Table 1 Demographic characteristics of the National Health and Nutrition Examination Survey 2005–2010 participants (N = 2529), aged 6-19 years
Characteristics
|
Obesity
569
|
No obesity
1959
|
P value
|
Age (y), mean (SE)
|
12.54 (3.82)
|
12.52 (4.01)
|
0.926
|
Gender
|
|
|
0.651
|
Male
|
276 (10.91%)
|
1038 (41.04%)
|
|
Female
|
250 (9.89%)
|
964 (38.12%)
|
|
Race
|
|
|
<0.001
|
Mexican American
|
163 (6.45%)
|
550 (21.75%)
|
|
Other Hispanic
|
56 (2.21%)
|
175 (6.92%)
|
|
Non-Hispanic White
|
114 (4.51%)
|
637 (25.19%)
|
|
Non-Hispanic Black
|
170 (6.72%)
|
520 (20.56%)
|
|
Other Race
|
23 (0.91%)
|
120 (4.74%)
|
|
Education level
|
|
|
0.172
|
5 grade
|
235 (9.29%)
|
902 (35.67%)
|
|
6-8 grade
|
125 (4.94%)
|
435 (17.20%)
|
|
9-12 grade, No Diploma
|
127 (5.02%)
|
485 (19.18%)
|
|
High School Graduate
|
26 (1.03%)
|
85 (3.36%)
|
|
GED or Equivalent, More than high school
|
13 (0.51%)
|
95 (3.76%)
|
|
Family income-to-poverty ratio
|
|
|
0.010
|
1.30
|
269 (10.64%)
|
884 (34.95%)
|
|
1.31,3.50
|
181 (7.16%)
|
711 (28.11%)
|
|
3.50
|
76 (3.01%)
|
407 (16.09%)
|
|
Caloric intake
|
|
|
0.001
|
Normal intake
|
306 (12.10%)
|
1033 (40.85%)
|
|
Excessive intake
|
220 (8.70%)
|
969 (38.32%)
|
|
Serum cotinine (ng/mL), mean (SE)
|
6.03 (33.39)
|
10.24 (46.32)
|
0.042
|
Urinary creatine (mg/dL), GM (SE)
|
117.63 (77.82)
|
17.20 (82.12)
|
0.016
|
BMI, mean (SE)
|
30.36 (6.96)
|
19.70 (3.66)
|
<0.001
|
BMI z-score, mean (SE)
|
2.13 (0.33)
|
0.18 (0.94)
|
<0.001
|
Waist Circumference (cm), mean (SE)
|
94.79 (21.02)
|
69.36 (12.62)
|
<0.001
|
BMI: body mass index. Data are presented as mean SD or Geometric mean SD or n (%). The t-test and test were between the general obesity and no obesity groups.
Table 2 Distribution of the chemical exposures in National Health and Nutrition Examination Survey (NHANES) 2005-2010 (N =2529)
Chemical exposures
|
LOD
(ng/mL)
|
DF (%)
|
GM
|
Mean
|
Min
|
P5
|
P25
|
P50
|
P75
|
P95
|
Max
|
Phenols (ng/mL)
|
|
|
|
|
|
|
|
|
|
|
|
BPA
|
0.4
|
92.8%
|
4.79
|
4.23
|
0.28
|
0.40
|
1.20
|
2.30
|
4.30
|
13.10
|
241.00
|
BP-3
|
0.4
|
97.1%
|
490.00
|
262.00
|
0.28
|
1.40
|
4.80
|
12.30
|
39.63
|
537.65
|
94100.00
|
Paraben (ng/mL)
|
|
|
|
|
|
|
|
|
|
|
|
BuP
|
0.2
|
43.3%
|
6.98
|
3.82
|
0.14
|
0.14
|
0.14
|
0.14
|
0.53
|
13.50
|
1240.00
|
EtP
|
1.0
|
45.1%
|
24.91
|
13.80
|
0.71
|
0.71
|
0.71
|
0.71
|
2.10
|
11.93
|
1760.00
|
MeP
|
1.0
|
99.4%
|
417.70
|
271.80
|
0.71
|
4.44
|
6.90
|
57.90
|
224.00
|
1100.00
|
14900.00
|
PrP
|
0.2
|
93.8%
|
96.65
|
58.27
|
0.14
|
0.20
|
1.30
|
6.50
|
37.15
|
282.00
|
4150.00
|
Pesticides (μg/L)
|
|
|
|
|
|
|
|
|
|
|
|
2,5-DCP
|
0.2
|
98.6%
|
455.60
|
250.80
|
0.14
|
0.70
|
3.40
|
11.70
|
54.40
|
955.65
|
19400.00
|
2,4-DCP
|
0.2
|
90.3%
|
11.47
|
6.88
|
0.14
|
0.14
|
0.50
|
1.10
|
2.80
|
25.66
|
1230.00
|
2,4,5-TCP
|
0.1
|
30.5%
|
0.10
|
0.13
|
0.07
|
0.07
|
0.07
|
0.07
|
0.10
|
0.30
|
25.70
|
2,4,6-TCP
|
0.5
|
29.7%
|
0.45
|
0.61
|
0.35
|
0.35
|
0.35
|
0.35
|
0.60
|
1.50
|
19.00
|
Phthalate metabolites
(ng/mL)
|
|
|
|
|
|
|
|
|
|
|
|
MBzP
|
0.2
|
98.9%
|
36.93
|
29.86
|
0.15
|
1.49
|
6.48
|
14.68
|
31.20
|
90.74
|
3806.57
|
MEP
|
0.5
|
99.9%
|
357.90
|
250.80
|
0.37
|
11.09
|
33.47
|
76.93
|
209.82
|
1022.46
|
11810.04
|
MiBP
|
0.3
|
98.7%
|
25.27
|
20.80
|
0.21
|
1.50
|
5.23
|
10.90
|
20.52
|
52.07
|
6286.00
|
LOD: limit of detection; DF: detection frequency; GM: geometric mean.
Table 3 Association between a single chemical exposure and obesity in the National Health and Nutrition Examination Survey (NHANES) 2005–2010 (N = 2529)
Chemical exposures
|
Quartile 1
|
Quartile 2
|
Quartile 3
|
Quartile 4
|
Total
|
|
|
OR (95%CI)
|
P value
|
OR
(95%CI)
|
P value
|
OR (95%CI)
|
P value
|
OR
(95%CI)
|
P value
|
Phenols
|
|
|
|
|
|
|
|
|
|
BPA
|
Ref
|
0.94
|
0.689
|
1.02
|
0.888
|
1.04
|
0.802
|
1.04
|
0.771
|
|
|
(0.69,1.28)
|
|
(0.75,1.40)
|
|
(0.76,1.46)
|
|
(0.80, 1.36)
|
|
BP-3
|
Ref
|
0.94
|
0.682
|
1.10
|
0.517
|
0.95
|
0.735
|
0.98
|
0.826
|
|
|
(0.71,1.25)
|
|
(0.83,1.46)
|
|
(0.70,1.29)
|
|
(0.86, 1.13)
|
|
Paraben
|
|
|
|
|
|
|
|
|
|
BuP
|
Ref
|
|
Ref
|
0.88
|
0.37
|
1.05
|
0.716
|
0.99
|
0.877
|
|
|
|
|
(0.67,1.15)
|
|
(0.81,1.35)
|
|
(0.84, 1.15)
|
|
EtP
|
Ref
|
|
Ref
|
0.73
|
0.073
|
0.91
|
0.422
|
0.90
|
0.232
|
|
|
|
|
(0.51,1.02)
|
|
(0.71,1.15)
|
|
(0.75, 1.07)
|
|
MeP
|
Ref
|
0.71
|
0.020
|
0.69
|
0.015
|
0.66
|
0.012
|
0.81
|
0.011
|
|
|
(0.53,0.95)
|
|
(0.52,0.93)
|
|
(0.48,0.91)
|
|
(0.70, 0.95)
|
|
PrP
|
Ref
|
1.13
|
0.392
|
0.87
|
0.366
|
0.74
|
0.078
|
0.91
|
0.168
|
|
|
(0.85,1.50)
|
|
(0.64,1.18)
|
|
(0.53,1.03)
|
|
(0.80, 1.04)
|
|
Pesticides
|
|
|
|
|
|
|
|
|
|
2,5-DCP
|
Ref
|
1.30
|
0.092
|
1.59
|
0.003
|
1.74
|
0.001
|
1.21
|
0.001
|
|
|
(0.96,1.78)
|
|
(1.17,2.17)
|
|
(1.27,2.39)
|
|
(1.08, 1.35)
|
|
2,4-DCP
|
Ref
|
0.97
|
0.822
|
1.00
|
0.991
|
1.02
|
0.902
|
1.11
|
0.236
|
|
|
(0.71,1.32)
|
|
(0.73,1.38)
|
|
(0.74,1.42)
|
|
(0.94, 1.30)
|
|
2,4,5-TCP
|
Ref
|
|
Ref
|
1.29
|
0.093
|
0.90
|
0.445
|
0.87
|
0.517
|
|
|
|
|
(0.95,1.72)
|
|
(0.68,1.18)
|
|
(0.56, 1.32)
|
|
2,4,6-DCP
|
Ref
|
|
Ref
|
1.11
|
0.520
|
0.95
|
0.666
|
0.93
|
0.734
|
|
|
|
|
(0.80,1.54)
|
|
(0.74,1.21)
|
|
(0.60, 1.42)
|
|
Phthalate metabolites
|
|
|
|
|
|
|
|
|
|
MBzP
|
Ref
|
1.05
|
0.758
|
1.05
|
0.757
|
0.90
|
0.556
|
0.97
|
0.774
|
|
|
(0.78,1.41)
|
|
(0.77,1.44)
|
|
(0.64,1.27)
|
|
(0.77, 1.22)
|
|
MEP
|
Ref
|
1.08
|
0.628
|
1.32
|
0.086
|
1.47
|
0.028
|
1.33
|
0.005
|
|
|
(0.79,1.47)
|
|
(1.10,1.83)
|
|
(1.04,2.07)
|
|
(1.09, 1.63)
|
|
MiBP
|
Ref
|
1.31
|
0.085
|
1.38
|
0.055
|
1.46
|
0.039
|
1.37
|
0.023
|
|
|
(0.96,1.79)
|
|
(0.99,1.92)
|
|
(1.02,2.10)
|
|
(1.04, 1.80)
|
|
|
|
|
|
|
|
|
|
|
|
|
OR: odds ratio; CI: confidence interval. Multivariable logistic regression was conducted, and odds ratios (ORs) were calculated while comparing the second, third, and fourth quartiles of each chemical with reference to the first exposure quartile (N = 2529). Models were adjusted for age, gender, race, educational levels, family income-to-poverty ratio, caloric intake, serum cotinine and ln-transformed creatinine.
Table 4 Association between single chemical exposure and BMI z-score in National Health and Nutrition Examination Survey (NHANES) 2005–2010 (N = 2529)
Chemical exposures
|
Quartile 1
|
Quartile 2
|
Quartile 3
|
Quartile 4
|
Total
|
|
|
(95%CI)
|
P value
|
(95%CI)
|
P value
|
(95%CI)
|
P value
|
(95%CI)
|
P value
|
Phenols
|
|
|
|
|
|
|
|
|
|
BPA
|
Ref
|
0.02
|
0.774
|
0.07
|
0.329
|
-0.01
|
0.891
|
-0.06
|
0.331
|
|
|
(-0.12, 0.16)
|
|
(-0.07, 0.21)
|
|
(-0.16, 0.14)
|
|
(-0.18, 0.06)
|
|
BP-3
|
Ref
|
0.06
|
0.338
|
0.05
|
0.396
|
0.07
|
0.319
|
0.02
|
0.533
|
|
|
(-0.07, 0.19)
|
|
(-0.08, 0.19)
|
|
(-0.07, 0.21)
|
|
(-0.04, 0.08)
|
|
Paraben
|
|
|
|
|
|
|
|
|
|
BuP
|
Ref
|
Ref
|
|
-0.01
|
0.817
|
-0.01
|
0.969
|
-0.01
|
0.812
|
|
|
|
|
(-0.14, 0.11)
|
|
(-0.12, 0.12)
|
|
(-0.08, 0.06)
|
|
EtP
|
Ref
|
Ref
|
|
-0.02
|
0.746
|
0.01
|
0.940
|
-0.01
|
0.953
|
|
|
|
|
(-0.18, 0.13)
|
|
(-0.11, 0.12)
|
|
(-0.08, 0.07)
|
|
MeP
|
Ref
|
-0.13
|
0.059
|
-0.12
|
0.081
|
-0.14
|
0.071
|
-0.05
|
0.144
|
|
|
(-0.23, 0.01)
|
|
(-0.26, 0.02)
|
|
(-0.29, 0.01)
|
|
(-0.12, 0.02)
|
|
PrP
|
Ref
|
0.02
|
0.824
|
-0.05
|
0.497
|
-0.09
|
0.262
|
-0.02
|
0.368
|
|
|
(-0.12, 0.15)
|
|
(-0.18, 0.09)
|
|
(-0.24, 0.06)
|
|
(-0.08, 0.03)
|
|
Pesticides
|
|
|
|
|
|
|
|
|
|
2,5-DCP
|
Ref
|
0.04
|
0.538
|
0.14
|
0.050
|
0.07
|
0.358
|
0.02
|
0.457
|
|
|
(-0.09, 0.17)
|
|
(0, 0.27)
|
|
(-0.08, 0.21)
|
|
(-0.03, 0.07)
|
|
2,4-DCP
|
Ref
|
-0.08
|
0.276
|
0.03
|
0.710
|
-0.09
|
0.241
|
-0.03
|
0.377
|
|
|
(-0.21, 0.06)
|
|
(-0.12, 0.17)
|
|
(-0.24, 0.06)
|
|
(-0.11, 0.04)
|
|
2,4,5-TCP
|
Ref
|
Ref
|
|
0.07
|
0.369
|
-0.03
|
0.613
|
0.01
|
0.960
|
|
|
|
|
(-0.08, 0.21)
|
|
(-0.16, 0.09)
|
|
(-0.19, 0.19)
|
|
2,4,6-TCP
|
Ref
|
Ref
|
|
-0.04
|
0.656
|
0.01
|
0.942
|
0.02
|
0.876
|
|
|
|
|
(-0.19, 0.12)
|
|
(-0.11, 0.12)
|
|
(-0.18, 0.21)
|
|
Phthalate metabolites
|
|
|
|
|
|
|
|
|
|
MBzP
|
Ref
|
0.02
|
0.830
|
-0.04
|
0.577
|
-0.04
|
0.594
|
0
|
0.988
|
|
|
(-0.12, 0.15)
|
|
(-0.18, 0.10)
|
|
(-0.20, 0.11)
|
|
(-0.10, 0.11)
|
|
MEP
|
Ref
|
0.03
|
0.705
|
0.12
|
0.097
|
0.16
|
0.044
|
0.13
|
0.003
|
|
|
(-0.11, 0.16)
|
|
(-0.02, 0.26)
|
|
(0.01, 0.31)
|
|
(0.04, 0.23)
|
|
MiBP
|
Ref
|
0.11
|
0.118
|
0.07
|
0.381
|
0.08
|
0.307
|
0.06
|
0.337
|
|
|
(-0.03, 0.24)
|
|
(-0.08, 0.21)
|
|
(-0.08, 0.25)
|
|
(-0.06, 0.19)
|
|
CI: confidence interval; Multivariable linear regression was conducted and regression coefficients () were calculated while comparing the second, third and fourth quartiles of each chemical with reference to the first exposure quartile (N = 2529). Models were adjusted for age, gender, race, educational levels, family income-to-poverty ratio, caloric intake, serum cotinine, and ln-transformed creatinine.
Table 5 Association between the WQS index and obesity in NHANES 2005–2010 (N = 2529)
Outcomes
|
OR/
|
95% CI of OR
|
P value
|
Obesity
|
|
|
|
Model 1
|
1.61
|
(1.25, 2.07)
|
<0.001
|
Model 2
|
1.53
|
(1.18, 2.00)
|
0.001
|
BMI z-score
|
|
|
|
Model 1
|
0.12
|
(0.002, 0.24)
|
0.047
|
Model 2
|
0.11
|
(-0.03, 0.25)
|
0.117
|
CI: confidence interval. The weighted quantile sum (WQS) regression was fitted for the obesity and BMI z-score, which scored all the chemical exposures into quantiles and estimated the weight index. OR estimates represent the odds ratios of obesity as 1 quartile increased in the WQS index. estimates represent the mean differences in the BMI z-score as 1 quartile increased in the WQS index. Model 1: Adjusted for age, gender, ethnicity, and ln-transformed creatinine. Model 2: Adjusted for age, gender, ethnicity, educational levels, family income-to-poverty ratio, caloric intake, serum cotinine, and ln-transformed creatinine.
Table 6 Group posterior inclusion probabilities (PIPs) and conditional posterior inclusion probabilities in the Bayesian kernel machine regression (BKMR) model in National Health and Nutrition Examination Survey (NHANES) 2005–2010 (N = 2529)
Chemicals
|
Group
|
Obesity
|
BMI z-score
|
|
|
groupPIP
|
condPIP
|
groupPIP
|
condPIP
|
Phenols
|
|
|
|
|
|
BPA
|
1
|
0.756
|
0.056
|
0.612
|
0.314
|
BP-3
|
1
|
0.756
|
0.093
|
0.612
|
0.150
|
Paraben
|
|
|
|
|
|
BuP
|
1
|
0.756
|
0.058
|
0.612
|
0.059
|
EtP
|
1
|
0.756
|
0.066
|
0.612
|
0.163
|
MeP
|
1
|
0.756
|
0.437
|
0.612
|
0.203
|
PrP
|
1
|
0.756
|
0.291
|
0.612
|
0.111
|
Pesticides
|
|
|
|
|
|
2,5-DCP
|
2
|
0.926
|
0.782
|
0.616
|
0.201
|
2,4-DCP
|
2
|
0.926
|
0.065
|
0.616
|
0.247
|
2,4,5-TCP
|
2
|
0.926
|
0.069
|
0.616
|
0.380
|
2,4,6-TCP
|
2
|
0.926
|
0.084
|
0.616
|
0.172
|
Phthalate metabolites
|
|
|
|
|
|
MBzP
|
3
|
0.750
|
0.312
|
0.648
|
0.151
|
MEP
|
3
|
0.750
|
0.403
|
0.648
|
0.630
|
MiBP
|
3
|
0.750
|
0.285
|
0.648
|
0.219
|
Models were adjusted for age, gender, race, educational levels, family income-to-poverty ratio, caloric intake, serum cotinine, and ln-transformed creatinine.