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Urinary Polycyclic Aromatic Hydrocarbons and Advanced Cardiovascular-Kidney-Metabolic Syndrome:
Yifeng Huang1,2, Youxia Zhao3, Qizhang Man2
1Nephrology Department of Ganzhou People's Hospital, Ganzhou, Jiangxi, China, gzsrmyy.com.
Mediators of Inflammation
|June 2, 2026
Summary
Environmental polycyclic aromatic hydrocarbons (PAHs) exposure is linked to advanced Cardiovascular-Kidney-Metabolic (CKM) syndrome. The red blood cell distribution width-to-albumin ratio (RAR) acts as a key mediator in this association.
Area of Science:
- Environmental Health
- Metabolic Syndrome Research
- Toxicology
Background:
- Polycyclic aromatic hydrocarbons (PAHs) are prevalent environmental pollutants with known adverse health effects.
- The specific impact of PAHs on Cardiovascular-Kidney-Metabolic (CKM) syndrome requires further investigation.
Purpose of the Study:
- To investigate the association between urinary PAH levels and advanced CKM syndrome.
- To explore the mediating role of the red blood cell distribution width-to-albumin ratio (RAR) in this relationship.
Main Methods:
- Cross-sectional analysis of 11,043 participants from NHANES.
- Quantification of urinary PAH metabolites.
- Assessment of CKM syndrome using established criteria.
- Mediation analysis to evaluate the RAR biomarker.
Main Results:
- Elevated urinary levels of specific PAHs (2-NAP, 2-FLU) were significantly associated with advanced CKM syndrome.
- Observed exposure-response relationships and threshold effects for key PAHs.
- RAR was identified as a significant mediator, explaining 6.13%–37.81% of the PAH-CKM association.
Conclusions:
- PAHs are independently and jointly associated with advanced CKM status.
- RAR serves as a critical mediator, highlighting its potential as a biomarker.
- Findings emphasize reducing PAH exposure and utilizing RAR for early detection and risk stratification.
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