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ORIGINAL RESEARCH article

Front. Public Health
Sec. Environmental Health and Exposome
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1451686

The association between brominated flame retardants exposure with Parkinson's disease in US adults: A cross-sectional study of the national health and nutrition examination survey (NHANES) 2009-2016

Provisionally accepted
Jiajie Lv Jiajie Lv 1*Yi-Chi Zhang Yi-Chi Zhang 1*Xin-Yu Li Xin-Yu Li 1*Lin-Jie Zhang Lin-Jie Zhang 1*Zhuo-Ma Yixi Zhuo-Ma Yixi 1*Cheng-Hao Yang Cheng-Hao Yang 2*Xu-Hui Wang Xu-Hui Wang 2*
  • 1 Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
  • 2 Shanghai Putuo People's Hospital, Putuo, Shanghai, China

The final, formatted version of the article will be published soon.

    Background: Increasing evidence suggests that environmental factors play a crucial role in the pathogenesis of Parkinson's disease (PD). Humans are simultaneously exposed to multiple brominated flame retardants (BFRs) in the environment. However, the relationship between BFRs and PD remains unclear. This study was designed to investigate the overall association between BFRs and PD in a nationally representative US population and to further identify significant chemicals. Methods: This study used data from 7,161 NHANES participants from 2009 through 2016. The serum BFRs registry included PBDE-28, PBDE-47, PBDE-85, PBDE-99, PBDE-100pbde-100, PBDE-153, PBDE-154, PBDE-183, PBDE-209 and PBB-153PBR-153. A survey-weighted generalized logistic regression model with restricted cubic splines (RCS) was used to evaluate the association between single BFRs exposure and periodontitis. Meanwhile, weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) were used to evaluate the overall association of mixed frankincense powder with periodontitis and to identify significant chemicals. Sensitivity analysis was performed to evaluate the robustness of the results. Results: Among the 7,161 participants, 65 had Parkinson's disease (PD). PD patients were older (mean age 57.79 vs 46.57 years) and had a higher proportion of females (70.86%) compared to non-PD participants. Serum levels of PBB-153 were significantly higher in those with PD. Logistic regression analyses revealed a non-linear, inverted U-shaped relationship between serum PBB-153 and PD risk. The risk of PD increased with higher PBB-153 levels up to the 3rd quartile (Q3), beyond which the risk declined (Q3 vs Q1: OR=4.98, 95% CI=1.79-13.86; Q4 vs Q1: OR=3.23, 95% CI=1.03-10.08). PBB-153 (43.40%), PBDE-153 (24.75%), and PBDE-85 (19.51%) contributed most to the weighted quantile sum index associated with PD risk. Bayesian kernel machine regression confirmed the inverted U-shaped dose-response pattern for PBB-153 and the overall BFR mixture. Restricted cubic spline analyses corroborated the non-linear relationship between PBB-153 and PD, which was more pronounced among women and those aged 37-58 years. Sensitivity analyses substantiated these findings. Conclusion: This nationally representative cross-sectional study revealed a novel non-linear, inverted U-shaped relationship between serum levels of the brominated flame retardant PBB-153 and Parkinson's disease risk in U.S. adults.

    Keywords: Brominated flame retardants, Parkinson's disease, The National Health and Nutrition Examination Survey, Cross-sectional study, BKMR analysis

    Received: 24 Jun 2024; Accepted: 07 Oct 2024.

    Copyright: © 2024 Lv, Zhang, Li, Zhang, Yixi, Yang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Jiajie Lv, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
    Yi-Chi Zhang, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
    Xin-Yu Li, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
    Lin-Jie Zhang, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
    Zhuo-Ma Yixi, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
    Cheng-Hao Yang, Shanghai Putuo People's Hospital, Putuo, Shanghai, China
    Xu-Hui Wang, Shanghai Putuo People's Hospital, Putuo, Shanghai, China

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