Association of urinary phthalate metabolites with osteoarthritis in American adults: Results from the national health and nutrition examination survey 2003-2014

Antioxidant diet/lifestyle could mitigate the adverse impacts of urinary polycyclic aromatic hydrocarbons on lung function

BACKGROUND

Extant research has demonstrated a correlation between exposure to polycyclic aromatic hydrocarbons (PAHs) and impaired lung function. The maintenance of an antioxidant-rich diet/lifestyle positively benefits pulmonary health. However, the potential ameliorative impact of an antioxidant-based diet/lifestyle on PAH-induced detrimental effects remains unclear.

METHODS

The study drew upon cross-sectional data encompassing 1615 participants derived from the National Health and Nutrition Examination Survey 2007 to 2012. To gauge the maintenance of an antioxidant-rich diet/lifestyle, we employed Oxidative Balance Score (OBS) that incorporates sixteen nutrients and four lifestyle factors. Lung function was evaluated using percent-predicted Forced Vital Capacity (FVC), Forced Expiratory Volume 1st Second (FEV1), FEV1/FVC, and fractional exhaled nitric oxide (FENO). Our analytical approach entailed the utilization of weighted linear models.

RESULTS

Our analysis unveiled interaction effects between urinary monohydroxy polycyclic aromatic hydrocarbons (OH-PAHs) and OBS concerning lung function. A one-unit increase in ∑OH-PAH (sum of eight OH-PAHs) was linked to a -0.75% reduction (95% CI: -1.28, -0.22) in FEV1/FVC. Individuals exhibiting low OBS displayed a marked decrease in FEV1/FVC (mean difference = -1.10%; 95% CI: -1.82, -0.39) for each unit increase in ∑OH-PAH, whereas no significant associations were discerned for those with medium or high OBS. Further stratification by gender yielded consistent results. The correlation between ∑OH-PAH and FENO proved statistically significant among participants with low OBS (P = 0.002) and medium OBS (P = 0.001), but non-significant for those with high OBS. Parallel findings emerged when examining percent-predicted FEV1 and FVC.

CONCLUSIONS

In conclusion, our study underscores the existence of statistically significant interactions between OH-PAHs and the maintenance of an antioxidant-rich diet and lifestyle concerning lung function. These findings underscore the pivotal role of maintaining an antioxidant-based diet and lifestyle in mitigating the adverse impacts of PAH exposure on lung function.

The Significant Role of Alcohol in the Relationship between C-Reactive Protein and Self-Reported Osteoarthritis

BACKGROUND

Despite the known inflammatory nature of osteoarthritis (OA) and the established role of C-reactive protein (CRP) as an inflammation marker, the influence of alcohol consumption on the CRP-OA relationship remains uncertain, with previous research providing conflicting results.

OBJECTIVES

This study aims to examine the potential moderating effect of alcohol on the association between CRP concentrations and self-reported OA.

METHODS

We conducted a cross-sectional study involving 50,259 participants, all data collected from NHANES between 2005-2010 and 2015-2018. A multivariable logistic regression model was used to analyze the relationship between CRP and OA.

RESULTS

We found a nonsignificant positive association between CRP concentration and prevalence of self-reported OA after adjusting for covariates in the raw dataset or 5 multiple imputed datasets. In the stratified analysis by alcohol drinking, for every 10 mg/L higher in CRP concentration, the prevalence of self-reported OA was higher by 13 % in nondrinkers (P = 0.007, adjusted for covariates). Conversely, for every 10 mg/L higher in CRP concentration, the prevalence of self-reported OA was lower by 59 % in drinkers (P = 0.005, adjusted for covariates). Furthermore, we discovered that the directions of the association between CRP concentrations (10 mg/L) and prevalence of self-reported OA [odds ratio (OR) < 1 in the drinking subgroup and OR > 1 in the no-drinking subgroup] were stable in both the main and sensitivity analyses. The significant interaction between CRP concentration and alcohol drinking on the prevalence of self-reported OA was shown in most of our analyses (P-interaction < 0.05).

CONCLUSION

Alcohol consumption may be an interaction factor between CRP and self-reported OA. To our knowledge, our findings are the first to highlight the importance of incorporating analysis of alcohol consumption differences into future studies of CRP and self-reported OA.

Chronic neck pain is associated with increased mortality in individuals with osteoarthritis: results from the NHANES database prospective cohort study

BACKGROUND

Neck pain (NP) is a common symptom reported in the elderly. However, no study has examined the relationship between NP and osteoarthritis (OA) so far, and this study aimed to investigate the association of neck pain with the prevalence and mortality of OA.

METHODS

A total of 5965 participants were included in this cohort study based on the National Health and Nutrition Examination Survey data set of the USA (NHANES). Death outcomes follow-up information was ascertained by linkage to National Death Index (NDI). The association between NP and OA was studied by multi-various logistic regression models after adjusting for potential confounding factors. Cox proportional hazards models were used to elucidate the relationship between NP and all-cause mortality in OA patients.

RESULTS

Among all participants, 8.18% had osteoarthritis, and 5.92% suffered from neck pain. Neck pain was associated with osteoarthritis [1.932 (1.232, 3.028), p < 0.01], which still reminded significant after adjustments [2.519 (1.325, 4.788), p < 0.01] and stratified analysis by sex, race, and smoke status. In OA patients, chronic neck pain (over 1 year) was significantly associated with higher risks of all-cause mortality before [2.94 (1.61, 5.37), p < 0.01] and after adjustment [3.30 (1.23, 45.85), p < 0.05].

CONCLUSION

Neck pain was strongly associated with osteoarthritis. Moreover, chronic neck pain over 1 year significantly increased the mortality of OA patients. Our study demonstrates the need to screen osteoarthritis in the neck pain population and select a more appropriate treatment strategy promptly for those patients.

Associations between urinary phthalate metabolite concentrations and rheumatoid arthritis in the U.S. adult population

Phthalates are ubiquitous environmental contaminants. Nevertheless, limited data is available about the impacts of phthalates on rheumatoid arthritis (RA). The purpose of this study was to use National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2018 to assess the individual and combined effects of exposure to phthalate mixtures on RA in adults. A total of 8240 participants with complete data participated in the study, of whom 645 had RA. The levels of ten phthalate metabolites were detected in urine samples. In the single-pollutant models, independent associations were identified between urinary mono-(carboxyoctyl) phthalate (MCOP), mono-(3-carboxylpropyl) phthalate (MCPP), mono-isobutyl phthalate (MiBP) and mono-benzyl phthalate (MBzP) with the incidence of RA. The results of multi-pollutant models, including weighted quantile sum (WQS) regression, quantile-based g computation (qgcomp), and Bayesian kernel machine regression (BKMR) approaches consistently revealed that co-exposure to phthalates was positively associated with RA incidence. Such association was more pronounced in adults over 60 years of age, where MCOP was identified as the dominant positive driver. Overall, our findings add novel evidence that co-exposures to phthalates might be positively associated with RA incidence. Given the limitations of the NHANES study, well-designed longitudinal studies are required to verify or disprove these results.

Association between urinary phthalate levels and chronic pain in US adults, 1999-2004: A nationally representative survey

Introduction

Chronic pain is a public health concern throughout the world. Ascertaining and managing its risk factors helps develop well-directed treatment plans and prevention strategies. Phthalates (PAEs) exposure leads to various health problems. The present study aims to explore the potential correlation between urinary PAEs metabolites and chronic pain in adults.

Methods

The study population data were extracted from the National Health and Nutrition Examination Survey (NHANES) conducted from 1999 to 2004 in the United States. Seven urinary PAEs metabolites were used to assess long-term PAEs exposure. The assessment of chronic pain was determined by a self-report questionnaire. Weighted analyses were conducted to consider the complex sampling design. Models were adjusted by demographic data and lifestyle factors. Urinary PAEs metabolites were assessed as both continuous and categorical variables. Tertile 1 was considered as the reference. Stratified analyses were performed by gender and pain site. All data analyses were conducted with STATA, version 15.1. P < 0.05 was considered with statistical significance.

Results

A total of 4,196 participants were considered in our final analysis. Chronic pain prevalence reached 52.19% (n = 2,138) among the participants, with women accounting for a large proportion (57.75% vs. 42.25%). After multivariable logistic regression analysis, a higher prevalence of chronic pain was observed among participants in the third tertile of mono-(2-ethyl)-hexyl phthalate (MEHP) (OR = 1.23, 95% CI = 1.02-1.48, P = 0.034) and mono-benzyl phthalate (MBzP) (OR = 1.28, 95% CI = 1.04-1.58, P = 0.022) in our adjusted model. The logtransformed concentration of MBzP also showed a significant association with chronic pain prevalence (OR = 1.09, 95% CI = 1.01-1.18, P = 0.036) in the adjusted model. In further analysis, the positive correlations of urinary phthalate metabolites with chronic pain remained robust when stratified by gender and chronic pain site.

Conclusions

Our findings presented a positive correlation between urinary PAEs metabolites and chronic pain among adult participants, and more causal research should be conducted to ascertain the interactions between the two and to expound their underlying mechanisms.

Identification for heavy metals exposure on osteoarthritis among aging people and Machine learning for prediction: A study based on NHANES 2011-2020

Objective

Heavy metals are present in many environmental pollutants, and have cumulative effects on the human body through water or food, which can lead to several diseases, including osteoarthritis (OA). In this research, we aimed to explore the association between heavy metals and OA.

Methods

We extracted 18 variables including age, gender, race, education level, marital status, smoking status, body mass index (BMI), physical activity, diabetes mellitus, hypertension, poverty level index (PLI), Lead (Pb), cadmium (Cd), mercury (Hg), selenium (Se), manganese (Mn), and OA status from National Health and Nutrition Examination Survey (NHANES) 2011-2020 datasets.

Results

In the baseline data, the t test and Chi-square test were conducted. For heavy metals, quartile description and limit of detection (LOD) were adopted. To analyze the association between heavy metals and OA among elderly subjects, multivariable logistic regression was conducted and subgroup logistic by gender was also carried out. Furthermore, to make predictions based on heavy metals for OA, we compared eight machine learning algorithms, and XGBoost (AUC of 0.8, accuracy value of 0.773, and kappa value of 0.358) was the best machine learning model for prediction. For interactive use, a shiny application was made (https://alanwu.shinyapps.io/NHANES-OA/).

Conclusion

The overall and gender subgroup logistic regressions all showed that Pb and Cd promoted the prevalence of OA while Mn could be a protective factor of OA prevalence among the elderly population of the United States. Furthermore, XGBoost model was trained for OA prediction.

Does healthy lifestyle attenuate the detrimental effects of urinary polycyclic aromatic hydrocarbons on phenotypic aging? An analysis from NHANES 2001-2010

Existing evidence has showed that exposure to polycyclic aromatic hydrocarbons (PAHs) increases the risk of many chronic diseases. Given the close connection between aging (a major risk factor) and chronic diseases, however, very few studies have evaluated the association between PAHs and aging. Furthermore, whether modifiable healthy lifestyle could attenuate the detrimental effect of PAHs on aging remains unknown. Therefore, we conducted this study, aiming to: (1) examine the associations of urinary monohydroxy polycyclic aromatic hydrocarbons (OH-PAHs) and lifestyle with Phenotypic Age Acceleration (PhenoAge.Accel), a novel aging measure that captures morbidity and mortality risk; and (2) evaluate the potential interaction effects of OH-PAHs and lifestyle on PhenoAge.Accel. Cross-sectional data of 2,579 participants (aged 20-84 years, n = 1,292 females) from the National Health and Nutrition Examination Survey for years 2001-2010 were analyzed. A lifestyle index was constructed based on five components (drinking, smoking, body mass index, physical activity, and diet), ranging from 0 to 5. We calculated PhenoAge.Accel using algorithms developed previously. General linear regression models were used to examine the associations. We observed strong associations of OH-PAHs and lifestyle with PhenoAge.Accel. For instance, one unit increase in ∑NAP (sum of 1- and 2-hydroxynaphthalene) was associated with 0.37 year (95% confidence interval [CI]: 0.26, 0.48) increase in PhenoAge.Accel. We did not observe statistically significant interaction effects between OH-PAHs and lifestyle on PhenoAge.Accel. After stratified by sex, we observed strong associations as well as statistically significant interactions of OH-PAHs and lifestyle with PhenoAge.Accel among females. In conclusion, both OH-PAHs and lifestyle were independently associated with phenotypic aging and there were statistically significant interactions between OH-PAHs and lifestyle on phenotypic aging among females. The findings highlight the importance of adherence to a healthy lifestyle to attenuate the detrimental effects of exposures to PAHs on phenotypic aging among females.

Phthalates exposure is associated with non-alcoholic fatty liver disease among US adults

PURPOSE

Non-alcoholic fatty liver disease (NAFLD) has become the most common liver disease in the western countries. We aimed to ascertain the relationship of urinary phthalates concentrations with presence of NAFLD among US adults.

METHODS

A cross-sectional analysis of data from National Health and Nutrition Examination Survey (NHANES) during 2003-2016 was performed. NAFLD was predicted by Hepatic Steatosis Index (HSI) and US Fatty Liver Index (US FLI), respectively. The logistic regression models were conducted to evaluate associations of urinary phthalates with NAFLD by adjustment for other covariates.

RESULTS

Of the 4206 participants (mean age 47.99 years old; 50.06% men), risk of suspected NAFLD was increased in those with higher concentrations of urinary phthalates. The results of multivariate models suggested that urinary phthalate metabolites MEOHP (odds ratio [OR] = 1.56, 95% confidence interval [CI] = 1.08-2.24), MEHHP (OR = 1.55, 95% CI = 1.09-2.21), MECPP (OR = 1.44, 95% CI = 1.06-1.95) and the mixtures of nine phthalates (OR = 1.58, 95%CI = 1.18-2.11) were positively related to NAFLD defined by HSI; the similar significant associations were observed for MEHHP (OR = 1.98, 95% CI = 1.32-2.97) when NAFLD was determined based upon US FLI ≥30. In subgroup analyses, the positive associations of urinary phthalates concentrations with NAFLD risk remained robust both in males and females, whereas only in individuals aged <60 years.

CONCLUSIONS

Phthalates exposure was independently associated with NAFLD both in males and females, regardless of being defined using HSI or US FLI.