Pattern-based environmental antibiotic exposure associated with elevated cardiovascular risk and lipidomic disruption in children: a dual-center study
- 1Institute of Child and Adolescent Health & School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
- 2Corresponding author at: Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, UNESCO Chair on Global Health and Education of Peking University, No.38 Xueyuan Road, Haidian District, Beijing 100191, China.
Abstract
Childhood exposure to environmental antibiotics, particularly those related to veterinary use, may contribute to health risks, but evidence on the association between mixture patterns and childhood cardiovascular risk and underlying pathways remains limited. We aimed to identify reproducible urinary antibiotic exposure patterns in children, evaluate their associations with cardiovascular phenotypes, and explore potential lipidomic pathways. We analyzed data from two cohorts, the CBPEFC cohort (n = 584) and the 4C cohort (baseline, n = 686). Twenty-four urinary antibiotics were quantified by HPLC–MS/MS. Exposure patterns were derived using an integrated unsupervised clustering framework. Associations were assessed using generalized estimating equations (GEEs) and generalized linear models. Lipidomics was conducted in a small longitudinal subset and analyzed using multilevel PLS-DA, GEEs, LION enrichment, and mediation analysis. Two reproducible exposure patterns were identified: an azithromycin-high peak (AHP, 23.3–25.7%) and a ciprofloxacin-high peak (CHP, 74.3–76.7%). Compared with AHP, the CHP pattern was associated with higher SBP Z-score ( β = 0.145, 95% CI : 0.074 to 0.216), DBP Z-score ( β = 0.126, 95% CI : 0.025 to 0.228), and elevated blood pressure (EBP, OR = 1.512, 95% CI: 1.009 to 2.266). The CHP pattern was also associated with higher end-systolic volume ( β = 0.998, 95% CI: 0.085 to 1.911). Lipid dysregulation in the CHP group involved enrichment on glycerolipids, lipid droplets and lipid storage pathways, which were also implicated among blood pressure-associated lipids. Several glycerophospholipids showed evidence of potential indirect association though these did not remain statistically significant after multiple corrections. These findings suggest that the ciprofloxacin dominant pattern may represent a more adverse environmental exposure signature associated with cardiovascular health in children.
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BibTeX
@article{zhang2026patternbased,
title = {{Pattern-based environmental antibiotic exposure associated with elevated cardiovascular risk and lipidomic disruption in children: a dual-center study}},
author = {Yi Zhang and Xinli Song and Zhiying Song and Li Chen and Ruolin Wang and Jianuo Jiang and Jieyu Liu and Ziqi Dong and Zhenting Lu and Yinuo Li and Jun Ma and Yanhui Dong},
journal = {Environment International},
year = {2026},
month = oct,
doi = {10.1016/j.envint.2026.110523},
url = {https://doi.org/10.1016/j.envint.2026.110523},
note = {CC BY},
}
RIS
TY - JOUR
TI - Pattern-based environmental antibiotic exposure associated with elevated cardiovascular risk and lipidomic disruption in children: a dual-center study
AU - Yi Zhang
AU - Xinli Song
AU - Zhiying Song
AU - Li Chen
AU - Ruolin Wang
AU - Jianuo Jiang
AU - Jieyu Liu
AU - Ziqi Dong
AU - Zhenting Lu
AU - Yinuo Li
AU - Jun Ma
AU - Yanhui Dong
PY - 2026
DA - 2026/10/24
JO - Environment International
DO - 10.1016/j.envint.2026.110523
UR - https://doi.org/10.1016/j.envint.2026.110523
AB - Childhood exposure to environmental antibiotics, particularly those related to veterinary use, may contribute to health risks, but evidence on the association between mixture patterns and childhood cardiovascular risk and underlying pathways remains limited. We aimed to identify reproducible urinary antibiotic exposure patterns in children, evaluate their associations with cardiovascular phenotypes, and explore potential lipidomic pathways. We analyzed data from two cohorts, the CBPEFC cohort (n = 584) and the 4C cohort (baseline, n = 686). Twenty-four urinary antibiotics were quantified by HPLC–MS/MS. Exposure patterns were derived using an integrated unsupervised clustering framework. Associations were assessed using generalized estimating equations (GEEs) and generalized linear models. Lipidomics was conducted in a small longitudinal subset and analyzed using multilevel PLS-DA, GEEs, LION enrichment, and mediation analysis. Two reproducible exposure patterns were identified: an azithromycin-high peak (AHP, 23.3–25.7%) and a ciprofloxacin-high peak (CHP, 74.3–76.7%). Compared with AHP, the CHP pattern was associated with higher SBP Z-score ( β = 0.145, 95% CI : 0.074 to 0.216), DBP Z-score ( β = 0.126, 95% CI : 0.025 to 0.228), and elevated blood pressure (EBP, OR = 1.512, 95% CI: 1.009 to 2.266). The CHP pattern was also associated with higher end-systolic volume ( β = 0.998, 95% CI: 0.085 to 1.911). Lipid dysregulation in the CHP group involved enrichment on glycerolipids, lipid droplets and lipid storage pathways, which were also implicated among blood pressure-associated lipids. Several glycerophospholipids showed evidence of potential indirect association though these did not remain statistically significant after multiple corrections. These findings suggest that the ciprofloxacin dominant pattern may represent a more adverse environmental exposure signature associated with cardiovascular health in children.
SN - 0160-4120
ER -