巴尔的摩，马里兰州在9个月的前瞻性队列研究。COPD基线发病率指标包括：健康状况和生活质量指标（CAT：COPD评估测试，CCQ：临床COPD问卷，SGRQ：圣乔治呼吸问卷; mMRC：改良医学研究理事会呼吸困难量表）和肺功能。在9个月纵向随访期间，每月监测一次前瞻性急性加重数据的信息。为了检查发病率测量和邻苯二甲酸酯暴露之间的关联，我们分别使用多变量线性和泊松回归模型进行连续和计数结果，调整年龄，性别，种族/民族，教育和吸烟包-年。（β，2.41; 95%CI，0.31-4.51）、mMRC（β，0.33; 95%CI 0.11-0.55）和SGRQ（β，7.43; 95%CI 2.70-12.2）评分。邻苯二甲酸单苄酯（MBzP）也与基线时的CCQ和SGRQ评分呈正相关。较高浓度的邻苯二甲酸二（2-乙基己基）酯（DEHP）摩尔总和与随访期间加重发生率增加相关（中度和重度加重的发生率比，IRR = 1.73; 95%CI 1.11，2.70和IRR = 1.94; 95%CI 1.22，3.07）。MEP浓度呈负相关，恶化的发病率在随访periods.ConclusionsWe发现，暴露于选择邻苯二甲酸酯与COPD患者的呼吸系统发病率。考虑到邻苯二甲酸酯的广泛暴露，以及如果观察到的关系是因果关系，则对COPD患者的潜在影响，需要在更大规模的研究中对结果进行进一步检查。
BackgroundChronic Obstructive Pulmonary Disease (COPD) affects ∼16 million U.S. adults. Phthalates, synthetic chemicals in consumer products, may adversely impact pulmonary function and airway inflammation; however, their role on COPD morbidity remains unknown.ObjectiveWe examined associations between phthalate exposures and respiratory morbidity among 40 COPD patients who were former smokers.MethodsWe quantified 11 phthalate biomarkers in urine samples collected at baseline in a 9-month prospective cohort study in Baltimore, Maryland. COPD baseline morbidity measures included: health status and quality of life measures (CAT: COPD Assessment Test, CCQ: Clinical COPD Questionnaire, SGRQ: St. George's Respiratory Questionnaire; mMRC: Modified Medical Research Council Dyspnea Scale), and lung function. Information on prospective exacerbation data was monitored monthly during the 9-month longitudinal follow-up period. To examine associations between morbidity measures and phthalate exposures, we used multivariable linear and Poisson regression models for continuous and count outcomes, respectively, adjusting for age, sex, race/ethnicity, education, and smoking pack-years.ResultsHigher mono-n-butyl phthalate (MBP) concentrations were associated with increased CAT(β, 2.41; 95%CI, 0.31–4.51), mMRC (β, 0.33; 95%CI 0.11–0.55), and SGRQ (β, 7.43; 95%CI 2.70–12.2) scores at baseline. Monobenzyl phthalate (MBzP) was also positively associated with CCQ and SGRQ scores at baseline. Higher concentrations of the molar sum of Di (2-ethylhexyl) phthalate (DEHP) were associated with increased incidence of exacerbations during the follow-up period (incidence rate ratio, IRR = 1.73; 95%CI 1.11, 2.70 and IRR = 1.94; 95%CI 1.22, 3.07, for moderate and severe exacerbations, respectively). MEP concentrations were inversely associated with incidence of exacerbations during the follow-up period.ConclusionsWe found that exposure to select phthalates was associated with respiratory morbidity among COPD patients. Findings warrant further examination in larger studies given widespread phthalate exposures and potential implications for COPD patients should relationships observed be causal.