2025 / 06 Attending Physician Hui-Ju Tsai (Division of Family Medicine, KMSH)

Studies concerning the effect of co-exposure to melamine and phthalates on kidney function in children are rare. Thus, this study examines the above-mentioned relationship and their sex-different effect. Whether the exposure of the two chemicals from their mothers, when children were in the womb during the third trimester, affected renal injury markers in children afterwards is also examined. This study was from Taiwan Maternal and Infant Cohort Study cohort established in October 2012 to enroll third-trimester pregnant mothers up to May 2015. Their offspring were subsequently recruited between 2016 and 2020 as our study children. One-spot urine specimens were collected from both pregnant mothers (2012-2015) and study children (2016-2020) for the simultaneous measurement of melamine and 11 phthalate metabolites. Daily intakes of melamine and five phthalates, including DEHP (di-2-ethylhexylphthalate), DiBP (Dibutyl phthalate), DnBP (Di-n-butyl phthalate), BBzP (Butyl benzyl phthalate), and DEP (Diethyl phthalate), were estimated using a creatinine excretion-based model in both study children and their mothers. Two early markers of renal injury, microalbumin and N-acetyl-beta-D-glucosaminidas (NAG), were measured in urine samples of study children (2016-2020). A total of 552 eligible children were studied, with a mean age of 4 years. We found that boys in the highest quartile of estimated melamine intake (≥ 0.68 µg/kg/day) had significantly higher urine ACR levels and in the highest quartile of estimated phthalate intake of DEHP (≥ 5.36 µg/kg/day), DEP (≥ 0.89 µg/kg/day), and DiBP (≥ 1.19 µg/kg/day) had significantly higher urine NAG levels when compared to the combined three lowest quartile ones as comparison groups. No significant associations were found between their mothers’ phthalates and melamine intake during the third trimester and urine ACR and NAG in children. We conclude that children (particularly boys) with high co-exposure of melamine and certain phthalate chemicals among children have increased early markers of kidney injury.

Application and Highlights:

1. Melamine and phthalates are two common and potential environmental nephrotoxins.
2. This study aims to examine the interactive relationship of environmental melamine and/or phthalate exposures with early markers of renal injury in children in total and by sex.
3. Boys with high exposure of melamine and certain phthalate chemicals (DEHP, DEP, and DiBP) have increased markers of early kidney damages.
4. The same significant results were not found in girls.

出處:
Tsai HJ, Wu CF, Li SS, Chen JJ, Hsieh CJ, Chen CC, Wang SL, Chen ML, Wu MT*. Sex-specific Association of Co-exposures to Melamine and Phthalates in Children with Their Early Renal Injury. Environmental Pollution. 2025 Jun 1;374:126206. (SCIE, IF₂₀₂₄: 7.3, 47/376=12.30% in ENVIRONMENTAL SCIENCES)

團隊簡介:
The Taiwan Maternal and Infant Cohort Study (TMICS) team comprises Prof. Ming-Chang Wu and Associate Prof. Hui-Ru Tsai from the Department of Family Medicine at Kaohsiung Medical University; Research Fellows Shu-Li Wang and Chu-Chih Chen from the National Health Research Institutes (NHRI); Prof. Mei-Lien Chen from National Yang Ming Chiao Tung University; Associate Prof. Chia-Jung Hsieh from Tzu Chi University; and Assistant Research Fellow Chia-Fang Wu from Academia Sinica. Since 2012, the team has conducted long-term follow-up of women across Taiwan and their offspring to investigate the relationships between environmental exposures and health outcomes, and has continuously published multiple papers in high-impact journals.