Association between Endocrine-Disrupting Chemical Mixture and Metabolic Indices Among Children, Adolescents, And Adults: A Population-Based Study in Korea

Abstract

Exposure to endocrine-disrupting chemicals (EDCs) play a role in the etiology of obesity and dyslipidemia. However, few studies have analyzed the combined effects of EDC mixtures. This study explored the association between concurrent exposure to EDCs and obesity or dyslipidemia in children, adolescents, and adults. A total of 1,454 children, 891 adolescents, and 3,765 adults from the Korean National Environmental Health Survey 2015 to 2017 were included in this cross-sectional study. Urinary concentrations of eight phthalate metabolites, three phenols, three parabens, and one pyrethroid pesticides metabolite were quantified. Body mass index (BMI) was measured for all participants, and triglyceride (TG) and high-density lipoprotein cholesterol (HDL-c) levels were measured for adolescents and adults. Associations between combined EDC mixtures with the BMI and TG to HDL-c ratio were evaluated using Bayesian Kernel Machine Regression (BKMR). In all age groups, most of the chemical exposures, with the exception of BPF and BPS, were detected in more than 90% of participants. There were significant moderate to high correlations within phthalate metabolites and a high correlation within parabens. The BKMR showed that EDC mixtures were associated with higher BMI in both adolescents and adults, with greater significance in adults compared with adolescents, and a higher TG/HDL in male adolescents. The findings of this study suggest that exposure to EDC mixtures is associated with higher BMI and TG/HDL, and adolescence may be a critical period for EDC mixture in terms of both outcomes. Further studies are needed, but strategies to reduce EDC exposure from early life stages may be necessary to lower the risk of metabolic disease.

Note:

Funding Information: This research was supported by the Chung-Ang University Research Grants in 2021.

Declaration of Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Ethical Approval Statement: We used publicly available data from 2015 to 2017 in the Korean National Environmental Health Survey (KoNEHS), which collects data through questionnaires, physical examinations, and biospecimen sampling and is approved by the Institutional Review Board of the National Institute of Environmental Research (NIER), Korea (approval no. NIER-2016-Br-003-01); all participants provided written informed consent to participate in the study.

Keywords: Endocrine disrupting chemicals, Body mass index, triglycerides, high-density lipoprotein cholesterol, mixture analysis, Bayesian kernel machine regression