Associations between phthalate metabolites and two novel systemic inflammatory indexes: a cross-sectional analysis of NHANES data

Background The potentially risky effects of metabolites of phthalates (mPAEs) on inflammation and immune function have attracted much attention in recent years. However, direct studies on the relationship between these metabolites and the systemic immune inflammatory index (SII) and systemic inflamm...

Full description

Saved in:
Bibliographic Details
Main Authors: Fangyu Cheng, Yueyuan Li, Kai Deng, Xinyu Zhang, Wenxue Sun, Xin Yang, Xiaofang Zhang, Chunping Wang
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Annals of Medicine
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/07853890.2025.2496411
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850179615988908032
author Fangyu Cheng
Yueyuan Li
Kai Deng
Xinyu Zhang
Wenxue Sun
Xin Yang
Xiaofang Zhang
Chunping Wang
author_facet Fangyu Cheng
Yueyuan Li
Kai Deng
Xinyu Zhang
Wenxue Sun
Xin Yang
Xiaofang Zhang
Chunping Wang
author_sort Fangyu Cheng
collection DOAJ
description Background The potentially risky effects of metabolites of phthalates (mPAEs) on inflammation and immune function have attracted much attention in recent years. However, direct studies on the relationship between these metabolites and the systemic immune inflammatory index (SII) and systemic inflammatory response index (SIRI) are limited.Methods This cross-sectional study used generalized linear regression models (GLM), restricted cubic splines (RCS), weighted quantile sum (WQS), and Bayesian kernel-machine regression (BKMR) to analyze data from 2,763 U.S. adults aged between 20 and 80 years, obtained from the U.S. National Health and Nutrition Examination Survey (NHANES) conducted between 2013 and 2018. The study aimed to investigate the relationship between urine samples of nine mPAEs and levels of SII/SIRI in a single, nonlinear, and mixed relationship and explored the robustness of the findings under single and mixed effects using two sensitivity analyses for completeness. In addition, the effects of six variables (age, sex, BMI, the percentage of total daily energy intake from ultra-processed foods (UPFs), total vegetable intake, and dietary supplements) on the association results were explored through subgroup analyses to identify potentially important confounders.Results In single exposure analyses, mono-n-butyl phthalate (MnBP), mono-ethyl phthalate (MEP), and monobenzyl phthalate (MBzP) were positively associated with SII/SIRI. The findings from the two mixed exposure models demonstrated a positive association between the collective concentrations of mPAEs and levels of SII/SIRI, with MBzP being identified as a significant contributor to the urinary levels of mPAEs. The subgroup analysis results of the effects of single and mixed exposures show that the association between mPAEs and SII/SIRI is more significant in females, overweight/obese populations, young/middle-aged populations, and populations with high levels of intake of UPFs.Conclusion Positive associations were identified between mPAEs and SII/SIRI. MBzP was determined to have the most significant impact. The association between mPAEs and SII/SIRI is significantly influenced by female groups, young and middle-aged populations, overweight and obese individuals, as well as those with a higher intake of UPFs.
format Article
id doaj-art-4c95e826cbb540eda00c8e606d14499e
institution OA Journals
issn 0785-3890
1365-2060
language English
publishDate 2025-12-01
publisher Taylor & Francis Group
record_format Article
series Annals of Medicine
spelling doaj-art-4c95e826cbb540eda00c8e606d14499e2025-08-20T02:18:27ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2496411Associations between phthalate metabolites and two novel systemic inflammatory indexes: a cross-sectional analysis of NHANES dataFangyu Cheng0Yueyuan Li1Kai Deng2Xinyu Zhang3Wenxue Sun4Xin Yang5Xiaofang Zhang6Chunping Wang7School of Public Health, Shandong Second Medical University, Weifang, Shandong, ChinaSchool of Public Health, Shandong Second Medical University, Weifang, Shandong, ChinaSchool of Public Health, Shandong Second Medical University, Weifang, Shandong, ChinaSchool of Public Health, Shandong Second Medical University, Weifang, Shandong, ChinaSchool of Public Health, Shandong Second Medical University, Weifang, Shandong, ChinaSchool of Public Health, Shandong Second Medical University, Weifang, Shandong, ChinaSchool of Public Health, Shandong Second Medical University, Weifang, Shandong, ChinaSchool of Public Health, Shandong Second Medical University, Weifang, Shandong, ChinaBackground The potentially risky effects of metabolites of phthalates (mPAEs) on inflammation and immune function have attracted much attention in recent years. However, direct studies on the relationship between these metabolites and the systemic immune inflammatory index (SII) and systemic inflammatory response index (SIRI) are limited.Methods This cross-sectional study used generalized linear regression models (GLM), restricted cubic splines (RCS), weighted quantile sum (WQS), and Bayesian kernel-machine regression (BKMR) to analyze data from 2,763 U.S. adults aged between 20 and 80 years, obtained from the U.S. National Health and Nutrition Examination Survey (NHANES) conducted between 2013 and 2018. The study aimed to investigate the relationship between urine samples of nine mPAEs and levels of SII/SIRI in a single, nonlinear, and mixed relationship and explored the robustness of the findings under single and mixed effects using two sensitivity analyses for completeness. In addition, the effects of six variables (age, sex, BMI, the percentage of total daily energy intake from ultra-processed foods (UPFs), total vegetable intake, and dietary supplements) on the association results were explored through subgroup analyses to identify potentially important confounders.Results In single exposure analyses, mono-n-butyl phthalate (MnBP), mono-ethyl phthalate (MEP), and monobenzyl phthalate (MBzP) were positively associated with SII/SIRI. The findings from the two mixed exposure models demonstrated a positive association between the collective concentrations of mPAEs and levels of SII/SIRI, with MBzP being identified as a significant contributor to the urinary levels of mPAEs. The subgroup analysis results of the effects of single and mixed exposures show that the association between mPAEs and SII/SIRI is more significant in females, overweight/obese populations, young/middle-aged populations, and populations with high levels of intake of UPFs.Conclusion Positive associations were identified between mPAEs and SII/SIRI. MBzP was determined to have the most significant impact. The association between mPAEs and SII/SIRI is significantly influenced by female groups, young and middle-aged populations, overweight and obese individuals, as well as those with a higher intake of UPFs.https://www.tandfonline.com/doi/10.1080/07853890.2025.2496411Phthalate metabolitessystemic inflammatory indexesmixed exposureNHANESsubgroup analysisdietary intake
spellingShingle Fangyu Cheng
Yueyuan Li
Kai Deng
Xinyu Zhang
Wenxue Sun
Xin Yang
Xiaofang Zhang
Chunping Wang
Associations between phthalate metabolites and two novel systemic inflammatory indexes: a cross-sectional analysis of NHANES data
Annals of Medicine
Phthalate metabolites
systemic inflammatory indexes
mixed exposure
NHANES
subgroup analysis
dietary intake
title Associations between phthalate metabolites and two novel systemic inflammatory indexes: a cross-sectional analysis of NHANES data
title_full Associations between phthalate metabolites and two novel systemic inflammatory indexes: a cross-sectional analysis of NHANES data
title_fullStr Associations between phthalate metabolites and two novel systemic inflammatory indexes: a cross-sectional analysis of NHANES data
title_full_unstemmed Associations between phthalate metabolites and two novel systemic inflammatory indexes: a cross-sectional analysis of NHANES data
title_short Associations between phthalate metabolites and two novel systemic inflammatory indexes: a cross-sectional analysis of NHANES data
title_sort associations between phthalate metabolites and two novel systemic inflammatory indexes a cross sectional analysis of nhanes data
topic Phthalate metabolites
systemic inflammatory indexes
mixed exposure
NHANES
subgroup analysis
dietary intake
url https://www.tandfonline.com/doi/10.1080/07853890.2025.2496411
work_keys_str_mv AT fangyucheng associationsbetweenphthalatemetabolitesandtwonovelsystemicinflammatoryindexesacrosssectionalanalysisofnhanesdata
AT yueyuanli associationsbetweenphthalatemetabolitesandtwonovelsystemicinflammatoryindexesacrosssectionalanalysisofnhanesdata
AT kaideng associationsbetweenphthalatemetabolitesandtwonovelsystemicinflammatoryindexesacrosssectionalanalysisofnhanesdata
AT xinyuzhang associationsbetweenphthalatemetabolitesandtwonovelsystemicinflammatoryindexesacrosssectionalanalysisofnhanesdata
AT wenxuesun associationsbetweenphthalatemetabolitesandtwonovelsystemicinflammatoryindexesacrosssectionalanalysisofnhanesdata
AT xinyang associationsbetweenphthalatemetabolitesandtwonovelsystemicinflammatoryindexesacrosssectionalanalysisofnhanesdata
AT xiaofangzhang associationsbetweenphthalatemetabolitesandtwonovelsystemicinflammatoryindexesacrosssectionalanalysisofnhanesdata
AT chunpingwang associationsbetweenphthalatemetabolitesandtwonovelsystemicinflammatoryindexesacrosssectionalanalysisofnhanesdata