The association between ethylene oxide exposure and asthma risk: a population-based study

Li, Ziye; Shi, Pingfan; Chen, Zhibo; Zhang, Wenjia; Lin, Shumeng; Zheng, Tiansheng; Li, Ming; Fan, Lihong

doi:10.1007/s11356-022-23782-3

Cited by 20 publications

(12 citation statements)

References 30 publications

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“…Exposure to EO may lead to a range of adverse health effects, including angina, heart attack, total cardiovascular disease, dyslipidemia, and its genotoxicity and mutagenic abilities have been widely reported in several experimental studies ( 21 , 22 , 24 , 27 , 49 , 50 ). The research of Zhu, Huang and Cheang suggests that the relationship between EO and lipid abnormalities, chronic obstructive pulmonary disease, and asthma is mediated by the inflammatory response caused by EO ( 22 , 27 , 28 ). Studies have found that exposure to EO can cause inflammation in rodent organs and promote the occurrence of pulmonary fibrosis in rodents ( 51 , 52 ).…”

Section: Discussionmentioning

confidence: 99%

“…National Health and Nutrition Examination Survey (NHANES) is an ongoing, nationally representative series of surveys conducted every two years to monitor the health and nutritional status of non-institutionalized citizens in the United States ( 26 ). The study cohort was confined to the survey period from 2013 to March 2020, as EO measurements were unavailable before this timeframe ( 27 , 28 ). In NHANES 2013-2020, a total of 33657 participants completed both interviews and medical examinations.…”

Section: Methodsmentioning

confidence: 99%

“…To better ascertain the relationship between HbEO levels and MetS, we categorized HbEO levels into four groups using quartiles (Q1<22.62, Q2: 22.62-33.515, Q3: 33.515-148, Q4 >148 pmol/g Hb) ( 28 , 38 , 39 ). Statistical analyses were conducted following the guidelines of NHANES, considering the complex sampling design of the survey to address the bias associated with sample selection, oversampling, and nonresponse ( 22 ).…”

Section: Methodsmentioning

confidence: 99%

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Positive association between blood ethylene oxide levels and metabolic syndrome: NHANES 2013-2020

Zhou,

Wang,

et al. 2024

Front. Endocrinol.

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PurposeThe exposure of Ethylene oxide (EO) is linked to systemic inflammatory response and various cardiovascular risk factors. Hemoglobin’s binding to ethylene oxide (HbEO) was used to measure serum EO level. This research aims to explore the association between metabolic syndrome (MetS) and HbEO, and between HbEO and components of metabolic syndrome.MethodThis research included 1842 participants from 2013 to 2020 in National Health and Nutrition Examination Survey (NHANES) database. Weighted logistic regression models were used to analyze the relationship between HbEO and metabolic syndrome risk, using odds ratio (OR) and 95% confidence interval (CI). The restricted cubic spline plot explores whether there is a dose-response relationship between HbEO and MetS risk. Subgroup analysis was performed to analyze study heterogeneity.ResultsSignificant differences were found in gender, educational level, marital status, diabetes status and hypertension among different groups (P < 0.001, P = 0.007, P = 0.003, P < 0.001, P < 0.001, respectively). The serum HbEO level exhibited positive correlation with metabolic syndrome risk in Q2 level (OR=1.64, 1.04~2.48), Q3 level (OR=1.99, 1.29~3.08), and Q4 level (OR=2.89, 1.92~4.34). The dose-response association suggested a possible linear association between serum HbEO and metabolic syndrome risk (P-overall=0.0359, P-non-linear=0.179). L-shaped association was found between HbEO and the risk of MetS in female population, obese population and mid-age and elder population (P-overall<0.001, P-non-linear=0.0024; P-overall=0.0107, P-non-linear=0.0055 P-overall<0.001 P-non-linear=0.0157).ConclusionThis study indicates a linear correlation between MetS and HbEO, with MetS risk escalating as HbEO levels increase. The prevalence of MetS varies depending on BMI, age and gender, and these factors can also influence MetS prevalence when exposed to EO.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Positive association between blood ethylene oxide levels and metabolic syndrome: NHANES 2013-2020

Zhou,

Wang,

et al. 2024

Front. Endocrinol.

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“…By using a self-administered questionnaire, NHANES collected information on asthma and associated symptoms (21). Patients who answered affirmatively to the following two questions were defined as having current asthma: "Has a doctor or other health professional ever told you that you have asthma?"…”

Section: Assessment Of Asthmamentioning

confidence: 99%

Associations of complete blood cell count-derived inflammatory biomarkers with asthma and mortality in adults: a population-based study

Qiu

Fan

et al. 2023

Front. Immunol.

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ObjectiveThis study aims to assess the associations of complete blood cell count (CBC)-derived inflammatory biomarkers with the prevalence of asthma and mortality.MethodsData was collected from the 1999-2018 National Health and Nutrition Examination Survey (NHANES). Mortality was identified using the National Death Index until December 31, 2019. The study analyzed the relationship between CBC-derived inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic inflammatory response index (SIRI), and systemic immune-inflammation index (SII), and the prevalence of asthma using multiple logistic regressions. To assess the significance of CBC-derived inflammatory biomarkers in predicting all-cause and respiratory disease mortality in asthma patients, Cox proportional regressions and the random survival forest (RSF) analysis were utilized.ResultsA total of 48,305 participants were included, with a mean age of 47.27 ± 0.18 years and 49.44% male. Among them, 6,403 participants had asthma, with a prevalence of 13.28%. The all-cause and respiratory disease deaths at a median follow-up of 8.2 (4.5, 12.8) years were 929 and 137 respectively. After adjusting for confounders, the prevalence of asthma was found to be positively associated with NLR, PLR, MLR, SIRI and SII. Compared to the lowest quartile, the highest quartile of NLR (HR=1.765 [1.378-2.262]), MLR (HR=1.717 [1.316-2.241]), SIRI (HR=1.796 [1.353-2.383]) and SII (HR=1.432 [1.141-1.797]) were associated with an increased risk of all-cause mortality. These associations were more pronounced in respiratory disease mortality of asthma patients. RSF analysis showed that MLR had the highest predictive value for all-cause and respiratory disease mortality in adults with asthma. The sensitivity analysis demonstrated the stability of our results.ConclusionThe findings suggest that CBC-derived inflammatory biomarkers are associated with a higher risk of all-cause and respiratory disease mortality in adults with asthma.

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“…The underlying mechanisms were required to be identify in the future study.Hemoglobin adducts of EO (HbEO) produced by the reaction between EO and hemoglobin (Hb) is a sensitive and effective hematological marker to assess EO exposure [10,11].Current evidence which suggested, as a potential exogenous toxicant, EO can pose deteriorated effects in human health is not extensive. Although some epidemiological studies reported that exposure to EO was associated with increased risk of asthma, serum lipid, hypertension, diabetes, and cardiovascular diseases (CVD) [12][13][14][15][16], one recent cross-sectional study have found an inverse association of blood EO levels with obesity in adults [17]. Considering that obesity and hypertension, diabetes, and CVD are all important risk factors in contributing to the development of NAFLD, it is required to further evaluate the uncertain association between EO and NAFLD.…”

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confidence: 99%

Association of ethylene oxide with nonalcoholic fatty liver disease among US adults.

Yan,

Pei,

et al. 2024

Preprint

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Background Growing evidence suggest that ethylene oxide (EO) may have deleterious effects on health conditions, but the relationship between EO and adulthood nonalcoholic fatty liver disease (NAFLD) remains vague. Our objective is to evaluate whether EO exposure would influence the prevalence of NAFLD in a nationally cross-sectional study. Materials and methods In this cross-sectional study, We analyzed 2,394 participants from the National Health and Nutrition Examination Survey (NHANES) 2013-2018. Blood concentrations of EO were measured using high-performance liquid chromatography coupled with tandem mass spectrometry. US fatty liver index (USFLI) and FLI were applied to define NAFLD. Logistic regression analysis was adopted to investigate the relationship of Hemoglobin adducts of EO (HbEO) exposure with the prevalence of NAFLD. Mediation analysis was performed to assess the effect of inflammatory biomarkers on the association between HbEO levels and USFLI, FLI, and NAFLD. Results After adjustment for age, gender, race/ethnicity, education, income, smoking, drinking, hypertension, diabetes, and TC, logistic regression analysis showed that HbEO in the highest quartile was negatively associated with the prevalence of NAFLD than those in the lowest quartile (OR: 0.50, 95% CI: 0.33-0.92, P for trend = 0.008 for USFLI and OR: 0.42, 95% CI: 0.29-0.61, P for trend <0.001 for FLI). In addition, inflammation significantly mediated the relationships between HbEO and NAFLD. Conclusions Our study demonstrated that higher EO levels were negatively associated with the prevalence of NAFLD. The underlying mechanisms were required to be identify in the future study.

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The association between ethylene oxide exposure and asthma risk: a population-based study

Cited by 20 publications

References 30 publications

Positive association between blood ethylene oxide levels and metabolic syndrome: NHANES 2013-2020

Positive association between blood ethylene oxide levels and metabolic syndrome: NHANES 2013-2020

Associations of complete blood cell count-derived inflammatory biomarkers with asthma and mortality in adults: a population-based study

Association of ethylene oxide with nonalcoholic fatty liver disease among US adults.

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