Associations of urinary polycyclic aromatic hydrocarbons with albuminuria in US adults, NHANES 2003-2014

Background: Polycyclic aromatic hydrocarbons (PAHs) exposure has been shown to be a risk factor for many diseases. However, studies on the association between PAHs exposure and kidney disease are limited. The aim of this study was to explore the association between urinary PAHs and albuminuria based on a national representative sample from the general U.S. population. Method: The data utilized were extracted from the 2003-2014 National Health and Nutrition Examination Survey (NHANES). Eight urinary PAHs were detected as PAH metabolites (OH-PAHs). Multivariable logistic regression analyses were applied to examine the association between urinary OH-PAHs and urinary albumincreatinine ratio (ACR). All models were adjusted for confounding demographic, anthropometric and lifestyle factors. Result: A total of 8149 NHANES (2003-2014) participants with complete data were eligible. Compared with the lowest quartile, an increased prevalence of high ACR level ( > 3 mg/mmol) was observed in the participants with the highest quartile of 2-hydroxynaphthalene [OR (95% CI), 1.56 (1.28-1.90), P < 0.001], 3-hydroxyfluorene [OR (95% CI), 1.29 (1.06-1.58), P = 0.011] and 2-hydroxyfluorene [OR (95% CI), 1.47 (1.20-1.80), P < 0.001] levels after adjusting for confounding factors. In subgroup analysis, significantly high OH-PAHs leveland a strong relationship between OH-PAHs and ACR were observed in current smokers in the adjusted model. Conclusion: High levels of urinary OH-PAHs were positively associated with high levels of ACR in the U.S. population. Our finding provided evidence that PAHs exposure might potentially be related to albuminuria and therefore might have implications for environmental governance and prevention/treatment of this condition.