The Association of Urinary Phthalate Concentrations with Asthma-Related Outcomes among Adults: NHANES 2003-2012 公开

He, Jiabei (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/h989r4209?locale=zh
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Abstract

Background: Phthalates are a family of synthetic chemicals used in a wide spectrum of plastic products, such as personal care products, building materials, food packages, medical devices and pharmaceuticals. Phthalates are classified into low and high molecular weight compounds. Previous studies indicate that phthalates are related to allergic and inflammatory processes in humans. Asthma is a common pulmonary disease characterized by airway hypersensitivity. We conducted this analysis to evaluate the relationship between urinary phthalate metabolite concentrations and asthma-related outcomes.
Methods: Five 2-year cycles of the National Health and Nutrition Examination Survey (NHANES 2003-2012) were merged for our analysis dataset. A total of 7,298 adult participants with available urinary phthalates metabolites, asthma, and covariate data were included. After stratification and confounder adjustment, logistic regression was performed that incorporated sample weights to account for the complex, multistage probability sampling design used to select participants that represent the non-institutionalized US population.
Results: Mono-n-methyl phthalate (MNM) was positively associated (OR: 1.25, CI: 1.04-1.50) with ever asthma among all adults. Among adult females, MCNP, MCOP and MCPP were positively associated with ever asthma (ORs=1.26-1.34). Among females reporting ever asthma, MiBP was positively associated with past asthma (OR: 1.83, CI: 1.10-3.04). Among black females, MCPP and MEHP were associated with ever asthma (ORs: 1.44, CI: 1.02-2.05 and OR: 1.55, CI 1.08-2.21, respectively). Among white females reporting a history of asthma, MiBP was positively associated with past asthma (OR: 2.29, CI: 1.11-4.71).
Conclusion: In this cross-sectional sample of US adults we did not observe a consistent pattern of association with asthma-related outcomes across the phthalate metabolites measured, however, the associations we did observe were positive. Given the cross-sectional design of the survey, we cannot infer causality and because of the variable associations observed, the observations may be a result of chance alone.

Table of Contents

Tables of Contents…………………………………………………………………………………1
Background……………………………………………………………………………………..…...2
Phthalates………………………………………………………………………………......………2
Asthma……………………………………………………………………………………........……4
Hypothesis……………………………………………………………………………….....……...6
Methods…………………………………………………………………………………....………….6
Data Source and Study Population…………………………………………...………….6
Measurement of Exposures and Outcomes……….…………………………………..7
Covariates……………………………………….…………………………………………….......8
Statistical Analysis……………………………………………………………………...……….8
Results………………………………………………………………………………………...……...9
Descriptive statistics…………………………………………………………………..……….9
Logistic regression……………………………………………………………………....……..10
Discussion…………………………………………………………………………………...……...11
References……...………………………………………………………………………..…………14
Appendix…………………………………………………………………………………….....…….19

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