Associations of brominated flame retardants exposure with chronic obstructive pulmonary disease: A US population-based cross-sectional analysis

Association of Life's Essential 8 with the prevalence and mortality of chronic obstructive pulmonary disease

Objective

To study the correlation between Life's Essential 8 (LE8) and the occurrence of chronic obstructive pulmonary disease (COPD) among US adults, as well as the association between LE8 and all-cause and cardiovascular disease (CVD) mortality among individuals with COPD.

Methods

Data from National Health and Nutrition Examination Survey (2005-2018 year) were analyzed. The correlation between LE8 scores and the prevalence of COPD was evaluated using logistic regression models. Additionally, the Cox proportional hazards model was applied to investigate how LE8 scores relate to the risk of mortality from all causes and cardiovascular diseases. To ensure the robustness of the findings, sensitivity analyses and subgroup analyses were performed.

Results

In the overall population, an inverse relationship was observed between a 10-point increase in LE8 score and the risk of COPD [OR = 0.78, 95%CI (0.75 ~ 0.82), p < 0.001]. Those diagnosed with COPD experienced a 65% increased rate of all-cause mortality and 5% higher rate of mortality due to cardiovascular diseases compared to the non-COPD group. Within the COPD patient cohort, an inverse relationship was similarly observed between a 10-point increase in the LE8 score and the risk of all-cause mortality [HR = 0.87, 95%CI (0.8 ~ 0.95), p = 0.002]. However, no significant association was found between the LE8 score and CVD mortality [HR = 0.83, 95%CI (0.68 ~ 1.02), p = 0.073]. In further exploration through subgroup analysis, no statistically significant interactions were found, suggesting consistency across different demographic or clinical subgroups.

Conclusion

Higher LE8 adherence is linked to lower COPD prevalence and all-cause mortality, yet no clear link to CVD mortality was found. This highlights the need for more extensive research to clarify LE8's role in CVD outcomes.

Association Between Urinary Glyphosate Concentrations and Chronic Obstructive Pulmonary Disease in USA Participants: Evidence from NHANES 2013-2018

Background

Glyphosate has raised health concerns due to its widespread detection in environment and human tissues. Limited evidence exists found in the association between urinary glyphosate concentrations and chronic obstructive pulmonary disease.

Methods

Analyzing data from 2588 participants, we applied survey-weighted logistic regression models and cubic spline techniques to quantify link between urinary glyphosate concentrations and prevalence of COPD. Further subgroup and sensitivity analyses were also conducted.

Results

Study revealed a significant association between higher urinary glyphosate concentrations that increased risk of COPD. In fully adjusted models, a one-unit increase in natural logarithm of urinary glyphosate was associated with a 35% increased risk of COPD (OR, 1.35, 95% CI, 1.01-1.82, P=0.043). Subgroup analyses showed consistent associations across different demographic groups with a pronounced association in current smokers and females. Sensitivity analyses and exclusion of participants with chronic kidney disease reinforced the robustness of the findings.

Conclusion

Findings provide evidence of a positive association between urinary glyphosate concentrations and prevalence of COPD in a representative sample of the adult population at the United States of America. Further studies are needed to investigate the influence of factors and other environmental pollutants on COPD.

The impact of brominated flame retardants exposure on serum total bilirubin: A cross-sectional analysis

BACKGROUND

Brominated flame retardants (BFRs) are harmful, bioaccumulative, and persistent environmental pollutants, posing significant health risks. Elevated bilirubin levels can cause neurotoxicity and damage to the heart, liver, kidneys, and other organs. This study utilizes National Health and Nutrition Examination Survey (NHANES) data to investigate the association between exposure to BFRs and total bilirubin (TB) levels in adult participants.

METHODS

Based on data from the NHANES 2007-2016, TB levels were divided into tertiles. Spearman's rank correlation was used to analyze the relationship between individual BFRs and TB levels. Weighted linear regression analysis, restricted cubic splines (RCS), and stratified analysis were conducted to assess the correlation between individual BFRs and TB levels. Weighted quantile sum (WQS) regression and quantile-based g-computation (QGC) analysis were used to comprehensively evaluate the impact of BFRs exposure on serum TB levels.

RESULTS

The study included 5831 participants. The results showed that PBB153, PBDE17, PBDE47, PBDE85, PBDE99, PBDE100, PBDE209, and PBDE183 were significantly correlated with TB levels (p <  0.05), with PBDE183 having the highest Spearman rank correlation coefficient of 0.292. After adjusting for confounding factors, most BFR remained significantly positively correlated with TB, while PBDE153 (β: - 0.031, 95%CI: - 0.317, 0.255, p =  0.829) and PBDE66 (β: 0.285, 95%CI: - 0.208, 0.777, p =  0.253) were not statistically significant. RCS analysis indicated that PBDE153 concentration had a significant U-shaped correlation with TB (p <  0.05), while PBDE17, PBDE99, PBDE154, and PBDE209 had an inverted "J"-shaped correlation (p <  0.05). PBB153, PBDE66, PBDE85, and PBDE183 also exhibited significant nonlinear S-shaped correlations with TB (p <  0.05). After stratification by age and gender, most individual BFR remained significantly positively correlated with TB levels (p <  0.05). WQS regression and QGC analysis indicated that mixed BFRs exposure was positively correlated with TB levels (β: 0.553, 95%CI: 0.384, 0.722, p <  0.001 and β: 1.060, 95%CI: 0.587, 1.532, p <  0.001), with PBDE183 contributing the most.

CONCLUSIONS

BFRs exposure is significantly positively correlated with TB levels, further suggesting the potential health impact of BFRs exposure on humans.

Associations between brominated flame retardants, including polybrominated diphenyl ethers, and immune responses among women in the California Teachers Study

Objective

To evaluate the associations between brominated flame retardants (BFRs), including polybrominated diphenyl ethers (PBDEs), exposure and circulating immune markers in a subset of women from the California Teachers Study cohort.

Methods

In this cross-sectional study, serum from 813 female participants in the California Teachers Study collected in 2013-2016 were evaluated for 11 BFR congeners and 16 immune markers. Three BFR congeners [BDE153 [2,2',4,4',5,5'-Hexabromodiphenyl ether], BDE47 [2,2',4,4'-Tetrabromodiphenyl ether], PBB153 [2,2',4,4',5,5'-Hexabromobiphenyl]] had median levels that were above the level of detection and were further evaluated for associations with circulating immune markers. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by a logistic regression model where BFR congeners (in quartiles) were associated with immune markers (dichotomized as above and below the respective median), adjusted for age and total lipids. Sensitivity analyses were also conducted evaluating BFR congeners as a continuous exposure (per pg/ml).

Results

All participants had at least one of the 11 measured BFR congeners detected in their serum. Increasing levels of BDE47 were associated with elevated levels of BAFF (B-cell activating factor; ORQuartile 4 = 1.67, 95% CI = 1.11-2.51), soluble CD27 (sCD27, cluster of differentiation 27; ORQuartile 4 = 1.69, 95% CI = 1.12-2.55) and IL6 (interleukin 6; ORQuartile 4 = 1.74, 95% CI = 1.13-2.66). Increasing levels of PBB153 were associated with elevated levels of CXCL13 (chemokine ligand 13; ORQuartile 4 = 1.55, 95% CI = 1.02-2.35) but inversely associated with sCD27 (ORQuartile 4 = 0.57, 95% CI = 0.38-0.87). Results from continuous models of BFR were largely consistent. No associations were observed between BDE153 and any of the immune markers assessed.

Conclusions

Two BFR congeners were statistically associated with altered levels of circulating immune markers involved in B cell activation pathways; replication and further evaluation of these novel associations are warranted. If confirmed, our results add to the current literature regarding possible immune mechanisms by which BFR exposures contribute to immune-related health endpoints and conditions where B cell activation is prominent, including autoimmune conditions.

Associations between exposure to brominated flame retardants and hyperlipidemia risk in U.S. Adults

BACKGROUND

Environmental exposure to toxic brominated flame retardants (BFRs) has been confirmed to have detrimental effects on human health. The impact of serum BFRs on hyperlipidemia risk has not been sufficiently examined. Our objective is to identify both the individual and combined effects of serum BFRs on hyperlipidemia and to further investigate the most influential chemicals.

METHODS

We included 7,009 individuals with complete details on 9 types of serum BFRs, hyperlipidemia, and other covariates from the NHANES in 2007-2016. Multivariate logistic regression was conducted to evaluate the individual impact of BFRs exposure on hyperlipidemia risk. We assessed the cumulative effect of BFRs on hyperlipidemia risk through weighted quantile sum (WQS) regression, quantile g-computation (QGC), and Bayesian kernel machine regression models.

RESULTS

PBDE 28, PBDE 47, PBDE 85, PBDE 99, PBDE 100, PBDE 154, PBDE 209, and PBB153 were found to be positively associated with hyperlipidemia risk. The results of WQS and QGC revealed consistent positive correlation. PBDE209 emerged as the most significant chemicals exerting influence. The restricted cubic splines regression further identified significant dose-response relationship.

CONCLUSION

Exposure to individual and combined serum BFRs has been associated with an increased risk of hyperlipidemia. The causal relationship still requires confirmation through large-scale cohort studies.

Combined exposure to mixed brominated flame retardants on obstructive sleep apnea syndrome in US adults

BACKGROUND

Accumulating research highlights that exposure to serum brominated flame retardants (BFRs) may elevate health risks. The effects of serum BFRs, both alone and in combination, on obstructive sleep apnea syndrome (OSAS) have not been thoroughly studied. Our main goal was to examine the association between individual and mixtures of serum BFRs and OSAS risk.

METHODS

Data from the National Health and Nutrition Examination Survey (NHANES) were employed, including 1,341 participants. We included participants with full details on OSAS, covariates, and 7 types of serum BFRs (PBDE28, PBDE47, PBDE99, PBDE100, PBDE153, PBB153, and PBDE209). To investigate the OSAS risk with BFRs exposure, multivariate logistic regression, weighted quantile sum (WQS) regression, quantile g-computation (QGC), Bayesian kernel machine regression (BKMR) models, and restricted cubic splines (RCS) were implemented.

RESULTS

Serum BFRs, including PBDE28, PBDE47, PBDE99, PBDE100, and PBB153, showed positive correlations with the OSAS risk. The toxic effect of serum BFRs co-exposure on OSAS risk was consistently demonstrated through the results of WQS regression, QGC and BKMR models. PBB153 was determined to be the most weighted BFRs. Additionally, RCS regression model also verified the strong non-linear relationship that existed between OSAS risk and PBB153.

CONCLUSIONS

Findings of the study prove that BFRs co-exposure exerts a deleterious effect on OSAS risk. Future large-scale prospective investigations and experimental studies are desirable to confirm these findings.

Association between brominated flame retardants and obesity: a mediation analysis through markers of oxidative stress and inflammation

BACKGROUND

Recent studies have provided compelling evidence that exposure to brominated flame retardants (BFRs) can adversely affect human health. We aim to explore the potential impact of BFRs on adiposity and central obesity.

METHODS

Data from the National Health and Nutrition Examination Surveys (NHANES) cycles conducted between 2009 and 2014 was used to study the connections between variables. After filtering, we analyzed a sample of 4,110 adults aged 20 years and above. Our goal was to examine the potential association between BFRs and consequences and investigate the part played by oxidative stress and inflammatory markers as intermediaries. To achieve this, we used advanced statistical methods such as weighted quantile sum (WQS) regression, quantile-based g-computation (QGC), and the Bayesian kernel machine regression (BKMR).

RESULTS

The findings showed that among the examined chemicals, exposure to PBDE85 (weight: 41%), PBDE100 (24%), and PBB153 (23%) may be the dominant contributors to general obesity risk. Upon controlling for all variables that could impact the results, it was found that the QGC outcomes indicated a positive correlation between exposure to mixtures of brominated flame retardants and the occurrence of abdominal obesity (OR = 1.187, 95% CI: 1.056-1.334, p = 0.004). Significant contributions were made by PBDE85 (52%), PBB153 (27%), and PBDE100 (21%). Mediation analysis shows that lymphatic cells (LC) and albumin (ALB) partially mediate the link between brominated flame retardants and obesity. The results of BKMR are generally consistent with those of WQS and QGC.

CONCLUSION

At a population level, our research has revealed a noteworthy correlation between BFRs and obesity. However, further investigation is required through prospective cohort studies and in-depth mechanistic exploratory studies.

The Association Between Dietary Magnesium Intake and Frailty in Patients with Chronic Obstructive Pulmonary Disease: National Health and Nutrition Examination Survey

Background

Patients with chronic obstructive pulmonary disease (COPD) are at high risk of developing frailty and need to be prevented and managed. This study aims to investigate the relationship between dietary magnesium (Mg) intake and the risk of frailty in patients with COPD.

Methods

We conducted a cross-sectional study from the National Health and Nutrition Examination Survey (NHANES) in the United States, focusing on patients with COPD. We used logistic regression to determine the adjusted odds ratios (OR) and 95% confidence interval (CI). Curve fitting, subgroup analysis, and sensitivity analysis were performed to further assess the relationship between dietary Mg intake and frailty in patients with COPD.

Results

There were 1696 participants in this study, and the mean age was 60.4 ± 0.4 years. Weighted logistic regression and curve fitting showed a linear relationship between dietary Mg intake and frailty in patients with COPD. The risk of frailty decreased by 15% for each 100-unit increase in Mg intake (OR: 0.85, 95% CI: 0.76-0.96). Participants in the highest quartile Q4 of Mg intake had a lower risk of frailty than those in the lowest quartile Q1 (OR: 0.48, 95% CI: 0.32-0.72).

Conclusion

There is a linear relationship between dietary Mg intake and frailty in patients with COPD. Increasing dietary Mg intake is associated with a decreased risk of frailty in COPD.

The potential protective effects of probiotics, prebiotics, or yogurt on chronic obstructive pulmonary disease: Results from NHANES 2007-2012

Chronic obstructive pulmonary disease (COPD) ranks among the world's three leading causes of mortality, owing to the increased smokers and aging populations. Previous studies showed that gut microbiota could help to ameliorate respiratory diseases. Hence, the current study aims to evaluate the effects of probiotics, prebiotics, or yogurt on the prevalence of COPD. A cross-sectional study was carried out by investigating data from three consecutive NHANES cycles during 2007-2012. Individuals who met the inclusion and exclusion criteria were studied. Prescription medications and dietary were reviewed to identify the intake of probiotics, prebiotics, or yogurt. The included participants were then divided into two groups depending on their consumption of probiotics, prebiotics, or yogurt. Multivariate logistic regression analysis was conducted to analyze the effects of probiotics, prebiotics, or yogurt consumption on the prevalence of COPD. Out of 7486 enrolled participants, 1656 (22.12%) were categorized into the probiotics, prebiotics, or yogurt intake group. This study indicated that consuming probiotics, prebiotics, or yogurt were correlated with a lower incidence of COPD, even when factors like gender, age, education, moderate-intensity activities, vigorous activities, hypertension, asthma, diabetes, smoking and alcohol consumption were accounted for (Model 1: OR, 0.68, 95% CI, 0.53-0.87; Model 2: OR, 0.77, 95% CI, 0.59-0.99; Model 3: OR, 0.75, 95% CI, 0.57-0.98). The findings reveal that consuming probiotics, prebiotics, or yogurt might play a beneficial role in preventing COPD.

Association between brominated flame retardants (BFRs) and periodontitis: Results from a large population-based study

BACKGROUND

Brominated flame retardants (BFRs) are widely utilized to mitigate the flammability of various materials. Previous studies have revealed the impact of BFRs exposure on hormonal disruption and bone metabolism which are closely related to periodontitis. However, it remains unknown the potential relationship between BFRs and periodontitis. This study aimed to explore the association between BFRs exposure and periodontitis in US adults.

METHODS

The data analyzed in this study were obtained from the National Health and Nutrition Examination Survey (NHANES) 2009-2014. Twelve serum BFRs were quantified using isotope dilution gas chromatography high-resolution mass spectrometry. Univariable and multivariable logistic regression was employed to evaluate the association between serum BFRs and periodontitis. Bayesian kernel machine regression (BKMR) analyses were utilized to assess the association between mixtures of BFRs and periodontitis.

RESULTS

A total of 3311 eligible participants were included. Serum BFRs (PBDE-47, PBDE-99, and PBDE-154) were significantly associated with periodontitis, and the odds ratios (ORs) and corresponding 95% confidence intervals(CIs) were 1.15(1.01,1.29), 1.10(1.01,1.20), and 1.12(1.01,1.25), respectively. Notably, these three BFRs were also significantly associated with the severity of periodontitis. Additionally, the BKMR model revealed a significant association between the mixture of all twelve BFRs and periodontitis.

CONCLUSIONS

This preliminary study suggests a significant association between specific serum BFRs (PBDE-47, PBDE-99, and PBDE-154) and periodontitis and its severity. Further prospective and experimental studies are warranted to validate our findings.

The impact of brominated flame retardants (BFRs) on pulmonary function in US adults: a cross-sectional study based on NHANES (2007-2012)

Brominated flame retardants (BFRs) are a group of chemicals widely used in various applications to prevent or slow down the spread of fire. However, they have adverse effects on human health. There is a relative scarcity of population-based studies regarding BFRs, particularly their impact on the respiratory system. This study aimed to investigate the influence of BFRs on pulmonary function using data from the National Health and Nutrition Examination Survey. The study found that elevated serum concentrations of certain BFRs were associated with pulmonary ventilatory dysfunction. Adjusted analyses revealed positive correlations between PBDE47, PBDE183, and PBDE209 concentrations and ventilatory dysfunction. The analysis of mixed BFRs showed a positive relationship with pulmonary ventilation dysfunction, with PBDE47 making the most significant contribution. Our study demonstrates that both individual and combined BFRs exposure can lead to impaired pulmonary ventilation function. These findings provide evidence of the adverse effects of BFRs on lung function, emphasizing the importance of further investigating the potential health consequences of these compounds. Further large-scale longitudinal studies are needed to investigate this relationship in the future.