AUTHOR=Xiao Yingqi , Zhang Li , Liu Hu , Huang Wei 

TITLE=Systemic inflammation mediates environmental polycyclic aromatic hydrocarbons to increase chronic obstructive pulmonary disease risk in United States adults: a cross-sectional NHANES study

JOURNAL=Frontiers in Public Health

VOLUME=11

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1248812

DOI=10.3389/fpubh.2023.1248812

ISSN=2296-2565

ABSTRACT=<sec><title>Introduction</title><p>This study explored the relationship between environmental polycyclic aromatic hydrocarbons (PAHs) and Chronic obstructive pulmonary disease (COPD), and identified systemic inflammation as a mediator of the increased risk of COPD from PAHs.</p></sec><sec><title>Methods</title><p>Data were obtained from 60,936 middle-aged and older Americans recruited in the National Health and Nutrition Examination Survey 2005–2016. Environmental PAHs were measured in terms of urinary concentrations of PAHs metabolites (NAP: 1-hydroxynaphthalene, FLU: 2-hydroxyfluorene, PA: 1-hydroxyphenanthrene, and PYR: 1-hydroxypyrene). We used multifactor logical analysis to figure out the link between PAHs and COPD, and the non-linear relationship was examined using Restricted cubic spline. Spearman correlation analysis was utilized to analyze the connection between PAHs and systemic immune-inflammation index (SII).</p></sec><sec><title>Results</title><p>The results showed that the COPD population had higher NAP (3.550 vs. 3.282, <italic>p</italic> &lt; 0.001), FLU (2.501 vs. 2.307, <italic>p</italic> &lt; 0.001), PA (2.155 vs. 2.082, <italic>p</italic> = 0.005), and PYR (2.013 vs. 1.959, <italic>p</italic> = 0.008) levels than non-COPD population. In unadjusted logistics analysis, the risk of COPD with log NAP was higher [OR = 1.461, 95% CI (1.258–1.698), <italic>p</italic> &lt; 0.001]. Upon taking into account, confounders like sex, age, race, and log NAP still increased a possible COPD risk [OR = 1.429, 95% CI (1.224–1.669), <italic>p</italic> &lt; 0.001]. Similarly, FLU, PA, and PYR significantly increased the risk of COPD (all OR &gt; 1, <italic>p</italic> &lt; 0.05), both unadjusted and adjusted. Furthermore, Restricted cubic spline demonstrated a strong link between PAHs levels and COPD risk (<italic>p</italic> &lt; 0.05). Additionally, a Spearman correlation analysis revealed a favorable association between log FLU and log SII (<italic>R</italic> = 0.43, <italic>p</italic> = 0.006), while NAP, PA, and PYR levels were not associated with log SII (all <italic>p</italic> &gt; 0.05). Ultimately, the mediating effect analysis revealed a mediating effect capacity of 5.34% for the SII-mediated association between FLU and COPD.</p></sec><sec><title>Conclusion</title><p>The findings suggest that the risk of COPD is significantly increased when environmental PAHs exposure is at high levels, and that systemic inflammation may be involved in the process.</p></sec>