Analysis of clinical and epidemiological interactions of phenol and phthalate levels in blood and urine with anamnestic and biochemical health measures during the formation of multisystem organ pathology

Background. Phenol and its derivatives (eg. parabens), phthalates and a number of other aromatic compounds exhibit various toxic effects when entering the human body due to unfavorable ecology, smoking, intake with food and medications. Integrated clinical and epidemiological studies into the clinical consequences of such effects are currently lacking.

Objective: To identify patient history parameters that are significantly associated with blood and urine levels of phenols and urine levels of phthalates.

Material and methods. The database of the UNESCO Institute for Microelements was used to compile a sample of patient descriptions (n=2746) containing information on the serum and/or urine levels of phenol and urine levels of phthalates. The data sample was analyzed using the methods of Zhuravlev–Rudakov topological and metric data analysis, as well as parametric and nonparametric statistics. The data analysis was carried out in three stages: (1) identification of statistically significant pairwise interactions by the methods of topological data analysis; (2) identification of clusters of pairwise interactions; (3) description of the obtained patterns in the form of metric diagrams, topological “interaction formulas” and “interaction types”.

Results. Higher urine levels of phenol were associated with increased levels of bone and cartilage destruction markers, hematopoiesis disorders (decreased hemoglobin and mean corpuscular volume), liver and kidney dysfunction (increased creatinine and albumin levels), decreased systolic blood pressure (hypotension) in the setting of lower intake of fiber, vitamins E, A, C, B2, B6, folates, and magnesium. Higher urine phenol concentrations were correlated with higher levels of a smoking biomarker (cotinine), indicating that smoking is a significant source of phenol and its derivatives in the human body. Higher blood phenol concentrations were associated with a history of smoking, asthma, type 2 diabetes mellitus (T2DM), vasomotor paroxysms (hot flashes), and pain symptoms. Significantly higher blood phenol concentrations were found in participants not taking vitamin and mineral supplements (VMS). Higher urine phthalate levels were found in patients with chronic obstructive pulmonary disease (COPD), alcoholism, pain symptoms (headaches, lower back and leg pain), diabetic polyneuropathy, hematopoiesis disorders (increased erythrocyte distribution width), cartilage homeostasis, liver dysfunction, kidney dysfunction and, in general, a decreased quality of life. Elevated urine phthalate levels corresponded to a lower intake of vitamins A, C, B2, B12, folates, cobalt, iron and lutein n the setting of higher blood concentrations of toxic cadmium, lead and cotinine. This confirms the correlation between smoking and increased concentrations of phenol and its derivatives.

Conclusion. Elevated urine levels of phenols and phthalates and blood serum levels of phenols are associated with a number of socially significant chronic pathologies (T2DM, COPD, pain, cartilage, and bone homeostasis disorders) and with lower VMS intakes. Thus, correction of the vitamin and microelement status is an ffective approach to supporting the body's detoxification systems against the negative impact of phenol and its derivatives.

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