Abstract
BACKGROUND: Evidence linking urinary metabolites of volatile organic compounds (UMVOCs) to dyslipidemia remains limited and scarce. This research sought to thoroughly clarify the UMVOCs-dyslipidemia associations and evaluate the inflammation's mediating effect in this association. METHODS: Nationally representative data (from 6,962 enrolled participants) obtained from the National Health and Nutrition Examination Survey (NHANES) formed the basis of this analysis. We applied weighted logistic regression models for the assessment of relationship between individual UMVOC exposure and dyslipidemia, and weighted quantile sum (WQS) regression for the evaluation of the impact of co-exposure to multiple mixed UMVOCs on dyslipidemia. We performed mediation analysis for investigation into inflammation's role as a mediator, with white blood cell count (WBC), neutrophil count (NC), as well as lymphocyte count (LC) incorporated for the evaluation of their respective contributions to the overall mediation effect. RESULTS: Urinary concentrations of 34MHA and CEMA were positively linked to dyslipidemia, with respective odds ratios (OR) of 1.10 (95% confidence interval [CI]: 1.00-1.21) and 1.21 (95% CI: 1.08-1.35). Furthermore, through WQS regression analysis, we found that exposure to a mixture of 16 UMVOCs was significantly and positively linked to dyslipidemia (OR = 1.14, 95% CI: 1.04-1.24, P = 0.002), with CEMA making the greatest relative contribution (29.75%). Mediation analysis demonstrated that WBC, NC, and LC partially mediated the association between CEMA and dyslipidemia, accounting for 10.35%, 6.54%, and 6.52% of the total mediation effects, respectively (all P < 0.001). CONCLUSION: Simultaneous exposure to multiple UMVOCs is positively and significantly linked to the prevalence of dyslipidemia, with inflammation partially mediating this relationship. Our findings suggest that prolonged or high-level exposure to UMVOCs may contribute to dyslipidemia through inflammatory pathways, underscoring the potential metabolic health risks posed by environmental pollutants.