loading page

Association of phthalate exposure and airway dysfunction, with mediation by serum periostin
  • +5
  • Heysung Baek,
  • Ha Young Won,
  • Ju Hee Kim,
  • Eun Kyo Ha,
  • Hye Mi Jee,
  • Youn Ho Shin,
  • Mi Ae Kim,
  • Man Yong Han
Heysung Baek
Hallym University Kangdong Sacred Heart Hospital

Corresponding Author:[email protected]

Author Profile
Ha Young Won
Clinical Research Institute, Kangdong Sacred Heart Hospital, Hallym University College of Medicine
Author Profile
Ju Hee Kim
CHA Bundang Medical Center
Author Profile
Eun Kyo Ha
CHA University School of Medicine
Author Profile
Hye Mi Jee
CHA University School of Medicine
Author Profile
Youn Ho Shin
CHA Gangnam Medical Center, CHA University School of Medicine
Author Profile
Mi Ae Kim
, CHA Medical Center, CHA University School of Medicine
Author Profile
Man Yong Han
CHA University School of Medicine
Author Profile


Background: Phthalates can cause respiratory and immunological disorders. However, little is known about the role of serum periostin and YKL-40 levels in mediating the effects of phthalates. We investigated the mediating role of these biomarkers in the relationship between phthalates and airway dysfunction. Methods: A total of 487 children (aged 10 to 12 years-old) were examined. Four high-molecular-weight phthalate (HMWP) [Σ4HMWP] metabolites and 3 low-molecular-weight phthalate (LMWP) [Σ3LMWP] metabolites in urine samples were measured. Serum periostin and YKL-40 levels were measured. Airway function was measured using impulse oscillometry. A mediation model was used to quantify the mediating effects of periostin and YKL-40 on airway dysfunction. Results: After adjustment for height, gender, BMI z-score, aeroallergen sensitization, secondary smoking, and vitamin D level, the level of urinary Σ3LMWP metabolites was significantly associated with respiratory system resistance at 5 Hz (Rrs5; adjusted β: 0.020, 95% CI: 0.005 to 0.034; P = .010). The levels of urinary Σ4HMWP and Σ3LMWP metabolites were significantly associated with periostin level, but not with YKL-40 level. In addition, the periostin level was associated with Rrs5 (adjusted β: 0.048, 95% CI: 0.015 to 0.081; P = .005) and Rrs20-5 (adjusted β: 0.040, 95% CI: 0.011 to 0.069; P =.007). Serum periostin level had a significant effect in mediating the relationship between Σ3LMWP and Rrs5 (13.9%, 95% CI: 10.7 to 77.0; P < .001). Conclusion: Exposure to LMWPs was significantly associated with airway dysfunction, and this effect was partially attributable to increased serum periostin level.
12 Nov 2020Submitted to Pediatric Allergy and Immunology
18 Nov 2020Reviewer(s) Assigned
04 Dec 2020Review(s) Completed, Editorial Evaluation Pending
10 Dec 2020Editorial Decision: Revise Major
10 Mar 20211st Revision Received
11 Mar 2021Review(s) Completed, Editorial Evaluation Pending
17 Mar 2021Reviewer(s) Assigned
24 Mar 2021Editorial Decision: Revise Minor
23 Jun 20212nd Revision Received
23 Jun 2021Review(s) Completed, Editorial Evaluation Pending
23 Jun 2021Reviewer(s) Assigned
24 Jun 2021Editorial Decision: Accept
Nov 2021Published in Pediatric Allergy and Immunology volume 32 issue 8 on pages 1681-1690. 10.1111/pai.13602