PMID- 34489871
OWN - NLM
STAT- MEDLINE
DCOM- 20220211
LR  - 20220211
IS  - 1664-2392 (Print)
IS  - 1664-2392 (Electronic)
IS  - 1664-2392 (Linking)
VI  - 12
DP  - 2021
TI  - Combined Exposure to Multiple Endocrine Disruptors and Uterine Leiomyomata and 
      Endometriosis in US Women.
PG  - 726876
LID - 10.3389/fendo.2021.726876 [doi]
LID - 726876
AB  - BACKGROUND: Uterine leiomyomata (UL) and endometriosis (EM) are common 
      gynecological diseases damaging the reproductive health of fertile women. Among 
      all the potential factors, environmental endocrine-disrupting chemicals are 
      insufficiently addressed considering the multiple pollutants and mixture 
      exposure. METHODS: Women aged 20 to 54 years old in the National Health and 
      Nutrition Examination Survey (NHANES) 2001-2006, having a complete measurement of 
      ten commonly exposed endocrine-disrupting chemicals (including urinary phthalate 
      metabolites, equol, and whole blood heavy metals) and answered questions about UL 
      and EM were included (N=1204). Multivariable logistic regression model, weighted 
      quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) 
      models were implemented to analyze the combined effect of chemicals on the 
      overall association with UL and EM. RESULTS: In single chemical analysis, equol 
      (OR: 1.90, 95% CI: 1.11, 3.27) and mercury (Hg) (OR: 1.91, 95% CI: 1.14, 3.25) 
      were found positively associated with UL in tertile 3 vs. tertile 1. In WQS 
      regression and BKMR models, the significant positive association between WQS 
      index and UL (OR: 2.54, 95% CI: 1.52, 4.29) was identified and the positive 
      relationship between equol and Hg exposure and UL were further verified. Besides, 
      the mixture evaluation models (WQS and BKMR) also found MEHP negatively 
      associated with UL. Although none of the single chemicals in tertile 3 were 
      significantly associated with EM, the WQS index had a marginally positive 
      association with EM (OR: 2.01, 95% CI: 0.98, 4.15), and a significant positive 
      association was identified in subanalysis with participants restricted to 
      premenopausal women (OR: 2.18, 95% CI: 1.03, 4.70). MIBP and MBzP weighted high 
      in model of EM and MEHP weighted the lowest. CONCLUSION: Comparing results from 
      these three statistical models, the associations between equol, Hg, and MEHP 
      exposure with UL as well as the associations of MIBP, MBzP, and MEHP exposure 
      with EM warrant further research.
CI  - Copyright (c) 2021 Zhang, Lu, Ma, Xu and Wu.
FAU - Zhang, Yuqing
AU  - Zhang Y
AD  - Department of Women Health Care, Women's Hospital of Nanjing Medical University, 
      Nanjing Maternity and Child Health Care Hospital, Nanjing, China.
FAU - Lu, Yingying
AU  - Lu Y
AD  - Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical 
      University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.
FAU - Ma, Huiyuan
AU  - Ma H
AD  - Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical 
      University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.
FAU - Xu, Qing
AU  - Xu Q
AD  - Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical 
      University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.
FAU - Wu, Xiaoli
AU  - Wu X
AD  - Department of Women Health Care, Women's Hospital of Nanjing Medical University, 
      Nanjing Maternity and Child Health Care Hospital, Nanjing, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210820
PL  - Switzerland
TA  - Front Endocrinol (Lausanne)
JT  - Frontiers in endocrinology
JID - 101555782
RN  - 0 (Endocrine Disruptors)
SB  - IM
MH  - Adult
MH  - Bayes Theorem
MH  - Cross-Sectional Studies
MH  - Endocrine Disruptors/*adverse effects
MH  - Endometriosis/chemically induced/epidemiology/*pathology
MH  - Environmental Exposure/*adverse effects
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Leiomyoma/chemically induced/epidemiology/*pathology
MH  - Middle Aged
MH  - *Models, Statistical
MH  - Nutrition Surveys/*statistics & numerical data
MH  - Prognosis
MH  - United States/epidemiology
MH  - Uterine Neoplasms/chemically induced/epidemiology/*pathology
MH  - Young Adult
PMC - PMC8418539
OTO - NOTNLM
OT  - Bayesian kernel machine regression (BKMR)
OT  - endometriosis
OT  - mixed exposure
OT  - uterine leiomyomata
OT  - weighted quantile sum (WQS) regression
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/09/08 06:00
MHDA- 2022/02/12 06:00
PMCR- 2021/01/01
CRDT- 2021/09/07 07:43
PHST- 2021/06/17 00:00 [received]
PHST- 2021/08/02 00:00 [accepted]
PHST- 2021/09/07 07:43 [entrez]
PHST- 2021/09/08 06:00 [pubmed]
PHST- 2022/02/12 06:00 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - 10.3389/fendo.2021.726876 [doi]
PST - epublish
SO  - Front Endocrinol (Lausanne). 2021 Aug 20;12:726876. doi: 
      10.3389/fendo.2021.726876. eCollection 2021.