Antibiotic exposure and risk of overweight/obesity in school children: A multicenter, case-control study from China

Obesogenic effects of six classes of emerging contaminants

There is growing concern about the concept that exposure to environmental chemicals may be contributing to the obesity epidemic. However, there is no consensus on the obesogenic effects of emerging contaminants from a toxicological and environmental perspective. The potential human exposure and experimental evidence for obesogenic effects of emerging contaminants need to be systematically discussed. The main objective of this review is to provide recommendations for further subsequent policy development following a critical analysis of the literature for humans and experimental animals exposed to emerging contaminants. This article reviews human exposure to emerging contaminants (with a focus on antimicrobials, preservatives, water and oil repellents, flame retardants, antibiotics and bisphenols) and the impact of emerging contaminants on obesity. These emerging contaminants have been widely detected in human biological samples. Epidemiological studies provide evidence linking exposure to emerging contaminants to the risks of obesity in humans. Studies based on animal models and adipose cells show the obesogenic effects of emerging contaminants and identify modes of action by which contaminants may induce changes in body fat accumulation and lipid metabolic homeostasis. Some knowledge gaps in this area and future directions for further investigation are discussed.

Presence of antibiotics in children's urine: a silent risk beyond drinking water

This study investigated the presence of 32 antibiotic residues in drinking water, their potential association with antibiotic concentrations in children's urine samples, and anthropometric indicators. Water samples were collected from the primary water sources supplying Ilo, Peru (Pacocha and Pampa), and urine samples were analysed from children aged 2 to 10 years using liquid chromatography coupled to tandem mass spectrometry with triple quadrupole. Five antibiotics were detected in drinking water, with three of these representing a health risk due to high concentrations and risk quotients (RQ): Doxycycline (2.30), Sulfamethoxazole (1.04), and Metronidazole (25.68). Furthermore, there was no correlation between the antibiotics found in drinking water and those detected in urine samples, as the types and quantities of antibiotics differed. In urine samples, 21 antibiotics were detected in children from Pacocha and 19 from Pampa. The antibiotics and anthropometric variables did not show any significant correlation. Principal component analysis revealed that antibiotic profiles were highly similar across both areas, suggesting a shared source of contamination independent of drinking water. It is concerning that 100% of the children have at least three antibiotics in their urine, which could affect their health now and later in life.

Antibiotic exposure and risk of overweight/obesity in children: a biomonitoring-based study from eastern Jiangsu, China

Objective

To describe antibiotic exposure in children and explore its association with overweight/obesity.

Methods

In June 2022, 328 kindergarten and primary school children were selected from Nantong city in Jiangsu Province. Questionnaires were distributed, and morning urine samples were obtained. Total urinary concentrations of 41 antibiotics were measured using ultra-performance liquid chromatography and tandem mass spectrometry. The rates of antibiotic exposure were expressed as percentages (%), specific percentiles (P 95 and P 99), and the maximum values were used to describe the concentration of antibiotics. The association between urinary antibiotic creatinine-adjusted and overweight/obesity was analyzed using logistic regression.

Results

A total of 328 children were initially recruited, of which 295 aged 3-8 years met the inclusion criteria and were finally included in the study. The biomonitoring results revealed that 35 antibiotics were detected, with a total detection frequency of 98.31%. Among the included children, 24.75% were classified as overweight/obesity. Multinomial logistic regression analyses revealed significant associations between overweight/obese and exposure to veterinary antibiotics (VAs) and preferred veterinary antibiotics (PVAs). After adjusting for various overweight/obesity-relevant variables, higher exposure to sulfamethoxazole [OR = 2.35, 95% confidence interval (CI):1.17-4.70], norfloxacin (OR = 2.66, 95% CI: 1.01-7.08), and fluoroquinolones (OR = 1.97, 95% CI: 1.02-3.78) were significantly associated with overweight/obesity (p < 0.05). In addition, after stratification by sex and adjustment for confounding variables, sex-specific differences were observed in the association between antibiotic exposure and overweight/obesity. Notably, these associations were predominantly observed among boys.

Conclusion

Children were extensively exposed to antibiotics. Exposure to certain types of veterinary antibiotics and preferred veterinary antibiotic exposure, mainly through food or drinking water, are associated with an increased risk of overweight/obesity in children.

A Green HPLC Approach to Florfenicol Analysis in Pig Urine

Florfenicol (FF) is a broad-spectrum antibiotic used to treat gastrointestinal and respiratory infections in domestic animals. Considering FF's rapid elimination via urine after drug treatment, its use increases concerns about environmental contamination. The objective of the study was to establish a sustainable chromatographic method for simple analysis of FF in pig urine to investigate the urinary excretion of FF after a single intramuscular administration of 20 mg FF/kg body weight. The urine sample was prepared using a centrifuge and regenerated cellulose filter, and the diluted sample was analyzed. The method was validated in terms of linearity, the limit of detection (0.005 µg/mL) and quantitation (0.016 µg/mL), repeatability and matrix effect (%RSD ranged up to 2.5), accuracy (varied between 98% and 102%), and stability. The concentration-time profile of pig urine samples collected within 48 h post-drug administration showed that 63% of FF's dose was excreted. The developed method and previously published methods used to qualify FF in the urine of animal origin were evaluated by the National Environmental Method Index (NEMI), Green Analytical Procedure Index (GAPI) and Analytical GREENness Metric Approach (AGREE). The greenness profiles of published methods revealed problems with high solvents and energy consumption, while the established method was shown to be more environmentally friendly.

Antibiotic altered liver damage induced by aflatoxin B1 exposure in mice by modulating the gut microbiota

Aflatoxins B1 (AFB1) and antibiotic (AN) carry co-exposure risks, with the gut being a target organ for their combined effects. However, the current understanding of the impact of AN on gut and liver injury induced by AFB1 remains limited. In this study, we conducted a 9-week investigation into the implications of AN (ampicillin and penicillin) treatment on AFB1-induced intestinal and liver injury in C57BL/6J male mice fed a normal diet (ND) and a high-fat diet (HFD). The results showed that AN treatment significantly reduce the total number and diversity of intestinal species in both ND and HFD mice exposed to AFB1. Moreover, AN treatment alleviated AFB1-induced liver injury and lipid accumulation in mice on ND and HFD, while improving abnormal lipid metabolism in the liver and serum. However, AN treatment also promoted intestinal damage and reduced the levels of short-chain fatty acids in the gut. Correlation analysis demonstrated that, under the two dietary patterns, microorganisms across various genera were significantly positively or negatively correlated with alterations in liver, serum, and intestinal biochemical indexes. These genera include Akkermansia, Robinsoniella, Parabacteroides, Escherichia-Shigel, and Parabacteroides, Odoribacter. AN may alleviate long-term AFB1-induced liver injury through the regulation of intestinal microorganisms, with the effect being more pronounced in mice following an HFD pattern. These findings provide novel insights into the effects of AFB1 on the gut‒liver axis under complex exposure conditions, as well as the relationship between gut microbial homeostasis and liver injury across different dietary patterns.

Urinary antibiotic levels and risk of overweight/obesity in preschool children: A biomonitoring-based study from eastern China

There is limited evidence linking antibiotic exposure, particularly from contaminated food or drinking water, to childhood obesity. The study aimed to investigate the association between urinary antibiotic levels and overweight/obesity in preschool children. In the case-control study, 121 overweight/obese preschoolers and 242 controls (aged 3-6 years) from eastern China were enrolled in 2022 based on age, sex, and study site matching. Overweight/obesity was determined using body mass index (BMI) and weight for height (WFH) criteria derived from national data. A total of 50 antibiotics from 8 categories were analyzed using ultra-performance liquid chromatography and tandem mass spectrometry (UPLC-MS/MS). We identified major dietary patterns using principal component analysis (PCA) and examined the associations of antibiotic exposure with childhood overweight/obesity using multivariate logistic regression. Twenty-four individual antibiotics were detected in more than 10 % of the samples, and overall detection rates were up to 100 %. Overweight/obese children had a higher exposure to veterinary antibiotics (VAs) than normal weight children. PCA analysis showed that children who were overweight/obese had higher scores of "Aquatic products preferred dietary pattern" and "Cereals preferred dietary pattern" compared to children with normal weight. Multivariate logistic regression analyses indicated that exposure to elevated levels of deoxytetracycline (OR: 1.72; 95 %CI: 1.00-2.93) and quinolones (OR: 1.63; 95 %CI: 1.04-2.57) was significantly related to an increased risk of BMI-based overweight/obesity. Quinolones exposure was also significantly associated with WFH-based overweight/obesity, primarily in boys. After adjustment for all covariates, higher exposure to ofloxacin (of the quinolones) was significantly related to overweight/obesity in girls. Exposure to certain antibiotics, especially quinolones, may increase the risk of overweight/obesity in preschoolers. More prospective, well-designed studies are needed to clarify these findings.

Antibiotic residues in milk and dairy products in China: occurrence and human health concerns

Although veterinary antibiotics are essential in preventing and treating clinical diseases in cattle, the frequent use of antibiotics leads to antibiotic residues in milk and dairy products, consequently threatening human health. The massive milk consumption makes it necessary to assess antibiotic pollution and health impact comprehensively. Hence, we conducted a systematic review to evaluate antibiotics in milk and dairy products and their potential health risk. We searched four databases using multiple keyword combinations to retrieve 1582 pieces of literature and finally included eighteen articles to analyze antibiotic residues in milk and dairy products. These studies detected seven antibiotics in different regions of China. Quinolones and β-lactam antibiotics exceeded the MRL for raw and commercial milk. The maximum levels of sulfonamides and tetracyclines were detected in the same raw milk sample, exceeding the MRL. The estimated THQ and HI values in milk and dairy products are less than 1 for adults, indicating negligible noncarcinogenic health risk of antibiotics through consuming milk and dairy products. Children face higher health risks than adults, with the HI and THQ of quinolones exceeding 1. It is worth noting that quinolones accounted for nearly 89% of health risks associated with all antibiotics. Finally, we put forward possible research directions in the future, such as specific health effects of total dietary exposure to low levels of antibiotics. In addition, policymakers should effectively improve this problem from the perspectives of antibiotic use supervision, antibiotic residue analysis in food, and continuous environmental monitoring and control.

Preconception exposure to environmental antibiotics among childbearing couples in Anhui and health risk assessment: A multicenter population-based representative study

Only few studies have assessed the health effects due to preconception exposure to antibiotics among childbearing couples. This study investigated the status of preconception exposure to antibiotics among childbearing couples in Anhui, associated with health risks, and influencing factors. Overall, 1500 childbearing couples were randomly selected from the Reproductive Health of Childbearing Couples - Anhui Cohort (RHCC-AC). The urinary levels of 40 antibiotics and 2 metabolites were determined, and specific gravity (SG) adjusted concentrations of antibiotics were measured to assess health risks. Generalized linear models were used to assess the associations of urinary SG-adjusted concentration of antibiotics with demographic parameters and diet frequency. The total detection rates of all antibiotics were 98.9 % and 99.3 % in wives and husbands, respectively. The detection rates of veterinary antibiotics (VAs) and preferred as VAs (PVAs) were above 90 %. Among eight antibiotics, sulfonamides (95.1 %) and fluoroquinolones (87.6 %) had the highest detection rates in couples. Approximately four-fifths of couples were simultaneously exposed to at least three different antibiotics, and more than half of them were exposed to low concentrations of antibiotics. 8.9 % and 9.2 % of wives and husbands had hazard index value of antibiotics exposure greater than 1. Antibiotic concentrations were associated with residence, sampling season, and diet frequency. In Anhui, nearly 98 % of childbearing couples have environmental exposure to antibiotics, and VAs and PVAs are the primary antibiotics. More than 8 % of couples had health risks due to antibiotic exposure. Several potential determinants of urinary antibiotics deserve more attention in future research.

Bidirectional Interaction between Tetracyclines and Gut Microbiome

The escalating misuse of antibiotics, particularly broad-spectrum antibiotics, has emerged as a pivotal driver of drug resistance. Among these agents, tetracyclines are widely prescribed for bacterial infections, but their indiscriminate use can profoundly alter the gut microbiome, potentially compromising both their effectiveness and safety. This review delves into the intricate and dynamic interplay between tetracyclines and the gut microbiome, shedding light on their reciprocal influence. By exploring the effects of tetracyclines on the gut microbiome and the impact of gut microbiota on tetracycline therapy, we seek to gain deeper insights into this complex relationship, ultimately guiding strategies for preserving antibiotic efficacy and mitigating resistance development.

Urinary antibiotic concentrations in preschool children from eastern China and health risk assessment

Despite limited biomonitoring studies suggesting extensive antibiotic exposure in general population, the body burden of antibiotics in young children and their potential health risks remain unclear. To assess the antibiotic exposure levels in young children, 508 preschoolers aged 3-6 years were recruited from eastern China in 2022, and a total of 50 representative antibiotics from 8 categories, including 17 human antibiotics (HAs), 4 antibiotics preferred as HAs (PHAs), 16 veterinary antibiotics (VAs), and 13 antibiotics preferred as VAs (PVAs), were analyzed by UPLC-MS/MS. Hazard quotient (HQ) and hazard index (HI) were calculated to evaluate the health risks, and multivariate logistic regression was applied to examine diet with antibiotic exposure. Our results showed that there were 41 antibiotics detected in children's urine, and the overall detection frequency was as high as 100%. Sulfonamides, macrolides, β-lactams, quinolones, and azoles were the predominant categories of antibiotic detected. Among the studied children, 6.5% had a sum of estimated daily intake (EDI) of all VAs and PVAs larger than 1 μg/kg/day. Notably, 10.0% of the children had a microbiological HI value exceeding 1, primarily contributed by ciprofloxacin. Children with higher consumption of seafood had a relatively increased exposure to multiple categories of antibiotics, including HAs, VAs, quinolones, azoles, and others. Principal component analysis suggested that "Aquatic products and viscera preferred dietary pattern" scores were positively correlated with the exposure levels of ciprofloxacin (OR: 1.23; 95% CI: 1.02-1.47) and carbadox (OR: 1.32; 95% CI: 1.10-1.59), and a relatively increased exposure of PHAs was realized in children with higher "Meat-egg preferred dietary pattern" scores (OR: 1.24; 95% CI: 1.03-1.50). In conclusion, there was a widespread exposure to antibiotics among preschool children from eastern China, and children who consumed more animal-derived foods may had an increased exposure to antibiotics.

The different trends in the burden of neurological and mental disorders following dietary transition in China, the USA, and the world: An extension analysis for the Global Burden of Disease Study 2019

Introduction

The highly processed western diet is substituting the low-processed traditional diet in the last decades globally. Increasing research found that a diet with poor quality such as western diet disrupts gut microbiota and increases the susceptibility to various neurological and mental disorders, while a balanced diet regulates gut microbiota and prevents and alleviates the neurological and mental disorders. Yet, there is limited research on the association between the disease burden expanding of neurological and mental disorders with a dietary transition.

Methods

We compared the disability-adjusted life-years (DALYs) trend by age for neurological and mental disorders in China, in the United States of America (USA), and across the world from 1990 to 2019, evaluated the dietary transition in the past 60 years, and analyzed the association between the burden trend of the two disorders with the changes in diet composition and food production.

Results

We identified an age-related upward pattern in disease burden in China. Compared with the USA and the world, the Chinese neurological and mental disorders DALY percent was least in the generation over 75 but rapidly increased in younger generations and surpassed the USA and/or the world in the last decades. The age-related upward pattern in Chinese disease burdens had not only shown in the presence of cardiovascular diseases, neoplasms, and diabetes mellitus but also appeared in the presence of depressive disorders, Parkinson's disease, Alzheimer's disease and other dementias, schizophrenia, headache disorders, anxiety disorders, conduct disorders, autism spectrum disorders, and eating disorders, successively. Additionally, the upward trend was associated with the dramatic dietary transition including a reduction in dietary quality and food production sustainability, during which the younger generation is more affected than the older. Following the increase in total calorie intake, alcohol intake, ratios of animal to vegetal foods, and poultry meat to pulses, the burdens of the above diseases continuously rose. Then, following the rise of the ratios of meat to pulses, eggs to pulses, and pork to pulses, the usage of fertilizers, the farming density of pigs, and the burdens of the above disease except diabetes mellitus were also ever-increasing. Even the usage of pesticides was positively correlated with the burdens of Parkinson's disease, schizophrenia, cardiovascular diseases, and neoplasms. Contrary to China, the corresponding burdens of the USA trended to reduce with the improvements in diet quality and food production sustainability.

Discussion

Our results suggest that improving diet quality and food production sustainability might be a promising way to stop the expanding burdens of neurological and mental disorders.

Ecological and human health risks of antibiotics in marine species through mass transfer from sea to land in a coastal area: A case study in Qinzhou Bay, the South China sea

Antibiotics have been detected in aquatic environment around the world. Understanding internal concentrations of antibiotics in organisms could further improve risk governance. In this study, we investigated the occurrence of seven sulfonamides, four tetracyclines, five fluoroquinolones, and five macrolides antibiotics in six fish, four crustaceans, and five mollusks species collected from Qinzhou Bay, an important part of the Beibu Gulf in the South China Sea in 2018. 19 of all the 21 target antibiotics were detectable in biota. The total concentrations of the antibiotics ranged from 15.2 to 182 ng/g dry weight in all marine organisms, with sulfonamides and macrolides being the most abundant antibiotics. Mollusks accumulated more antibiotics than fish and crustaceans, implying the species-specific bioaccumulation of antibiotics. The pH dependent partition coefficients of antibiotics exhibited significantly positive correlation with their concentrations in organisms. The ecological risk assessment suggested that marine species in Qinzhou Bay were threatened by azithromycin and norfloxacin. The annual mass loading of antibiotics from Qinzhou Bay to the coastal land area for human ingestion via marine fishery catches was 4.02 kg, with mollusks being the predominant migration contributor. The estimated daily intakes of erythromycin indicated that consumption of seafood from Qinzhou Bay posed considerable risks to children (2-5 years old). The results in this study provide important insights for antibiotics pollution assessment and risk management.

Antibiotics in urine from general adults in Shenzhen, China: Demographic-related difference in exposure levels

Misuse or overuse of antibiotics can have a variety of detrimental microbial effects. However, the body burden of antibiotics in the general population is currently unclear. In this cross-sectional study, we determined four classes of widely-applied antibiotics (3 imidazoles, 2 sulfonamides, 5 quinolones, and 2 chloramphenicols) in urine samples from 1170 adult residents in Shenzhen, China. Antibiotics were detected in 30.8 % of all urine samples with concentrations ranging from <LOD to 3517 μg/mL, among which metronidazole, ofloxacin and florfenicol were predominant. Notably, antibiotics prohibited for human or veterinary use were detected in 21.0 % of samples, indicating that these antibiotics may still be overused in daily life. We found that the presence of antibiotics in urine is associated with being overweight (OR: 1.386, 95 % CI: 1.056-1.819, p = 0.019) and obesity (OR: 1.862, 95 % CI: 1.103-3.146, p = 0.020) in the adult population. Multilinear regression analysis showed that a percent increase of hydroxy metronidazole was related to 9.86 % positive change of body mass index (p = 0.029). Interestingly, we also found total antibiotic concentration higher in the unmarried group (p = 0.006). Besides, consumption of smoked foods was correlated with urinary antibiotic levels (p = 0.001), indicating smoked meat may be a potential exposure source of veterinary antibiotics. These results highlight the need to reduce human exposure to banned antibiotics. Future research could focus on assessing the health risk and other outcomes of antibiotic overuse.