Abstract
BACKGROUND: Ethylene oxide (EtO) has recently been linked to increased oxidative stress and related health disorders. Conversely, 25-hydroxyvitamin D [25(OH)D] concentrations are a well-recognized antioxidant with protective roles against oxidative damage. However, it remains unclear whether vitamin D deficiency is associated with elevated blood concentrations of EtO. Therefore, this study aimed to investigate the potential relationship between vitamin D deficiency and circulating EtO concentrations in the general population. METHODS: A total of 4125 adults who participated in the National Health and Nutrition Examination Survey 2013–2016 were analyzed. Participants were divided into 3 groups: vitamin D sufficiency [25(OH)D ≥ 75.0 nmol/L], insufficiency [25(OH)D: 50–74.9 nmol/L], and deficiency [25(OH)D < 50.0 nmol/L]. Adjusted linear and restricted cubic spline regression models were performed to evaluate the associations between vitamin D concentrations and blood concentrations of EtO. RESULTS: Compared with participants with vitamin D sufficiency, the adjusted mean EtO level was approximately 0.15 and 0.35 log-units higher in the presence of vitamin D insufficiency and vitamin D deficiency (P for trend < 0.01). The adjusted percent difference with a 95% confidence interval in EtO per interquartile range increase in 25(OH)D was − 1.17 (-1.71, -0.60). A restricted cubic spline model demonstrated that 25(OH)D concentrations are nonlinearly and inversely associated with blood concentrations of EtO (P for nonlinearity = 0.04). CONCLUSION: Our findings suggest that vitamin D deficiency is associated with an elevated blood concentration of EtO in a nationally representative sample of the United States population. Further research is warranted to understand how vitamin D may have a role in reducing blood concentrations of EtO. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-025-25400-6.