Exploring the association between exposure to pesticides, polycyclic aromatic hydrocarbons, and phthalates and metabolic syndrome in National Health and Nutrition Examination Survey in the USA, 2007-2012: utilizing a multi-step statistical strategy.

Abstract

Background: Pesticides, polycyclic aromatic hydrocarbons (PAHs), and phthalates are recognized as potential contributors to metabolic disorders. Nevertheless, the combined effect of simultaneous exposure to these chemicals on the metabolic syndrome (MetS) remains elusive.

Objectives: To explore the impacts of simultaneous exposure to pesticides, PAHs and phthalates and identify critical chemicals on MetS.

Methods: Based on the National Health and Nutrition Examination Survey (NHANES) database from 2007-2012, our study included 4030 non-pregnant individuals aged 20 years or older. We used the weighted linear regression model, variable selection models (including LASSO regression and BMA models), as well as a mixture exposure model (WQS model) to investigate the correlation between chemicals and MetS. Additionally, stratified analyses were performed based on gender and age.

Results: The weighted generalized linear regression model revealed a positive correlation of 2-hydroxyphenanthrene (2-PHEN) with MetS (OR: 1.37, 95% CI: 1.19-1.59, P < 0.001). Both the LASSO regression and BMA models identified 2-PHEN as a significant chemical positively associated with MetS. Additionally, the WQS model showed a positive association between overall exposure to the three chemical categories and MetS, with the highest weighted chemicals being 2-PHEN. Stratified analyses demonstrated a significant correlation between 2-PHEN and MetS between different subgroups. Notably, the WQS regression model revealed a significant association in the subgroup of female (OR = 1.40, 95% CI: 1.08-1.83, P < 0.05), with 2-PHEN, 2,5-dichlorophenol (2,5-DCP), 2-hydroxynaphthalene (2-NAP), and mono-ethyl phthalate (MEP) identified as the primary contributions to MetS.

Conclusion: Combined exposure to the three chemical groups was associated with an increased risk of MetS, with the PAHs group exhibiting the most pronounced effect and 2-PHEN emerging as a key chemical, underscoring significant public health concerns regarding the potential health risks of endocrine-disrupting chemicals (EDCs) exposure to metabolic diseases.