Associations between the compositional patterns of blood volatile organic compounds and chronic respiratory diseases and ages at onset in NHANES 2003-2012

Association between the CALLY index, vitamin D, and asthma: insights from NHANES

Purpose

The CALLY index integrates C-reactive protein (CRP), albumin and lymphocyte counts to accurately reflect the inflammatory, nutritional and immune status of the body. Multiple studies have indicated that the CALLY index plays a key role in a variety of diseases, especially asthma, and is closely associated with inflammatory response, airway remodeling and immune imbalance in asthma. Research has shown that vitamin D is associated with asthma susceptibility, severity, and control, and its levels may influence inflammatory and immune markers associated with the CALLY index, which may play a role in the association between the CALLY index and asthma.

Patients

Using data from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2010, the association between CALLY index and asthma and the role of vitamin D in American adults were analyzed in depth. Through multiple logistic regression, subgroup analysis, and other statistical means, the potential pathophysiological links between the three are revealed, providing theoretical support for the prevention and treatment of related diseases.

Results

A total of 17,946 individuals were included in this study, of which 2,317 were diagnosed with asthma. Fully adjusted multivariate logistic regression analysis revealed that the CALLY index was significantly negatively associated with asthma, with an odds ratio (OR) of 0.996 [95% confidence interval (CI) 0.993-0.999]. Specifically, each unit increase in the CALLY index was associated with a 0.996-fold reduction in asthma risk. In addition, mediation effect analysis showed that vitamin D partially mediated the association between the CALLY index and asthma, with a mediation ratio of 3.36%.

Conclusion

This study reveals an association between the CALLY index and reduced risk of asthma in the US population and suggests that vitamin D plays an incomplete mediating role. This finding provides a new theoretical basis for the diagnosis, treatment, and prevention of asthma and is expected to be a potential biomarker.

Exhaled breath is feasible for mild cognitive impairment detection: A diagnostic study with portable micro-gas chromatography

BackgroundMild cognitive impairment (MCI) is an important prodromal stage of Alzheimer's disease (AD), affecting 69 million individuals worldwide. At present, there is a lack of a community-applicable tool for MCI screening. Exhaled breath volatile organic compounds (VOCs) have been used to distinguish MCI from cognitively normal (CN) individuals only in small sample size studies and the efficacy has not been compared with blood biomarkers.ObjectiveThis diagnostic study aimed to assess the feasibility of using exhaled breath VOCs detection by a portable micro-gas chromatography (μGC) device as a screening tool to discriminate MCI from CN individuals in a community population.MethodsA detection model was developed and optimized from five distinct machine learning algorithms based on the differential VOCs between 240 MCI and 241 CN individuals. Among these 481 participants, five plasma biomarkers were measured in 397 individuals (166 MCI and 231 CN).ResultsThe final model (481 individuals) incorporating eight differential VOCs showed good performance with an area under the receiver-operating characteristic curve (AUC) of 0.84 (95% confidence interval (95% CI): 0.83-0.85). The AUC of the VOC model (0.80, 95% CI: 0.69-0.90) was higher than that of the plasma model (0.77, 95% CI: 0.65-0.88) (397 individuals).ConclusionsThe detection of exhaled breath VOCs by a portable μGC device is feasible for MCI screening in community populations, potentially facilitating early detection and intervention strategies for individuals at high risk.

Independent and combined associations of VOCs exposure and MetS in the NHANES 2017-2020

Introduction

As a worldwide public health concern, Metabolic syndrome (MetS) seriously endangers human health and life safety. It`s reported that there is a strong association between chemical pollutants and the development of MetS in recent years. Volatile organic compounds (VOCs), the primary emission pollutant in atmospheric pollutants, were closely associated with development of chronic diseases. However, the association between VOCs exposure and MetS is unclear. We aimed to investigate the association between VOCs and MetS and identify the behavioral patterns in which MetS patients may be exposed to VOCs.

Methods

We conducted a cross-sectional data analysis from 15,560 VOC-exposed participants in the NHANES. Multivariable logistic regression model, weighted quantile sum (WQS) regression model, and Bayesian kernel machine regression (BKMR) regression model were employed to explore chemical exposure`s independent and combined effects on MetS, respectively.

Results

A total of 2,531 individuals were included in our study, of whom 51.28% had MetS and 48.72% were non-MetS. The logistic regression model identified the association between N-acetyl-S-(N- methylcarbamoyl)-L-cysteine (AMCC), N-acetyl-S-(2-carboxyethyl)-L-cysteine (CEMA), N-acetyl-S-(2- cyanoethyl)-L- cysteine (CYMA) and MetS. In WQS regression analysis, the WQS index was significantly associated with AMCC, trans,trans-Muconic acid (t,t-MA), N-Acetyl-S-(1-cyano-2- hydroxyethyl)- L-cysteine (CYHA), CEMA, 2-Thioxothiazolidine-4-carboxylic acid (TTCA), N-acetyl- S-(3- hydroxypropyl-1-methyl)-L-cysteine (HPMM), CYMA, N-acetyl-S-(3,4-dihydroxybutyl)-L-cysteine (NADB), and N-Acetyl-S-(4-hydroxy-2-methyl-2-buten-1-yl)-L-cysteine (IPM3 cysteine). Finally, the combined association of MetS was positively associated with CEMA and CYMA in the BKMR regression model.

Discussion

In summary, we demonstrated that VOCs and their` metabolism were significantly associated with MetS. Compared results from these three models, CEMA and CYMA were identified as the factors associated with MetS. This study provides a research direction for the mechanism of VOCs that may induce the onset and development of MetS.

Relation of volatile organic compounds to renal function in American adolescents: three statistical models

This study was conducted to evaluate the relationship between 17 urinary metabolites of volatile organic compounds (mVOCs) in adolescents and renal function parameters (estimated glomerular filtration rate (eGFR), albumin-to-creatinine ratio (ACR), urinary albumin, serum uric acid (SUA), and blood urea nitrogen (BUN)). In adjusted generalised linear models (GLM), mVOCs were positively correlated with eGFR, urinary albumin, and BUN, and mVOCs were negatively correlated with ACR and SUA. Weighted Quartile Sum (WQS) index correlated with eGFR [β(95%CI): 0.040 (0.028, 0.052)], urine albumin [β(95%CI): 0.275 (0.203, 0.622)], SUA [β(95%CI): 0.040 (0.025, 0.055)] and BUN [β(95%CI): 0.102 (0.082, 0.122)]. In Bayesian Kernel Machine Regression (BKMR) model, total compound effect was positively correlated with eGFR, positive associations were observed in high concentration of the mixture with urine albumin and ACR. Findings suggest that single and mixed exposures to mVOCs may affect renal parameters in adolescents.

Association of volatile organic compound exposure and metabolic syndrome

The cumulative toxicity of volatile organic compounds (VOCs) cause many medical diseases. We analyzed the evidence of association between VOCs and risk of metabolic syndrome in the Korean population using 1771 participants from the 2023 National Health and Nutrition Examination Survey. The creatinine-corrected urinary concentrations of BMA, 2-MHA, PGA, SPMA, 3-HPMA, BPMA and DHBMA were higher in the metabolic syndrome group than in the non-metabolic syndrome group. Urine N-Acetyl-S-(phenyl)-L-cysteine (SPMA) levels were significantly associated with metabolic syndrome after adjusting for confounders (odds ratio: 1.71). 2-MHA (OR 1.29, P=0.035) and SPMA (OR 2.84, P<0.001) were associated with the risk of elevated FBG impairment and SPMA (OR 1.57) was positively connected with the high blood pressure (P=0.016). In conclusion, the findings indicated significant association between the metabolic syndrome and a number of VOCs. Among them, there was a substantial positive correlation between the urinary SPMA levels and metabolic syndrome.

A Comprehensive Review of Biomarker Sensors for a Breathalyzer Platform

Detecting volatile organic compounds (VOCs) is increasingly recognized as a pivotal tool in non-invasive disease diagnostics. VOCs are metabolic byproducts, mostly found in human breath, urine, feces, and sweat, whose profiles may shift significantly due to pathological conditions. This paper presents a thorough review of the latest advancements in sensor technologies for VOC detection, with a focus on their healthcare applications. It begins by introducing VOC detection principles, followed by a review of the rapidly evolving technologies in this area. Special emphasis is given to functionalized molecularly imprinted polymer-based biochemical sensors for detecting breath biomarkers, owing to their exceptional selectivity. The discussion examines SWaP-C considerations alongside the respective advantages and disadvantages of VOC sensing technologies. The paper also tackles the principal challenges facing the field and concludes by outlining the current status and proposing directions for future research.

Associations of Urinary Cadmium with Body Composition and Fat Distribution in US Adults: Findings from NHANES 2011-2018

The effects of cadmium (Cd) on metabolic physiology remain controversial. Given the varying metabolic impacts associated with different body compositions, investigating the relationship between Cd exposure and body composition may facilitate further research. Here, the associations of body composition and fat distribution with urine Cd (UCd) were evaluated. This analysis included 2979 adult participants from the 2011-2018 National Health and Demographic Survey (NHANES). UCd was measured using inductively coupled plasma mass spectrometry and adjusted for urinary creatinine. Body composition and fat distribution were estimated using dual-energy x-ray absorptiometry (DXA). The study results show that UCd was negatively associated with fat mass index (FMI) and percent fat mass (p for trend < 0.001), and the negative correlation between UCd and FMI was stronger in males and smokers (all p for interaction < 0.05). In terms of abdominal fat distribution, UCd was negatively associated with abdominal subcutaneous adipose tissue (SAT) mass (p for trend < 0.001), but with abdominal visceral adipose tissue (VAT) mass only in those with low percent fat mass (< 32.3%) (p for trend = 0.026 and p for interaction < 0.05). UCd was positively related to percent VAT (p for trend < 0.001) and visceral-to-subcutaneous (VAT/SAT) ratio (p for trend = 0.003). And there was a significant negative association between UCd and android-to-gynoid (A/G) ratio (p for trend = 0.001). Meanwhile, UCd was negatively correlated with fat-free mass index (FFMI) (p for trend < 0.001). And the negative correlation between UCd and FFMI was stronger in males, smokers, and individuals with < 32.3 percent fat mass (all p for interaction < 0.05). We found the association of UCd with body composition and fat distribution, with distinct patterns observed in different demographic groups. These findings underscore the importance of considering UCd exposure in the context of body composition and fat distribution.

Association between volatile organic compounds exposure and periodontitis: A representative cross-sectional study

AIM

Periodontitis is one of the most common oral diseases and a major cause of tooth loss in adults. Environmental pollution is closely associated with the prevalence of periodontitis. However, few studies have focused on the association between volatile organic compounds (VOCs) and periodontitis. This cross-sectional study aims to examine whether exposure to VOCs is associated with periodontitis, based on data from the National Health and Nutrition Examination Survey (NHANES, 2011-2014).

MATERIALS AND METHODS

We analysed data on blood VOC levels, periodontitis and related covariates from 2772 participants of the NHANES. The association between the blood VOCs and periodontitis was analysed using weighted logistic regression analysis, the restricted cubic spline (RCS) model and the weighted quantile sum (WQS) regression model. Interaction tests and mediation analysis were also conducted.

RESULTS

After adjusting for covariates, for each natural constant-fold increase in 1,4-dichlorobenzene, the odds of having periodontitis increased by 16% (odds ratio = 1.16; 95% confidence interval: 1.08-1.24, p < .001). WQS regression model indicated that 1,4-dichlorobenzene contributed the most to the association between VOC co-exposure and periodontitis. Mediation analysis further revealed that total bilirubin levels mediated the association between 1,4-dichlorobenzene and the prevalence of periodontitis, accounting for 4.32%. In addition, the positive association between o-xylene and periodontitis was more pronounced in the <65-year-old group.

CONCLUSIONS

This study has provided relatively little evidence to demonstrate a specific link between VOCs and periodontitis. Nonetheless, exposure to VOCs remains a non-negligible public health concern, and further research is required to investigate the association and potential mechanisms of action between VOCs and periodontitis.

Association between the C-reactive protein to albumin ratio with asthma and mortality in adult: a population-based study

Asthma is a prevalent chronic disease characterized by airflow obstruction, causing breathing difficulties and wheezing. This study investigates the association between the C-reactive protein to albumin ratio (CAR) and asthma prevalence, as well as all-cause and respiratory mortality among asthma patients, using data from the 2001-2018 National Health and Nutrition Examination Survey. We included participants aged 20 years and older with complete CAR data, excluding those who were pregnant or lost to follow-up. The analysis employed weighted logistic regression and Cox proportional hazards models with stepwise adjustment, restricted cubic spline analysis for nonlinear relationships, and time-dependent ROC curves for predictive accuracy. Results showed that the highest CAR quartile significantly increased the risk of asthma (OR 1.56, 95% CI 1.38-1.78), all-cause mortality (HR 2.20, 95% CI 1.67-2.89), and respiratory mortality (HR 2.56, 95% CI 1.30-5.38). The impact of CAR on all-cause mortality was particularly significant in hypertensive patients. These findings highlight CAR's potential as a valuable biomarker for predicting asthma prevalence and mortality, underscoring its role in asthma management and prognostication.

Associations of the planetary health diet index (PHDI) with asthma: the mediating role of body mass index

BACKGROUND

Given the global shifts in environmental conditions and dietary habits, understanding the potential impact of dietary factors and body mass index (BMI) on respiratory diseases, including asthma, is paramount. Investigating these relationships can contribute to the formulation of more effective prevention strategies. The Planetary Health Diet Index (PHDI), a dietary scoring system that balances human health with environmental sustainability, underscores the importance of increasing the consumption of plant-based foods while reducing the intake of red meat, sugar, and highly processed foods. The objective of this study was to assess the association between PHDI and the prevalence of asthma and the mediation effect of BMI in a US general population.

METHODS

This study utilized data from 32,388 participants in the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2018. Multivariate logistic regression and weighted quantile sum (WQS) regressions were employed to investigate the association between PHDI, individual nutrients, and asthma. Restricted cubic spline (RCS) analysis explored the linear or non-linear relationship between PHDI and asthma. Interaction analyses were conducted on subgroups to validate the findings. Mediation analysis was performed to examine the effect of BMI on the relationship between PHDI and asthma.

RESULTS

There was a significant negative association between PHDI and asthma. After adjusting for covariates, for every 10-point increase in PHDI, there was a 4% decrease in the prevalence of asthma (P = 0.025). Moreover, as PHDI increased, there was a trend towards lower asthma prevalence (P for trend < 0.05). WQS analyses showed consistent associations (OR = 0.93, 95%CI: 0.88, 0.98), with Fiber, Vitamin C, and Protein significant factors. The dose-response curve indicated a linear association between PHDI and asthma, with higher PHDI associated with lower asthma prevalence. Additionally, BMI is significantly positively associated with asthma (P < 0.001), and BMI decreases as the PHDI increases (β = -0.64, P < 0.001). Mediation analysis indicates that BMI significantly mediates the relationship between PHDI and asthma, with a mediation proportion of 33.85% (P < 0.001).

CONCLUSION

The results of this study show a strong negative correlation between PHDI and the prevalence of asthma. In addition, BMI mediated this negative relationship.

Combined association of urinary volatile organic compounds with chronic bronchitis and emphysema among adults in NHANES 2011-2014: The mediating role of inflammation

Evidence on the association of volatile organic compounds (VOCs) with chronic bronchitis (CB) and emphysema is spare and defective. To evaluate the relationship between urinary metabolites of VOCs (mVOCs) with CB and emphysema, and to identify the potential mVOC of paramount importance, data from NHANES 2011-2014 waves were utilized. Logistic regression was conducted to estimate the independent association of mVOCs with respiratory outcomes. Least absolute shrinkage and selection operator (LASSO) regression was performed to screen a parsimonious set of CB- and emphysema-relevant mVOCs that were used for further co-exposure analyses of weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR). Mediation analysis was employed to detect the mediating role of inflammatory makers in such associations. In single exposure analytic model, nine mVOCs were individually and positively associated with CB, while four mVOCs were with emphysema. In WQS regression, positive association between LASSO selected mVOCs and CB was identified (OR = 1.82, 95% CI: 1.25 to 2.69), and N-acetyl-S-(4-hydroxy-2-butenyl)-l-cysteine (MHBMA3) weighted the highest. Results from BKMR further validated such combined association and the significance of MHBMA3. As for emphysema, significantly positive overall trend of mVOCs was only observed in BKMR model and N-acetyl-S-(N-methylcarbamoyl)-l-cysteine (AMCC) contributed most to the mixed effect. White blood cell count (WBC) and lymphocyte number (LYM) were mediators in the positive pattern of mVOCs mixture with CB, while association between mVOCs mixture and emphysema was significantly mediated by LYM and segmented neutrophils num (NEO). This study demonstrated that exposure to VOCs was associated with CB and emphysema independently and combinedly, which might be partly speculated that VOCs were linked to activated inflammations. Our findings shed novel light on VOCs related respiratory illness, and provide a new basis for the contribution of certain VOCs to the risk of CB and emphysema, which has potential public health implications.

Urinary volatile organic compound metabolites and COPD among US adults: mixture, interaction and mediation analysis

BACKGROUND

Volatile organic compounds (VOCs) encompass hundreds of high production volume chemicals and have been reported to be associated with adverse respiratory outcomes such as chronic obstructive pulmonary disease (COPD). However, research on the combined toxic effects of exposure to various VOCs on COPD is lacking. We aimed to assess the effect of VOC metabolite mixture on COPD risk in a large population sample.

METHODS

We assessed the effect of VOC metabolite mixture on COPD risk in 5997 adults from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2020 (pre-pandemic) using multivariate logistic regression, Bayesian weighted quantile sum regression (BWQS), quantile-based g-Computation method (Qgcomp), and Bayesian kernel machine regression (BKMR). We explored whether these associations were mediated by white blood cell (WBC) count and total bilirubin.

RESULTS

In the logistic regression model, we observed a significantly increased risk of COPD associated with 9 VOC metabolites. Conversely, N-acetyl-S-(benzyl)-L-cysteine (BMA) and N-acetyl-S-(n-propyl)-L-cysteine (BPMA) showed insignificant negative correlations with COPD risk. The overall mixture exposure demonstrated a significant positive relationship with COPD in both the BWQS model (adjusted odds ratio (OR) = 1.30, 95% confidence interval (CI): 1.06, 1.58) and BKMR model, and with marginal significance in the Qgcomp model (adjusted OR = 1.22, 95% CI: 0.98, 1.52). All three models indicated a significant effect of the VOC metabolite mixture on COPD in non-current smokers. WBC count mediated 7.1% of the VOC mixture associated-COPD in non-current smokers.

CONCLUSIONS

Our findings provide novel evidence suggesting that VOCs may have adverse associations with COPD in the general population, with N, N- Dimethylformamide and 1,3-Butadiene contributing most. These findings underscore the significance of understanding the potential health risks associated with VOC mixture and emphasize the need for targeted interventions to mitigate the adverse effects on COPD risk.

Association of volatile organic compound exposure with metabolic syndrome and its components: a nationwide cross-sectional study

BACKGROUND

Metabolic syndrome (MetS) is a health issue consisting of multiple metabolic abnormalities. The impact of exposure to volatile organic compounds (VOCs) on MetS and its components remains uncertain. This study aimed to assess the associations of individual urinary metabolites of VOC (mVOCs) and mVOC mixtures with MetS and its components among the general adult population in the United States.

METHODS

A total of 5345 participants with eligible data were filtered from the 2011-2020 cycles of the National Health and Nutrition Examination Survey. Multivariate logistic regression models were applied to assess the associations of individual mVOCs with MetS and its components. The least absolute shrinkage and selection operator (LASSO) regression models were constructed to identify more relevant mVOCs. The weight quantile sum regression model was applied to further explore the links between mVOC co-exposure and MetS and its components.

RESULTS

The results indicated positive associations between multiple mVOCs and MetS, including CEMA, DHBMA, and HMPMA. CEMA was found to be positively correlated with all components of MetS. HMPMA was associated with elevated triglyceride (TG), reduced high-density lipoprotein, and fasting blood glucose (FBG) impairment; 3HPMA was associated with an elevated risk of high TG and FBG impairment; and DHBMA had positive associations with elevated TG and high blood pressure. The co-exposure of LASSO-selected mVOCs was associated with an increased risk of elevated TG, high blood pressure, and FBG impairment.

CONCLUSION

Positive associations of certain individual urinary mVOCs and mVOC mixtures with MetS and its components were observed by utilizing multiple statistical models and large-scale national data. These findings may serve as the theoretical basis for future experimental and mechanistic studies and have important implications for public health.

Association of dietary flavonoid intakes with prevalence of chronic respiratory diseases in adults

BACKGROUND AND AIMS

Flavonoids are a class of secondary plant metabolites that have been shown to have multiple health benefits, including antioxidant and anti-inflammatory. This study was to explore the association between dietary flavonoid consumption and the prevalence of chronic respiratory diseases (CRDs) in adults.

METHODS AND RESULTS

The six main types of flavonoids, including isoflavones, anthocyanidins, flavan-3-ols, flavanones, flavones, and flavonols, were obtained from the National Health and Nutrition Examination Survey (NHANES) 2007-2010 and 2017-2018 by the two 24-h recall interviews. The prevalence of CRDs, including asthma, emphysema, and chronic bronchitis, was determined through a self-administered questionnaire. The analysis included 15,753 participants aged 18 years or older who had completed a diet history interview. After adjustment for potential confounders, the inverse link was found with total flavonoids, anthocyanidins, flavanones, and flavones, with an OR (95%CI) of 0.86 (0.75-0.98), 0.84 (0.72-0.97), 0.80(0.69-0.92), and 0.85(0.73-0.98) for the highest group compared to the lowest group. WQS regression revealed that the mixture of flavonoids was negatively linked with the prevalence of CRDs (OR = 0.88 [0.82-0.95], P < 0.01), and the largest effect was mainly from flavanones (weight = 0.41). In addition, we found that flavonoid intake was negatively linked with inflammatory markers, and systemic inflammation significantly mediated the associations of flavonoids with CRDs, with a mediation rate of 12.64% for CRP (P < 0.01).

CONCLUSION

Higher flavonoid intake was related with a lower prevalence of CRDs in adults, and this relationship may be mediated through systemic inflammation.

Volatile organic compounds exposure associated with depression among U.S. adults: Results from NHANES 2011-2020

Volatile organic compounds (VOCs) are important contributors to air pollution. VOCs exposure was associated with various human diseases. Depression is one of the most prevalent mental disorders and poses a serious mental health burden. Although VOCs are neurotoxic and can damage the central nervous system, the association between VOCs exposure and depression remains obscure. Based on data from the National Health and Nutrition Examination Survey, we included 5676 adult individuals and 15 major components of urinary volatile organic compound metabolites (mVOCs). We comprehensively evaluated the potential association between each single urinary mVOC exposure and depressive symptoms using binary logistic and restricted cubic spline regression, whereas the weighted quantile sum regression and least absolute shrinkage and selection operator regression model were used to explore the mixture co-exposure association. The results indicated significantly higher mean concentrations of the 11 urinary mVOC components in the depression group than that in the non-depression group. And 12 mVOC components had a significantly positive association with depression. The overall effect of all 15 mVOCs components was also significantly positive. The corresponding odds ratio was 1.56 (95%CI: 1.2-2.03) in the categorical variable model and the regression coefficient was 0.36 (95%CI: 0.12-0.6) in the numerical variable model. Five urinary mVOCs (URXCYM, URXPHG, URX34 M, URXMB3, and URXAMC) were identified as the most relevant components associated with depression, with 89.06% total weights in the categorical variable model and 89.39% in the numerical variable model. The mVOCs were the biomarkers of VOCs, their concentrations in urine could specifically represent the contents of their metabolic parents in the human body. Considering that the metabolic parents of the above five mVOCs were predominantly acrylonitrile, toluene, styrene, acrylamide, 1,3-Butadiene, and xylenes, our results further indicated that exposure to these VOCs was closely related to depression, and more attention should be paid to the mental health risks of VOCs exposure.

Association between dietary antioxidant intakes and chronic respiratory diseases in adults

Background

Chronic respiratory diseases (CRDs) pose a significant global health burden. Antioxidant-rich diets have been associated with improved lung health, but the specific relationship with CRDs remains unclear.

Methods

This study examined the relationship between dietary antioxidant intakes and CRDs using data from the 2001-2018 National Health and Nutrition Examination Survey (NHANES). Information on dietary antioxidant intakes, including vitamins A, C, and E, zinc, selenium, and carotenoid, were collected from the 2 24-h recall interviews to calculate composite dietary antioxidant index (CDAI). CRDs were determined based on self-reported physician diagnoses. To examine the relationship between CDAI and CRDs, multivariate logistic regression was used. To study potential non-linear correlations within these associations, restricted cubic spline (RCS) regression was performed.

Results

The study involved 40 557 individuals. The median CDAI was -0.09 (-2.05, 2.25). We discovered those who were in the fourth quartile of CDAI scores had a 19% lower prevalence than those in the first quartile (OR = 0.81 [0.72-0.91], Ptrend < 0.01) after adjusting for all relevant covariates. The fourth quartile of CDAI was linked with a lower prevalence of emphysema (OR = 0.57 [0.40-0.81], Ptrend < 0.01) and chronic bronchitis (OR = 0.74 [0.62-0.88], Ptrend < 0.01). RCS regression showed that CDAI was non-linearly related to the prevalence of CRDs, with inflection points of 3.20 (P for non-linearity <0.01). The stratified analysis did not identify variables that significantly affected the results.

Conclusion

Higher dietary antioxidant intakes were related with a lower prevalence of CRDs (particularly emphysema and chronic bronchitis) in general adults.

Greenness and chronic respiratory health issues: a systematic review and meta-analysis

Introduction

The number of chronic respiratory disease (CRD) individuals worldwide has been continuously increasing. Numerous studies have shown that greenness can improve chronic respiratory health issues through different mechanisms, with inconsistent evidence. By quantitatively summarizing existing studies, our purpose is to determine the connection between greenness exposure and various chronic respiratory health.

Methods

We conducted a comprehensive search on PubMed, EMBASE, and Web of Science core databases to identify relevant studies on the correlation between greenness exposure and chronic respiratory health issues. Studies published up to January 2023 were included in the search. The study used the most frequent indicator (normalized difference vegetation index [NDVI]) as the definition of greenness exposure.

Results

We finally identified 35 studies for meta-analysis. We calculated pooled effects across studies using a random-effects model and conducted a subgroup analysis by age and buffer zones to discuss the effects on chronic respiratory health issues. This study showed that 0.1 increments in NDVI were significantly related to lower rates of asthma incidence, lung cancer incidence, and chronic obstructive pulmonary disease (COPD) mortality risk; the pooled RRs were 0.92 (95% CI: 0.85-0.98), 0.62 (95% CI: 0.40-0.95), and 0.95 (95% CI: 0.92- 0.99), respectively. For the age subgroup, the higher greenness exposure level was related to the incidence rate of asthma among teenagers aged 13-18years (RR: 0.91; 95% CI: 0.83-0.99). For the buffer subgroup, a positive relationship with greenness exposure and asthma incidence/prevalence at 200-300m and 800- 1000m buffers, as well as the COPD mortality at 800-1000m buffer, the pooled RRs were 0.92 (95% CI: 0.86-0.98), 0.87 (95% CI: 0.81-0.93), and 0.93 (95% CI: 0.88- 0.98), respectively. Evidence of publication bias was not detected in this study.

Discussion

Our study is the first global meta-analysis between greenness and various CRDs to report an inverse association. Further research is needed in order to determine the effect of greenness exposure on different CRDs. Therefore, when planning for green development, more consideration must be given to public health and green management as intervention measures.

https://www.crd.york.ac.uk/PROSPEROFILES/384029_STRATEGY_20230116.pdf.

Association of volatile organic compounds exposure with the risk of depression in U.S. adults: a cross‑sectional study from NHANES 2013-2016

BACKGROUND

Volatile organic compounds (VOCs) are a broad class of chemicals, and previous studies showed that VOCs could increase the risk of central nervous system disorders. However, few studies have comprehensively explored their association with depression among general adults.

OBJECTIVE

We aimed to explore the association between blood VOCs and depression risk based on a large cross-sectional study of the National Health and Nutrition Examination Survey (NHANES).

METHODS

We analyzed data from 3449 American adults in the NHANES 2013-2016. Survey-weighted logistic regression model was used to explore the association of ten blood VOCs with depression. Subsequently, the relative importance of the selected VOCs was determined using the XGBoost model. The weighted quantile sum (WQS) regression model was used to explore the overall association of 10 blood VOCs with depression. Subgroup analyses were performed to identify high-risk populations. Finally, restricted cubic spline (RCS) analysis was utilized to explore the dose-response relationship between blood VOCs and the risk of depression.

RESULTS

XGBoost Algorithm model identified blood 2,5-dimethylfuran was the most critical variable in depression. The logistic regression model showed that blood benzene, blood 2,5-dimethylfuran, and blood furan showed a positive correlation with depression. In subgroup analysis, we found that the effects of the above VOCs on depression existed among the female, young middle-aged, and overweight-obese population. Mixture VOCs exposure was positively associated with depression risk (OR = 2.089, 95% CI: 1.299-3.361), and 2,5-dimethylfuran had the largest weights in WQS regression. RCS displayed that blood benzene, blood 2,5-dimethylfuran, and blood furan were positively associated with depression.

CONCLUSION

The results of this study indicated that VOCs exposure was associated with an increased prevalence of depression in U.S. adults. Women, young and middle-aged, and overweight-obese populations are more vulnerable to VOCs.