Associations between environmental chemical mixtures and anthropometric measures in Korean girls: a cross-sectional...

The purpose of this study is to investigate the association between environmental chemicals and anthropometric indices using preliminary data from the Puberty and Environment in Adolescents Cohort Project. Random urine samples from 370 Korean girls aged 7-14 years were evaluated for 15 environmental phthalates, phenols, polycyclic aromatic hydrocarbon metabolites, and three heavy metals using growth metrics. We calculated the body mass index (BMI) z-score, weight z-score, height z-score, and waist-to-hip ratio (WHR) based on the World Health Organization growth references. Associations between environmental chemicals and weight and height indicators were assessed using single- and mixture-exposure models, controlling for the measured covariates. We identified 28 girls (7.6%) as overweight, 10 (2.7%) as underweight based on BMI z-scores, 17 (4.6%) as underweight based on weight z-scores, and 6 (1.6%) as having a low height status. Normal anthropometric measurements were reported in 85.9% of the girls. No positive associations between environmental chemical mixtures and BMI z-score, weight z-score, or WHR (β = -0.03, 95% confidence interval [CI]: -0.34, 0.26; -0.23, 95% CI: -0.51, 0.06; -0.00, 95% CI: -0.02, 0.02) were observed. A negative association was identified between environmental phthalate, phenol, and polycyclic aromatic hydrocarbons metabolites, and height z-score (β = -0.41, 95% CI: -0.63, -0.19). Heavy metal mixtures were negatively associated with weight and height z-scores (β = -0.20, 95% CI: -0.37 to -0.04; -0.21, 95% CI: -0.40 to -0.03).

Exposure to environmental chemical mixtures was negatively associated with height in girls. The different patterns of association observed in the single and mixture analyses provide insights into the health impacts of multiple chemicals on children.

• Environmental chemical mixtures including phenols, phthalates, PAHs, and heavy metals are associated with abnormal growth in children. • Exposure to these mixtures may influence body mass index and other anthropometric measures throughout childhood.

• This study evaluated the effects of environmental chemical mixtures on anthropometric indices in Korean adolescent girls, using a mixture-exposure approach. • Exposure to phthalates, phenols, polycyclic aromatic hydrocarbons, and heavy metals was inversely associated with height, whereas associations with body mass index, weight, or waist-to-hip ratio were not observed.