Use of NHANES data to link chemical exposures to chronic diseases: a cautionary tale.
Use of NHANES data to link chemical exposures to chronic diseases: a cautionary tale.
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使用NHANES数据将化学暴露与慢性疾病联系起来：警告性故事。
DOI：
10.1371/journal.pone.0051086
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Naiman DQ
中科院分区：
文献类型：
--
作者：
LaKind JS;Goodman M;Naiman DQ
国家健康和营养检查调查（NHANES）是横截面数据集的一个例子，用于得出关于环境化学品暴露和不良健康结果的因果推论。我们的目标是使用一致的先验选择方法分析四个NHANES数据集，以解决以下问题：尿双酚a （BPA）测量与糖尿病、冠心病（CHD）和/或心脏病发作之间是否存在一致的关联？NHANES是研究具有短生理半衰期的化学品（如BPA）与多因子病因的慢性疾病之间关系的合适数据集吗？2003-2004年、2005-2006年、2007-2008年和2009-2010年尿液双酚a与健康结果的数据是可用的。根据肌酐、年龄、性别、种族/民族、教育程度、收入、吸烟、酗酒、BMI、腰围、卡路里摄入量、心脏病家族史、高血压、久坐时间和总胆固醇调整回归模型。尿BPA与任何一项NHANES调查的不良健康结果均无显著相关性，冠心病的or （95% ci）为0.996（0.951-1.04）至1.03(0.978-1.09)，心脏病发作的or （95% ci）为0.987（0.941-1.04）至1.04(0.996 - 1.09)，糖尿病的or(0.957（0.899-1.02）至1.01（0.980-1.05）。使用科学和临床支持的排除标准和结果定义，我们一致发现尿BPA与心脏病或糖尿病之间没有关联。这些结果不支持先前使用不同标准和定义的研究中报告的关联和因果推论。关于双酚a是否是这些疾病的危险因素，我们还没有得出结论。我们的观点正好相反——使用像NHANES这样的横断面数据集来得出关于短期环境化学品和慢性复杂疾病的结论是不合适的。我们需要花费资源进行适当设计的流行病学研究和毒理学探索，以了解这些类型的化学品是否在慢性疾病中起因果作用。
The National Health and Nutrition Examination Survey (NHANES) is one example of cross-sectional datasets that have been used to draw causal inferences regarding environmental chemical exposures and adverse health outcomes. Our objectives were to analyze four NHANES datasets using consistent a priori selected methods to address the following questions: Is there a consistent association between urinary bisphenol A (BPA) measures and diabetes, coronary heart disease (CHD), and/or heart attack across surveys? Is NHANES an appropriate dataset for investigating associations between chemicals with short physiologic half-lives such as BPA and chronic diseases with multi-factorial etiologies? Data on urinary BPA and health outcomes from 2003–2004, 2005–2006, 2007–2008, and 2009–2010 were available. Regression models were adjusted for creatinine, age, gender, race/ethnicity, education, income, smoking, heavy drinking, BMI, waist circumference, calorie intake, family history of heart attack, hypertension, sedentary time, and total cholesterol. Urinary BPA was not significantly associated with adverse health outcomes for any of the NHANES surveys, with ORs (95% CIs) ranging from 0.996 (0.951–1.04) to 1.03 (0.978–1.09) for CHD, 0.987 (0.941–1.04) to 1.04 (0.996–1.09) for heart attack, and 0.957 (0.899–1.02) to 1.01 (0.980–1.05) for diabetes. Using scientifically and clinically supportable exclusion criteria and outcome definitions, we consistently found no associations between urinary BPA and heart disease or diabetes. These results do not support associations and causal inferences reported in previous studies that used different criteria and definitions. We are not drawing conclusions regarding whether BPA is a risk factor for these diseases. We are stating the opposite–that using cross-sectional datasets like NHANES to draw such conclusions about short-lived environmental chemicals and chronic complex diseases is inappropriate. We need to expend resources on appropriately designed epidemiologic studies and toxicological explorations to understand whether these types of chemicals play a causal role in chronic diseases.
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影响因子：
8.3
作者：
Everett, Charles J.;Mainous, Arch G., III;Matheson, Eric M.
通讯作者：
Matheson, Eric M.
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DOI：
10.3390/ijerph8051727
发表时间：
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影响因子：
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作者：
Egeghy PP;Cohen Hubal EA;Tulve NS;Melnyk LJ;Morgan MK;Fortmann RC;Sheldon LS
通讯作者：
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影响因子：
3.6
作者：
Charreire, Helene;Kesse-Guyot, Emmanuelle;Oppert, Jean-Michel
通讯作者：
Oppert, Jean-Michel
影响因子：
120.7
作者：
CASTELLI, WP;GARRISON, RJ;KANNEL, WB
通讯作者：
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Bisphenol A和Triclosan对美国人口免疫参数的影响，NHANES 2003-2006。
影响因子：
10.4
作者：
Clayton EM;Todd M;Dowd JB;Aiello AE
通讯作者：
Aiello AE