Association between exposure to a mixture of organochlorine pesticides and hyperuricemia in U.S.adults:A comparison of four statistical models

The association between the exposure of organochlorine pesticides(OCPs)and serum uric acid(UA)levels remained uncertain.In this study,to investigate the combined effects of OCP mixtures on hyperuricemia,we analyzed serum OCPs and UA levels in adults from the National Health and Nutrition Examination Survey(2005–2016).Four statistical models including weighted logistic regression,weighted quantile sum(WQS),quantile g-computation(QGC),and bayesian kernel machine regression(BKMR)were used to assess the relationship between mixed chemical exposures and hyperuricemia.Subgroup analyses were conducted to explore potential modifiers.Among 6,529 participants,the prevalence of hyperuricemia was 21.15%.Logistic regression revealed a significant association between both hexachlorobenzene(HCB)and trans-nonachlor and hyperuricemia in the fifth quintile(OR:1.54,95%CI:1.08–2.19;OR:1.58,95%CI:1.05–2.39,respectively),utilizing the first quintile as a reference.WQS and QGC analyses showed significant overall effects of OCPs on hyperuricemia,with an OR of 1.25(95%CI:1.09–1.44)and 1.20(95%CI:1.06–1.37),respectively.BKMR indicated a positive trend between mixed OCPs and hyperuricemia,with HCB having the largest weight in all three mixture analyses.Subgroup analyses revealed that females,individuals aged 50 years and above,and those with a low income were more vulnerable to mixed OCP exposure.These results highlight the urgent need to protect vulnerable populations from OCPs and to properly evaluate the health effects of multiple exposures on hyperuricemia using mutual validation approaches.