Urinary metabolites of organophosphate esters (OPEs) are associated with chronic kidney disease in the general US population, NHANES 2013-2014
Urinary metabolites of organophosphate esters (OPEs) are associated with chronic kidney disease in the general US population, NHANES 2013-2014
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DOI：
10.1016/j.envint.2019.105034
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发表时间：
2019-10-01
影响因子：
11.8
通讯作者：
Choi，Kyungho
中科院分区：
文献类型：
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作者：
Kang，Habyeong;Lee，Jeonghwan;Choi，Kyungho
有机磷酸酯（OPEs）作为阻燃剂和增塑剂在建筑材料和消费品中得到广泛应用。体外研究表明，OPEs对肾脏有不良影响。尽管有越来越多的证据表明广泛暴露于OPEs，但尚未评价其与人类肾功能的相关性。本研究旨在通过使用2013-2014年美国国家健康和营养检查调查（NHANES）的数据，研究美国一般成年人群中OPEs暴露与慢性肾病（CKD）之间的相关性。在1578名目前未怀孕的成年人中，尿OPE代谢物与两个CKD相关参数，即：评估肾小球滤过率（eGFR）和白蛋白/肌酐比值（ACR）以及CKD。为了解释尿液稀释，除了传统的肌酐校正外，还采用了协变量校正的肌酐标准化，其控制了肾功能的潜在混杂因素。还构建了多污染物模型，以验证在单个OPE代谢物模型中观察到的关联性。仅用协变量校正的标准化方法，尿二（2-氯乙基）磷酸盐（BCEP）水平与eGFR呈负相关，但与常规肌酐校正无关。此外，无论尿稀释调整方法如何，磷酸二（1，3-二氯-2-丙基）酯（BDCIPP）和磷酸二正丁酯（DNBP）均与ACR呈正相关。这三种化合物也与CKD相关。用协变量校正的标准化方法校正尿液稀释后，相关性变得更加明显。此外，在多污染物模型的二次分析中也观察到了类似的结果。在美国一般人群中，几种OPEs被确定为CKD的潜在化学决定因素。实验研究是必要的，以了解这一观察的潜在机制。
Organophosphate esters (OPEs) have been widely used in building materials and consumer products as flame retardants and plasticizers. In vitro studies have suggested adverse effects of OPEs on the kidney. Despite accumulating evidence indicating widespread exposure to OPEs, their association with renal function in humans has not been evaluated. This study aims to investigate the association between OPEs exposure and chronic kidney disease (CKD) among the general US adult population by employing data from the US National Health and Nutrition Examination Survey (NHANES) 2013–2014. Among 1578 adults who were not currently pregnant, the associations of the urinary OPE metabolites with two CKD-related parameters, i.e., estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR), and CKD were assessed. To account for urine dilution, in addition to conventional creatinine-adjustment, covariate-adjusted creatinine standardization, which controls for potential confounding by kidney function, was employed. Multi-pollutant models were also constructed to verify the associations observed in the models on individual OPE metabolites. The urinary bis(2-chloroethyl) phosphate (BCEP) level was negatively associated with eGFR only with the covariate-adjusted standardization method, but not with the conventional creatinine adjustment. In addition, both bis(1,3-dichloro-2-propyl) phosphate (BDCIPP) and di-n-butyl phosphate (DNBP) were positively associated with the ACR, regardless of methods of urine dilution adjustment. These three compounds were also associated with CKD. Following adjusting urine dilution with the covariate-adjusted standardization method, the association became more evident. Moreover, similar results were observed in the secondary analysis with the multi-pollutant models. Among the US general population, several OPEs were identified as potential chemical determinants of CKD. Experimental studies are warranted to understand the potential mechanisms underlying this observation.