Serum HDL partially mediates the association between exposure to volatile organic compounds and kidney stones: A nationally representative cross-sectional study from NHANES

Maolan Wu; Minghui Liu; Youjie Zhang; Jian Wu; Meng Gao; Fang Huang; Hequn Chen; Zewu Zhu

doi:10.1016/j.scitotenv.2023.167915

Serum HDL partially mediates the association between exposure to volatile organic compounds and kidney stones: A nationally representative cross-sectional study from NHANES

Sci Total Environ. 2024 Jan 10:907:167915. doi: 10.1016/j.scitotenv.2023.167915. Epub 2023 Oct 18.

Authors

Maolan Wu¹, Minghui Liu², Youjie Zhang², Jian Wu², Meng Gao², Fang Huang², Hequn Chen², Zewu Zhu³

Affiliations

¹ Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
² Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
³ Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Internal Medicine, Section Endocrinology, Yale University School of Medicine, New Haven, CT, USA. Electronic address: zewu.zhu@yale.edu.

PMID: 37858818
DOI: 10.1016/j.scitotenv.2023.167915

Abstract

Environmental exposure to volatile organic compounds (VOCs) is ubiquitous, and this study explored whether exposure to VOCs is associated with the risk of kidney stones. We performed a nationally representative US cross-sectional study using data from five survey cycles (2011-2020) of the National Health and Nutrition Examination Survey (NHANES) program. Exposure to VOCs was determined by urine creatinine-corrected metabolites of VOCs (mVOCs). In total 5505 participants and 15 urine mVOCs were included for analysis, and the prevalence of kidney stones was 9.57 % (527/5505). Multivariable logistic regression showed that urine AMCC (parent VOCs (pVOCs): N, N-Dimethylformamide), 3,4-MHA (pVOCs: xylene), MA (pVOCs: ethylbenzene; styrene), DHBMA (pVOCs: 1,3-butadiene), HMPMA (pVOCs: crotonaldehyde) and 2HPMA (pVOCs: propylene oxide) were significantly associated with an increased risk of kidney stones in US general population. Sub-analysis revealed that there was a more pronounced association in women and the overweight/obesity group (body mass index ≥ 25). Moreover, the weighted quantile sum (WQS) regression model and the Bayesian kernel machine regression (BKMR) model consistently identified a positive association between co-exposure to VOCs and the risk of kidney stones, in which AMCC played the most important role among the 15 mVOCs. Mediation analysis further identified serum high-density lipoprotein cholesterol (HDL) as a mediator of the association between VOC co-exposure and kidney stones. Our study draws attention to the previously unknown positive associations between non-occupational VOC exposure and the risk of kidney stones in the general population. However, further studies are required to clarify the existence of such causation.

Keywords: High-density lipoprotein cholesterol; Kidney stones; NHAENS; Volatile organic compounds.

MeSH terms

Bayes Theorem
Cross-Sectional Studies
Female
Humans
Kidney Calculi*
Nutrition Surveys
Volatile Organic Compounds* / metabolism

Substances

Volatile Organic Compounds