Association of phthalate exposure and airway dysfunction with mediation by serum periostin

Background Phthalates can cause respiratory and immunological disorders. However, little is known about the role of serum periostin and YKL-40 levels in mediating the effects of phthalates. We investigated the mediating role of these biomarkers in the relationship between phthalates and airway dysfunction. Methods A total of 487 children (aged 10-12 years old) were examined. Four high-molecular-weight phthalate (HMWP) [sigma 4HMWP] metabolites and 3 low-molecular-weight phthalate (LMWP) [sigma 3LMWP] metabolites in urine samples were measured. Serum periostin and YKL-40 levels were measured. Airway function was measured using impulse oscillometry. A mediation model was used to quantify the mediating effects of periostin and YKL-40 on airway dysfunction. Results After adjustment for height, gender, BMI z-score, aeroallergen sensitization, secondary smoking, and vitamin D level, the level of urinary sigma 3LMWP metabolites was significantly associated with respiratory system resistance at 5 Hz (Rrs5; adjusted beta: 0.020, 95% CI: 0.005-0.034; p = .010). The levels of urinary sigma 4HMWP and sigma 3LMWP metabolites were significantly associated with periostin level, but not with YKL-40 level. In addition, the periostin level was associated with Rrs5 (adjusted beta: 0.048, 95% CI: 0.015-0.081; p = .005) and Rrs20-5 (adjusted beta: 0.040, 95% CI: 0.011-0.069; p = .007). Serum periostin level had a significant effect in mediating the relationship between sigma 3LMWP and Rrs5 (13.9%, 95% CI: 10.7-77.0; p < .001). Conclusion Exposure to LMWPs was significantly associated with airway dysfunction, and this effect was partially attributable to increased serum periostin level.

Automated summary

Exposure to low molecular weight phthalates was significantly associated with airway dysfunction, and this effect was partially attributable to increased serum periostin levels.