Urinary antimicrobials are associated with bile acid homeostasis and childhood obesity

Yuanping Wang; Pu Liu; Yi Wang; Ke Zhao; Chuanxi Tang; Jiaqi Liu; Wenjuan Cong; Mahableshwar Shankar Albur; Yibao Zhou; Hexing Wang; Yue Chen; Qingwu Jiang

doi:10.1016/j.ecoenv.2025.119566

Urinary antimicrobials are associated with bile acid homeostasis and childhood obesity

Yuanping Wang, Pu Liu, Yi Wang, Ke Zhao, Chuanxi Tang, Jiaqi Liu, Wenjuan Cong, Mahableshwar Shankar Albur, Yibao Zhou^*, Hexing Wang^*, Yue Chen, Qingwu Jiang

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

Abstract

Background:
Exposure to antimicrobials has been suggested to affect bile acid homeostasis and adipogenesis in the human body, but relevant studies remain limited in children.

Methods:
This study selected 1134 children in Shanghai and determined 26 of antimicrobials and metabolites in urine, including five human antimicrobials (HAs), eight veterinary antimicrobials (VAs), 10 human/veterinary antimicrobials (H/VAs), and three metabolites of H/VAs, as well as nine urinary bile acids, including cholic acid (CA), deoxycholic acid (DCA), chenodeoxycholic acid (CDCA), lithocholic acid (LCA), ursodeoxycholic acid (UDCA), glycocholic acid (GCA), glycodeoxycholic acid (GDCA), glycochenodeoxycholic acid (GCDCA), and glycoursodeoxycholic acid (GUDCA). Bile acid ratios were constructed to indicate their microbial transformation. Body mass index (BMI), waist circumference (WC), general and central overweight/obesity were used as adipogenesis-related indexes.

Results:
HAs, VAs, H/VAs or all antimicrobials was positively associated with LCA, GCDCA, and LCA/CDCA, but negatively associated with seven bile acids (UDCA, CDCA, DCA, CA, GCDCA, GDCA, and GCA) and three bile acid ratios (CDCA/GCDCA, UDCA/GUDCA, and CA/GCA). Urinary H/VAs or all antimicrobials was positively associated with BMI, WC, or central overweight/obesity. Compared to children with no detectable antimicrobials, those with high concentrations of H/VAs or all antimicrobials had a higher proportion of central overweight/obesity (OR=1.705, 95 %CI: 1.130–2.574; OR=1.603, 95 %CI: 1.105–2.327). A higher WC was observed in children with middle concentrations of H/VAs (β=2.104, 95 %CI: 0.200–4.008) or in children with middle (β=2.119, 95 %CI: 0.436–3.801) and high (β=2.203, 95 %CI: 0.567–3.839) concentrations of all antimicrobials. Mediation analyses showed that DCA, GUDCA, GDCA, and UDCA/GUDCA explained 0.3 %-7.1 % of the associations of H/VAs or all antimicrobials with WC or central overweight/obesity.

Conclusions:
Exposure to antimicrobials might be associated with altered bile acid homeostasis and increased risk of childhood obesity. Bile acid dysregulation might play a partial mediation in the association between antimicrobial exposure and childhood obesity.

Original language	English
Article number	119566
Number of pages	11
Journal	Ecotoxicology and Environmental Safety
Volume	309
Early online date	15 Dec 2025
DOIs	https://doi.org/10.1016/j.ecoenv.2025.119566
Publication status	Published - 1 Jan 2026

Bibliographical note

Publisher Copyright:
© 2025 The Authors.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Access to Document

10.1016/j.ecoenv.2025.119566Licence: CC BY-NC-ND

Handle.net

Persistent link

Cite this

@article{62e71ef7098d44b69d128a475f476620,

title = "Urinary antimicrobials are associated with bile acid homeostasis and childhood obesity",

abstract = "Background: Exposure to antimicrobials has been suggested to affect bile acid homeostasis and adipogenesis in the human body, but relevant studies remain limited in children. Methods: This study selected 1134 children in Shanghai and determined 26 of antimicrobials and metabolites in urine, including five human antimicrobials (HAs), eight veterinary antimicrobials (VAs), 10 human/veterinary antimicrobials (H/VAs), and three metabolites of H/VAs, as well as nine urinary bile acids, including cholic acid (CA), deoxycholic acid (DCA), chenodeoxycholic acid (CDCA), lithocholic acid (LCA), ursodeoxycholic acid (UDCA), glycocholic acid (GCA), glycodeoxycholic acid (GDCA), glycochenodeoxycholic acid (GCDCA), and glycoursodeoxycholic acid (GUDCA). Bile acid ratios were constructed to indicate their microbial transformation. Body mass index (BMI), waist circumference (WC), general and central overweight/obesity were used as adipogenesis-related indexes. Results: HAs, VAs, H/VAs or all antimicrobials was positively associated with LCA, GCDCA, and LCA/CDCA, but negatively associated with seven bile acids (UDCA, CDCA, DCA, CA, GCDCA, GDCA, and GCA) and three bile acid ratios (CDCA/GCDCA, UDCA/GUDCA, and CA/GCA). Urinary H/VAs or all antimicrobials was positively associated with BMI, WC, or central overweight/obesity. Compared to children with no detectable antimicrobials, those with high concentrations of H/VAs or all antimicrobials had a higher proportion of central overweight/obesity (OR=1.705, 95 \%CI: 1.130–2.574; OR=1.603, 95 \%CI: 1.105–2.327). A higher WC was observed in children with middle concentrations of H/VAs (β=2.104, 95 \%CI: 0.200–4.008) or in children with middle (β=2.119, 95 \%CI: 0.436–3.801) and high (β=2.203, 95 \%CI: 0.567–3.839) concentrations of all antimicrobials. Mediation analyses showed that DCA, GUDCA, GDCA, and UDCA/GUDCA explained 0.3 \%-7.1 \% of the associations of H/VAs or all antimicrobials with WC or central overweight/obesity. Conclusions: Exposure to antimicrobials might be associated with altered bile acid homeostasis and increased risk of childhood obesity. Bile acid dysregulation might play a partial mediation in the association between antimicrobial exposure and childhood obesity.",

author = "Yuanping Wang and Pu Liu and Yi Wang and Ke Zhao and Chuanxi Tang and Jiaqi Liu and Wenjuan Cong and Albur, \{Mahableshwar Shankar\} and Yibao Zhou and Hexing Wang and Yue Chen and Qingwu Jiang",

note = "Publisher Copyright: {\textcopyright} 2025 The Authors.",

year = "2026",

month = jan,

day = "1",

doi = "10.1016/j.ecoenv.2025.119566",

language = "English",

volume = "309",

journal = "Ecotoxicology and Environmental Safety",

issn = "0147-6513",

publisher = "Academic Press",

}

TY - JOUR

T1 - Urinary antimicrobials are associated with bile acid homeostasis and childhood obesity

AU - Wang, Yuanping

AU - Liu, Pu

AU - Wang, Yi

AU - Zhao, Ke

AU - Tang, Chuanxi

AU - Liu, Jiaqi

AU - Cong, Wenjuan

AU - Albur, Mahableshwar Shankar

AU - Zhou, Yibao

AU - Wang, Hexing

AU - Chen, Yue

AU - Jiang, Qingwu

PY - 2026/1/1

Y1 - 2026/1/1

N2 - Background: Exposure to antimicrobials has been suggested to affect bile acid homeostasis and adipogenesis in the human body, but relevant studies remain limited in children. Methods: This study selected 1134 children in Shanghai and determined 26 of antimicrobials and metabolites in urine, including five human antimicrobials (HAs), eight veterinary antimicrobials (VAs), 10 human/veterinary antimicrobials (H/VAs), and three metabolites of H/VAs, as well as nine urinary bile acids, including cholic acid (CA), deoxycholic acid (DCA), chenodeoxycholic acid (CDCA), lithocholic acid (LCA), ursodeoxycholic acid (UDCA), glycocholic acid (GCA), glycodeoxycholic acid (GDCA), glycochenodeoxycholic acid (GCDCA), and glycoursodeoxycholic acid (GUDCA). Bile acid ratios were constructed to indicate their microbial transformation. Body mass index (BMI), waist circumference (WC), general and central overweight/obesity were used as adipogenesis-related indexes. Results: HAs, VAs, H/VAs or all antimicrobials was positively associated with LCA, GCDCA, and LCA/CDCA, but negatively associated with seven bile acids (UDCA, CDCA, DCA, CA, GCDCA, GDCA, and GCA) and three bile acid ratios (CDCA/GCDCA, UDCA/GUDCA, and CA/GCA). Urinary H/VAs or all antimicrobials was positively associated with BMI, WC, or central overweight/obesity. Compared to children with no detectable antimicrobials, those with high concentrations of H/VAs or all antimicrobials had a higher proportion of central overweight/obesity (OR=1.705, 95 %CI: 1.130–2.574; OR=1.603, 95 %CI: 1.105–2.327). A higher WC was observed in children with middle concentrations of H/VAs (β=2.104, 95 %CI: 0.200–4.008) or in children with middle (β=2.119, 95 %CI: 0.436–3.801) and high (β=2.203, 95 %CI: 0.567–3.839) concentrations of all antimicrobials. Mediation analyses showed that DCA, GUDCA, GDCA, and UDCA/GUDCA explained 0.3 %-7.1 % of the associations of H/VAs or all antimicrobials with WC or central overweight/obesity. Conclusions: Exposure to antimicrobials might be associated with altered bile acid homeostasis and increased risk of childhood obesity. Bile acid dysregulation might play a partial mediation in the association between antimicrobial exposure and childhood obesity.

AB - Background: Exposure to antimicrobials has been suggested to affect bile acid homeostasis and adipogenesis in the human body, but relevant studies remain limited in children. Methods: This study selected 1134 children in Shanghai and determined 26 of antimicrobials and metabolites in urine, including five human antimicrobials (HAs), eight veterinary antimicrobials (VAs), 10 human/veterinary antimicrobials (H/VAs), and three metabolites of H/VAs, as well as nine urinary bile acids, including cholic acid (CA), deoxycholic acid (DCA), chenodeoxycholic acid (CDCA), lithocholic acid (LCA), ursodeoxycholic acid (UDCA), glycocholic acid (GCA), glycodeoxycholic acid (GDCA), glycochenodeoxycholic acid (GCDCA), and glycoursodeoxycholic acid (GUDCA). Bile acid ratios were constructed to indicate their microbial transformation. Body mass index (BMI), waist circumference (WC), general and central overweight/obesity were used as adipogenesis-related indexes. Results: HAs, VAs, H/VAs or all antimicrobials was positively associated with LCA, GCDCA, and LCA/CDCA, but negatively associated with seven bile acids (UDCA, CDCA, DCA, CA, GCDCA, GDCA, and GCA) and three bile acid ratios (CDCA/GCDCA, UDCA/GUDCA, and CA/GCA). Urinary H/VAs or all antimicrobials was positively associated with BMI, WC, or central overweight/obesity. Compared to children with no detectable antimicrobials, those with high concentrations of H/VAs or all antimicrobials had a higher proportion of central overweight/obesity (OR=1.705, 95 %CI: 1.130–2.574; OR=1.603, 95 %CI: 1.105–2.327). A higher WC was observed in children with middle concentrations of H/VAs (β=2.104, 95 %CI: 0.200–4.008) or in children with middle (β=2.119, 95 %CI: 0.436–3.801) and high (β=2.203, 95 %CI: 0.567–3.839) concentrations of all antimicrobials. Mediation analyses showed that DCA, GUDCA, GDCA, and UDCA/GUDCA explained 0.3 %-7.1 % of the associations of H/VAs or all antimicrobials with WC or central overweight/obesity. Conclusions: Exposure to antimicrobials might be associated with altered bile acid homeostasis and increased risk of childhood obesity. Bile acid dysregulation might play a partial mediation in the association between antimicrobial exposure and childhood obesity.

U2 - 10.1016/j.ecoenv.2025.119566

DO - 10.1016/j.ecoenv.2025.119566

M3 - Article (Academic Journal)

C2 - 41401549

SN - 0147-6513

VL - 309

JO - Ecotoxicology and Environmental Safety

JF - Ecotoxicology and Environmental Safety

M1 - 119566

ER -

Urinary antimicrobials are associated with bile acid homeostasis and childhood obesity

Abstract

Bibliographical note

UN SDGs

Access to Document

Handle.net

Fingerprint

Cite this