Environmental Risks for Obesity, Diabetes & Kidney Disease in Children
Led by principal investigator Leonardo Trasande, MD, MPP, researchers in NYU Langone’s Division of Environmental Pediatrics are conducting two studies to investigate how children’s health is affected by exposure to commonly used chemicals known as bisphenol A (BPA) and phthalates.
Environmental Oxidant Stressors in Pediatric Chronic Kidney Disease
With funding from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), we assess the effect of exposure to BPA and phthalates on children with chronic kidney disease.
Chronic kidney disease can be caused by congenital abnormalities of the genitourinary tract or by acquired glomerular disorders. Regardless of the underlying etiology, current treatment yields disappointing outcomes, and many affected children progress to end-stage kidney disease. It is important to identify modifiable factors that impact the clinical course of chronic kidney disease in order to design interventions that can be adjuncts to medical therapy for affected children.
BPA and phthalate metabolites, which are commonly found in processed foods, have been shown to cause oxidant stress, are associated with obesity and hypertension in children, and have been linked to increased risk of cardiovascular disease in adults. Preliminary data suggest that exposure to BPA and phthalates is associated with an increase in low-grade albuminuria in healthy children. However, the implications for these exposures in children who are more vulnerable because of medical conditions such as chronic kidney disease have not been studied.
Our study analyzes stored biosamples that were obtained during four NIDDK-funded clinical studies (CKiD, NEPTUNE, FSGS Clinical Trial, and the FONT trial) and compares two groups of children with chronic kidney disease, one with focal segmental glomerulosclerosis and one with nonglomerular disease, to assess the effect of exposure to environmental oxidant stressors.
Phthalates, Bisphenol A, Trajectories of In and Ex Utero Growth, and Cardiometabolic Risks
With funding from the National Institute of Environmental Health Sciences, research teams at NYU Grossman School of Medicine, Erasmus University Medical Center, and the New York State Department of Health are leading a study to examine prenatal and childhood phthalate and BPA exposures in relationship to fetal growth, body mass, insulin resistance, fat mass, and blood pressure in childhood.
The phthalate di-2-ethylhexyl phthalate and its metabolites are chemicals commonly found in processed foods and have been associated with childhood obesity and insulin resistance. BPA, which is used to manufacture a polycarbonate resin used to coat food and beverage containers, has been found to produce molecular hallmarks of obesity and insulin resistance.
Our study is based on the analysis of samples provided by 1,431 pregnant women at 3 points in their pregnancies, as well as samples from their babies obtained at 2 points in childhood. We obtained these samples from Generation R, a prospective, longitudinal multi-ethnic birth cohort study that has longitudinally followed 9,778 pregnancies with birth dates between 2002 and 2006. This will permit examination of period-specific associations of phthalate metabolites and BPA with body mass, insulin resistance, and cardiovascular risks. The project endeavors to challenge the existing clinical–practice paradigm that obesity prevention should focus only on improved energy balance in favor of an approach that also recognizes the role of chemical factors in the environment that may impart risk independently.