ORIGINAL RESEARCH article
Front. Physiol.
Sec. Renal Physiology and Pathophysiology
Volume 16 - 2025 | doi: 10.3389/fphys.2025.1523940
Investigating Ethylene Oxide Exposure and Its Associations with Kidney Indicators and Lipid Profiles: The Mediating Effect of HDL in NHANES 2013-2020
Provisionally accepted
- 1The First School Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
- 2School of Public Health, Southern Medical University, Guangzhou, China
- 3Shenzhen Anorectal Hospital of Traditional Chinese Medicine, Shenzhen, China
- 4Gynecology and Oncology Department of Ganzhou Cancer Hospital, Ganzhou, China
- 5Department of Obstetrics and Gynecology, Guangdong Provincial People's Hospital, Guangzhou, China
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Ethylene oxide (EO) exposure has been associated with various health conditions, including cancer and cardiovascular diseases. While recent studies have examined its health impacts, its effects on kidney function and lipid profiles remain poorly understood. This study examines associations between EO exposure and kidney and lipid parameters in 3,500 US adults, using hemoglobin adducts of EO (HbEO) as a biomarker. Higher HbEO levels were significantly associated with decreased albumin (Alb) levels (β = -0.79, 95% CI: -1.15, -0.43), whereas blood urea nitrogen (BUN) increased in the second and third exposure quartiles (Q2 β = 0.79, 95% CI: 0.34, 1.24; Q3 β = 0.81, 95% CI: 0.35, 1.27). In contrast, uric acid (UA) levels showed a significant inverse association with the highest quartile of HbEO exposure (β = -0.23, 95% CI: -0.36, -0.09). Continuous log10-transformed HbEO was also inversely associated with Alb, UA, and the UA/serum creatinine (Scr) ratio. Regarding lipid parameters, triglycerides, total cholesterol, and low-density lipoprotein showed no significant associations. However, EO exposure was negatively associated with high-density lipoprotein (HDL) levels (β = -3.57, 95% CI: -5.18, -1.96).Mediation analysis revealed that HDL mediated the relationships between EO and kidney parameters, explaining 6.51% of the association between EO and Alb, 12.44% with UA (inverse direction), and 11.01% with urinary creatinine. These findings suggest that EO exposure is associated with changes in kidney function and HDL levels, warranting further mechanistic research.
Keywords: Ethylene Oxide, Kidney parameters, Lipid profiles, Epidemiology, National Health and Nutrition Examination Survey
Received: 13 Nov 2024; Accepted: 09 May 2025.
Copyright: © 2025 Luo, Xu, Zhang, Wang, Kuang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Weiyong Zhang, Shenzhen Anorectal Hospital of Traditional Chinese Medicine, Shenzhen, China
Mingqin Kuang, Gynecology and Oncology Department of Ganzhou Cancer Hospital, Ganzhou, China
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