Urine phthalate levels were associated with skin barrier dysfunction and atopic sensitization in children

초록

OBJECTIVE: Phthalates can cause immunological disorders and aggravate allergic diseases. Thus, we investigated the relationship between urinary phthalate, skin barrier function, and atopic sensitization in children. PATIENTS AND METHODS: In total, 448 school children [334 with severe allergic disease; and 123 with severe atopic dermatitis (AD)] aged 10-12 years were enrolled in this study between June and July 2017. Four high-molecular-weight phthalates (HMWP) [Sigma 4HMWP] and three low- molecular-weight phthalates ( LMWP) [ Sigma 3LMWP] metabolites in urine samples, specific immunoglobulin E (IgE), and total eosinophil count were measured. Four-part trans epidermal water loss (TEWL) (cheek, leg, and upper/ lower arm; Sigma 4TEWL) was measured to evaluate the skin barrier function. RESULTS: After adjusting for confounding variables, Sigma 4TEWL was significantly associated with the quartiles of urinary Sigma 4HMWP [adjusted ss=7.897, 95% confidence interval (CI): 0.636-15.158, p=0.033] and S3LMWP (adjusted ss=9.670, 95% CI: 2.422-16.919, p= 0.009). The adjusted analyses revealed that the quartiles of urinary Sigma 4HMWP and Sigma 3LMWP were not significantly associated with total eosinophil count, atopic sensitization, and severe AD (p>0.05). According to the quartiles of urinary Sigma 4HMWP and Sigma 3LMWP, there were significant differences in the TEWL of the lower arm and leg ( p< 0.05) but not in cheek and upper arm. CONCLUSIONS: Exposure to HMWPs and LMWPs was significantly associated with skin barrier dysfunction but not with atopic sensitization. These results suggest that children exposed to phthalates may be more susceptible to fragile skin barrier function.

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