Association between urinary concentrations of polycyclic aromatic hydrocarbons and risk of endometriosis in the NHANES 2003-2006

To explore the association between exposure to polycyclic aromatic hydrocarbons (PAHs) and endometriosis risk. Data were obtained from the 2003–2006 National Health and Nutrition Examination Survey database. Urinary concentrations of PAHs were divided into quartiles, and weighted multivariate logistic regression, restricted cubic spline, and subgroup analyses were performed. An extreme gradient boosting (XGBoost) algorithm was used to screen the most important PAHs. After multivariable adjustments, 9-fluorene, 1-phenanthrene, 2-phenanthrene, and 4-phenanthrene exposure were significantly associated with a risk of endometriosis. Specifically, compared with the reference group, the odds ratios (ORs) of endometriosis for the fourth quartile were 3.52 (95% confidence interval (CI): 1.15, 10.77), 3.10 (95% CI: 1.37, 6.97), 4.86 (95% CI: 1.93, 12.21), and 2.67 (95% CI: 1.02, 7.01) for 9-fluorene, 1-phenanthrene, 2-phenanthrene, and 4-phenanthrene, respectively. In terms of continuous exposure, each one-standard-deviation increase in the urinary concentration of 9-fluorene, 1-phenanthrene, 2-phenanthrene, and 4-phenanthrene was independently associated with a 66% (OR: 1.66, 95% CI: 1.15, 2.40), 62% (OR:1.62, 95% CI: 1.19, 2.20), 68% (OR: 1.68, 95% CI: 1.24, 2.28), and 56% (OR: 1.56, 95% CI: 1.11, 2.19) increase in the risk of endometriosis, respectively, in the fully adjusted model. A significant association between the urinary concentration of 9-fluorene and the risk of endometriosis was also observed in participants who had a high body-mass index (≥25 kg/m2), with a corresponding OR of 2.61 (95% CI: 1.37, 5.00; P for interaction = 0.006). Our findings show that high urinary concentrations of PAHs were associated with a high risk of endometriosis in participants and that the urinary concentration of 9-fluorene was related with a high susceptibility of endometriosis in participants with overweight. Similar content being viewed by others Data availability Obtaining data from corresponding authors with appropriate justification.

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We thank all the participants in the study. Author information Authors and Affiliations Contributions B.W., H.Z., and X.Z. conceived and designed the study. B.W., J.W., and H.W. analyzed and interpreted the data. B.W. and H.Z. drafted the manuscript. X.Z. contributed to the interpretation of the results. J.J. assisted with the data collection and analysis. All authors agreed to be accountable for all aspects of the work. All authors contributed to the article and approved the submitted version. Corresponding author Ethics declarations Ethical approval NHANES Institutional Review Board approved the ethical conduct of NHANES 2003–2006. Consent to participate Every participant signed an informed consent form. Consent for publication Not applicable. Conflict of interest The authors declare no competing interests. Additional information Responsible Editor: Lotfi Aleya Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Wang, B., Zhang, H., Zhang, X. et al. Association between urinary concentrations of polycyclic aromatic hydrocarbons and risk of endometriosis in the NHANES 2003–2006. Environ Sci Pollut Res 30, 117715–117728 (2023). https://doi.org/10.1007/s11356-023-30545-1 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s11356-023-30545-1