Individual and joint effects of organophosphate esters and hypertension or diabetes on renal injury among Chinese adults

IF 4.5 2区 医学 Q1 INFECTIOUS DISEASES
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Abstract

Exposure to environmental contaminants and the development of hypertension and diabetes represent crucial risk factors for chronic kidney disease (CKD). Toxicological studies have revealed that organophosphate esters (OPEs) impair kidney function. However, the joint effects of OPE exposure on kidney injury and the interactions of OPE exposure with hypertension or diabetes on kidney injury remain unclear. Our study aimed to investigate the individual and joint effects of OPE exposure on renal injury, as well as the potential interaction between OPE exposure and hypertension or diabetes on kidney injury. The study enrolled 1938 participants from Wuhan, China. To explore the relationship between OPE exposure and renal injury, we conducted multivariate linear and logistic regression analysis. The results indicated that each unit increase in 4-hydroxyphenyl diphenyl phosphate (4-HO-DPHP), bis(2-butoxyethyl) phosphate (BBOEP), and tris(2-chloroethyl) phosphate (TCEP) (1 μg/L-ln transformed) was associated with a decreased 0.57 mL/min/1.73 m2 (95%CI: -1.05, −0.09), 0.85 mL/min/1.73 m2 (95%CI: -1.52, −0.19) and 1.24 mL/min/1.73 m2 (95%CI: -2.26, −0.23) of estimated glomerular filtration rate (eGFR), while each unit increase in 4-HO-DPHP and BBOEP (1 μg/L-ln transformed) was associated with 14% and 20% elevation of incident impaired renal function (IRF) risk. Notably the highest tertile of BCIPHIPP was positively associated with eGFR, although the p for trend > 0.05. We employed Bayesian kernel machine regression (BKMR) and quartile-based g-computation (qgcomp) models to explore the joint effects of OPE mixtures on eGFR and IRF. Both the results of BKMR and qgcomp model consistently demonstrated negative associations between OPE mixtures and eGFR, and TCEP and 4-HO-DPHP were major contributors. Furthermore, we observed multiplicative interactions of diphenyl phosphate (DPHP), BBOEP, di-ocresyl phosphate (DoCP) & di-p-cresyl phosphate (DpCP), 1-hydroxy-2-propyl bis(1-chloro-2-propyl) phosphate (BCIPHIPP) and hypertension or diabetes on kidney injury (all P<0.05). Those with diabetes or hypertension and higher OPE metabolite concentrations had increased risk of kidney function impairment compared to those who did not have diabetes or hypertension. These findings suggest that specific OPE exposure may elevate the risk of renal injury, particularly among hypertensive and diabetic populations.

Abstract Image

有机磷酸酯与高血压或糖尿病对中国成年人肾损伤的单独和联合影响
接触环境污染物以及高血压和糖尿病的发生是慢性肾脏病(CKD)的重要风险因素。毒理学研究表明,有机磷酸酯(OPE)会损害肾功能。然而,暴露于 OPE 对肾损伤的共同影响以及暴露于 OPE 与高血压或糖尿病对肾损伤的相互作用仍不清楚。我们的研究旨在调查暴露于 OPE 对肾损伤的个体和联合影响,以及暴露于 OPE 与高血压或糖尿病对肾损伤的潜在相互作用。该研究在中国武汉市招募了 1938 名参与者。为探讨暴露于 OPE 与肾损伤之间的关系,我们进行了多变量线性回归分析和逻辑回归分析。结果表明,4-羟基苯基二苯基磷酸酯 (4-HO-DPHP)、双(2-丁氧基乙基)磷酸酯 (BBOEP) 和三(2-氯乙基)磷酸酯 (TCEP) 每增加一个单位(1 μg/L-ln 转化),就会导致 0.57 mL/min/1.73 m2 (95%CI:-1.05, -0.09)、0.85 mL/min/1.而4-HO-DPHP和BBOEP(1 μg/L-ln转化)每增加一个单位,就会导致肾功能受损(IRF)风险分别增加14%和20%。值得注意的是,BCIPHIPP 的最高三分位数与 eGFR 呈正相关,但趋势 p > 0.05。我们采用贝叶斯核机器回归(BKMR)和基于四分位数的 g 计算(qgcomp)模型来探讨 OPE 混合物对 eGFR 和 IRF 的共同影响。BKMR 和 qgcomp 模型的结果一致表明,OPE 混合物与 eGFR 之间存在负相关,TCEP 和 4-HO-DPHP 是主要的影响因素。此外,我们还观察到磷酸二苯酯(DPHP)、BBOEP、磷酸二对甲酚酯(DoCP)&amp、磷酸二对甲酚酯(DpCP)、1-羟基-2-丙基双(1-氯-2-丙基)磷酸酯(BCIPHIPP)与高血压或糖尿病对肾损伤的乘法相互作用(均为 P<0.05)。与没有糖尿病或高血压的人相比,患有糖尿病或高血压且 OPE 代谢物浓度较高的人肾功能受损的风险更高。这些研究结果表明,特定的 OPE 暴露可能会增加肾损伤的风险,尤其是在高血压和糖尿病人群中。
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来源期刊
CiteScore
11.50
自引率
5.00%
发文量
151
审稿时长
22 days
期刊介绍: The International Journal of Hygiene and Environmental Health serves as a multidisciplinary forum for original reports on exposure assessment and the reactions to and consequences of human exposure to the biological, chemical, and physical environment. Research reports, short communications, reviews, scientific comments, technical notes, and editorials will be peer-reviewed before acceptance for publication. Priority will be given to articles on epidemiological aspects of environmental toxicology, health risk assessments, susceptible (sub) populations, sanitation and clean water, human biomonitoring, environmental medicine, and public health aspects of exposure-related outcomes.
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