The Effect of Environmental Endocrine Disruptors on disease progression in children with Henoch- Schoenlein Purpura Nephritis

Abstract Objective To explore the cross-sectional relationship between exposure to Environmental Endocrine Disruptors (EEDs) and Henoch-Schoenlein Purpura Nephritis (HSPN) risk in Children. Methods This was a retrospective case-control study of 31 pediatric patients with diagnosed HSPN and 30 normal children through routine physical examination. All Participants' basic characteristics, clinical indicators were collected from January 2020 to December 2023 at our pediatric centers. Residues of related endocrine disruptors in the urine were detected by liquid chromatography. Logistic regression analysis was used to confirm the correlation between the results of each index and HSPN. The role of endocrine disruptors in early screening of HSPN was confirmed by ROC curve analysis. Results In age, and BMI-adjusted models, the levels of several EEDs in urine samples in the disease group were generally higher than those in the control group [OR = 3.16; 95% CI: 1.14–8.76]. BPA, Benzo(a)pyrene, Zearalenone, lead, and MEHP in urine samples from patients were significantly higher than those from healthy controls. The multivariate logistic regression showed that Benzo(a)pyrene (OR = 1.03; 95% CI: 1.01–1.04; p < .001), MEHP (OR = 1.0; 95% CI: 1.0–1.0; p < .001), Zearalenone (OR = 1.03; 95% CI: 1.01–1.05; p < .001), Lead (OR = 1.03; 95% CI: 1.00–1.00; p < .001) and BPA (OR = 1.01; 95% CI:1.00–1.01; p < .001) were significantly associated with the occurrence of HSPN. The ROC curve indicated that Benzo(a)pyrene (AUC = 0.83; p < .001), MEHP (AUC = 0.83; p < .001), Zearalenone (AUC = 0.70; p = 0.006), Lead (AUC = 0.69; p = 0.008) and BPA (AUC = 0.84; p < .001) have good early screening ability for predicting the pathogenesis of HSPN. Conclusions Our results suggest a link between environmental exposures to EEDs and HSPN. Benzo(a)pyrene, MEPH, Zearalenone, BPA, and Lead were associated with an increased risk of HSPN. These EEDs also have good early screening ability for predicting the pathogenesis of HSPN.