Association Between Mixed Exposure to Endocrine-Disrupting Chemicals and Cardiovascular Health: Results from the...

Accumulating evidence supports the association between endocrine disrupting chemicals (EDCs) exposure and cardiovascular disease (CVD). However, the link between EDCs and cardiovascular health (CVH) prior to CVD onset remains unclear. This study investigates the relationship between individual and combined EDC exposure and Life's Essential 8 (LE8). We included 9,940 participants from the National Health and Nutrition Examination Survey (NHANES) conducted between 2003 and 2016, excluding adults with known CVD. Twenty-two types of EDCs were detected in urine samples, including three phenols, two phenolic pesticides, eleven phthalates, and six polycyclic aromatic hydrocarbons (PAHs). Weighted generalized linear models (GLM) and weighted quantile sum (WQS) regression to explore the relationship between single/mixed exposure to EDCs and CVH. Overall, 9,940 individuals (weighted mean [SE] age, 42.53 [0.26] years; 5,313 women [weighted 53.7%]) without CVD were included, with a mean score of LE8 at 68.70. The GLM model reveals that specific exposures to EDCs are inversely associated with LE8, serving as independent risk factors contributing to poorer CVH. The WQS index of EDCs was independently associated with overall CVH, with an adjusted odds ratio (OR) of 3.00 (95% confidence interval [CI]: 2.30-3.90; P < 0.001). 2-Fluorenone (2-FLU) emerged as the most heavily weighted component in the overall CVH model. This study emphasizes the association between exposure to EDCs is correlated with a higher odds ratio for decline in CVH among American adults. 2-FLU emerges as a prominent contributor. It provides epidemiologic evidence for the detrimental effects of these chemicals on CVH.