Associations of phthalates and metal(loid)s co-exposure with abdominal obesity indices in Shenzhen, China

Previous studies have evaluated the obesogenic effects of phthalates or metal(loid)s individually, but the association between their co-exposure and abdominal obesity (AOB) indices, remains largely unknown. We thus aimed to investigate the individual and combined effects of metal(loid)s and phthalates exposure on AOB among adults in Shenzhen, China. The urinary levels of 21 metal(loid)s and 11 phthalates were detected in 652 adults in this study. Significant positive associations were found between urinary phthalates, metal(loid)s levels as single contaminants and all five AOB indices, including waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WtHR), conicity-index (C-index) and lipid accumulation product (LAP). Bayesian Kernel Machine Regression (BKMR) models indicated that the pollutant mixture was positively associated with WHR, WtHR, C-index and LAP but not WC, and mono (2-ethyl-5-oxohexyl) phthalate (MEOHP), mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), Vanadium (V), Chromium (Cr) and Zinc (Zn) were the key contributors. Furthermore, the relationships between Cr, MEHHP and the indices C-index, WHR or LAP might be partially mediated by high sensitivity C-reactive protein (hs-CRP) or homeostasis model assessment of insulin resistance (HOMA-IR). TP53 was identified as the core target in Cr-induced AOB by network toxicology analysis. Further studies with larger samples are needed to confirm these findings.