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[背景]邻苯二甲酸酯具有抗雄激素作用,可能会破坏脂质和碳水化合物的代谢。已有记录表明,种族(族裔)亚群的尿邻苯二甲酸酯浓度和儿童肥胖患病率有关联。[目的]在一个美国儿童和青少年的全国代表性样本中,检验尿邻苯二甲酸酯代谢物和体质结局之间的关联。[方法]采用分层和全样本横断面分析,研究2003—2008年美国健康和营养检查调查中6～19岁的2884名儿童。用多变量线性和logistic回归对体质指数(BMI)z得分、超重和肥胖相对低分子量(LMW)、高分子量(HMW)和邻苯二甲酸二-2-乙基己酯(DEHP)代谢物的摩尔浓度进行分析,控制性别、看电视、看护者教育程度、热量摄入、贫困收入比、种族(族裔)、血清可铁宁和年龄组。在消除样本加权、根据分子量标化邻苯二甲酸酯浓度、以及检验不同膳食摄入量协变量后,采用敏感性分析检验结果的稳健性。[结果]在分层多变量模型中,非西班牙裔黑人LMW代谢物每增加一个对数单位(约3倍)与超重和肥胖的风险分别增加21%和22%(95%CI:1.05～1.39和1.07～1.39)有关联,并与BMI z分值增加0.090-SD单位(95%CI:0.003～0.18)有关联。在控制潜在的混杂因素后,在任何其他种族(族裔)亚组或整体研究样本中,没有发现显著性的关联,与HMW或DEHP代谢物的关联不显著,在敏感性分析中结果没有发生显著改变。[结论]研究确定了一个全国代表性样本中特定种族(族裔)的邻苯二甲酸酯与儿童肥胖的关联。需要进一步研究证实该关联,并评估遗传/表观倾向和/或邻苯二甲酸酯暴露增加作为解释种族(族裔)亚群之间差异的可能性。
[Background] Phthalates have anti-androgenic effects that may disrupt lipid and carbohydrate metabolism. It has been documented that the urinary phthalate concentration in racial (ethnic) subgroups is associated with the prevalence of childhood obesity. [Purpose] To examine the association between urinary phthalate metabolites and physical outcome in a nationally representative sample of U.S. children and adolescents. [Method] By stratified and full sample cross-sectional analysis, 2884 children aged 6 to 19 years in the US Health and Nutrition Examination Survey 2003-2008 were studied. Body mass index (BMI) z scores, overweight and obesity LMW, HMW and DEHP metabolites were determined using multivariate linear and logistic regression Mole concentrations were analyzed to control gender, watch TV, caregiver education, calorie intake, poverty-to-income ratio, race (ethnicity), serum cotinine and age groups. Sensitivity analysis was used to test the robustness of the results after eliminating sample weights, scaling phthalate concentrations based on molecular weight, and examining covariates of different dietary intakes. [Results] The risk of overweight and obesity increased by 21% and 22% (95% CI: 1.05-1.39) for each additional log LMU metabolite (approximately 3-fold) in non-Hispanic black LMES metabolites in the stratified multivariate model And 1.07-1.39), and was associated with an increase of 0.090-SD BMI z score (95% CI: 0.003-0.18). After controlling for potential confounders, no significant association was found in any other racial (ethnic) subgroup or overall study sample, with no significant association with HMW or DEHP metabolites, and no results in sensitivity analyzes Significantly changed. [Conclusions] The study identified the association of specific ethnic (ethnic) phthalates with childhood obesity in a nationally representative sample. Further research is needed to confirm the association and to assess the genetic / predisposition and / or increased phthalate exposure as a possibility to explain differences between ethnic (ethnic) subgroups.