Coronary heart disease (CHD) is the leading cause of
global morbidity,
but the effect of plasticizers and antimicrobial additives on CHD
is unknown. Here, we conducted a case–control study to investigate
the mediating role of oxidative stress in the association between
co-exposure to seven bisphenols, four parabens, triclosan (TCS), triclocarban,
and CHD risk in Guangzhou, China. Quantile-based g-computation and weighted quantile sum regression were used to analyze
mixture-outcome associations. Quantile-based g-computation
showed a positive joint effect of a decile increase in exposure to
all examined pollutants on CHD risk (OR: 1.52, 95% CI: 1.25–1.84),
with bisphenol A (BPA), bisphenol F (BPF), n-butyl
paraben (BuP), and TCS representing major contributors. The results
also showed a decile nonmonotonic increase in the exposure mixtures,
positively correlated with a 2.22 ng/mL (95% CI: 1.21–3.23
ng/mL) elevation of 8-hydroxy-2′-deoxyguanosine (8-OHdG), with
BuP, TCS, bisphenol AP (BPAP), and BPF contributing dominantly. Mediation
analysis showed that 8-OHdG mediated the relationship between BPA,
BPF, BPAP, and TCS, and CHD risk. Moreover, the mediating role of
high-density lipoprotein (HDL) between several bisphenols and CHD
was also identified. It is yet to be verified, but bisphenols may
elevate CHD risk by reducing HDL status and increasing oxidative stress.