title: Antibiotics detected in urines and adipogenesis in school children.
abstract: BACKGROUND
  Although antibiotic use during early life has been demonstrated to be related to the altered adipogenesis in later life, limited data are available for the effect of antibiotic exposure in school children on adiposity from various sources, including from the use or contaminated food or drinking water.
  
  
  OBJECTIVE
  To explore the association between the internal exposure of antibiotics from various sources and adipogenesis in school children using the biomonitoring of urinary antibiotics.
  
  
  METHODS
  After 586 school children aged 8-11years were selected from Shanghai in 2013, total urinary concentrations (free and conjugated) of 21 common antibiotics from six categories (macrolides, β-lactams, tetracyclines, fluoroquinolones, sulfonamides, and phenicols), including five human antibiotics (HAs), two antibiotics preferred as HA, four veterinary antibiotics (VAs), and ten antibiotics preferred as VA, were measured by ultra-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry. Creatinine-corrected urinary concentrations of antibiotics were used to assess their exposure. Overweight or obesity was determined by the body mass index or waist circumference-based criteria deriving from national data.
  
  
  RESULTS
  All 21 antibiotics were found in urines with the overall detection frequency of 79.6%. The multinomial logistic regression analyses showed the significant associations of overweight and obesity with the exposure to VAs and antibiotics preferred as VA, but not with HAs or antibiotics preferred as HA. After adjusted for a number of obesity-relevant variables, the odds ratios (95% confidence interval) of BMI-based obesity risk of tertiles 2 and 3 of urinary concentrations relative to tertile 1 were respectively 2.54 (1.27, 5.07) and 2.92 (1.45, 5.87) for florfenicol, 0.57 (0.12, 2.63) and 3.63 (1.41, 9.32) for trimethoprim, and 3.00 (1.56, 5.76) and 1.99 (0.99, 4.01) for sum of veterinary antibiotics. Similar results were found when the outcome used WC-based obesity risk. The associations were sex related and mainly observed in boys.
  
  
  CONCLUSIONS
  Some types of antibiotic exposure, which were mainly from food or drinking water, were associated with an increased risk of obesity in school children. Due to the cross-sectional design, more longitudinal and experimental studies are warranted to further test these findings.
authors.affiliation: Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
authors.forename: Hexing
authors.initials: H
authors.lastname: Wang
authors.affiliation: Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
authors.forename: Na
authors.initials: N
authors.lastname: Wang
authors.affiliation: Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.affiliation: Minhang District Center for Disease Control and Prevention, Minhang District, Shanghai 201101, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Fang
authors.affiliation: Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
authors.forename: Chaowei
authors.initials: C
authors.lastname: Fu
authors.affiliation: Changning District Center for Disease Control and Prevention, Changning District, Shanghai 200051, China.
authors.forename: Chuanxi
authors.initials: C
authors.lastname: Tang
authors.affiliation: Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Jiang
authors.affiliation: Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
authors.forename: Gengsheng
authors.initials: G
authors.lastname: He
authors.affiliation: Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China. Electronic address: zhaoqi@shmu.edu.cn.
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhao
authors.affiliation: School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario K1H8M5, Canada.
authors.forename: Yue
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
authors.forename: Qingwu
authors.initials: Q
authors.lastname: Jiang
mesh_terms: D050156:Adipogenesis / Q000187:drug effects*; D050154:Adiposity / Q000187:drug effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D015992:Body Mass Index; D002648:Child; D002681:China; D003430:Cross-Sectional Studies; D004784:Environmental Monitoring / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000652:urine; D050177:Overweight / Q000453:epidemiology / Q000652:urine*; D012306:Risk; D055105:Waist Circumference
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers
keywords: Antibiotics; Biomonitoring; Obesity; School children; Urine; Use