Exposome and childhood multimorbidity

This project aims at studying multimorbidity/global health indicator in childhood and its environmental determinants (lifestyle, urban and chemical exposures). The approach considered is to create a multimorbidity/global health indicator considering cardiometabolic, child behavior, respiratory and allergy-related variables. To do so, statistical approaches that are considered are cluster-based analysis to identify health profiles and the development of a global health score. Then, the associations between the multimorbidity/global health indicator and environmental factors will be assessed, separately for lifestyle, urban exposures and chemical exposures (endocrine disruptors). For the lifestyle factors, an ExWAS approach is considered, and will be the base of a descriptive publication of the global health approach in childhood (first publication). For the urban exposome, multi-exposure models will be added to the ExWAS, such as DSA and LASSO (second publication). Finally, the association with chemical endocrine disruptors (phenols, phthalates) will be assessed with statistical methods such as ExWAS, DSA, LASSO, BKMR and/or BWQS (third publication).

Variables included in the project:
– Cardiometabolic outcomes: waist circumference (or BMI), lipids, blood pressure, insulin or glucose
– Mental outcomes: ADHD, internalizing, externalizing, Non-Verbal Intelligence test (optional)
– Respiratory outcomes: asthma, rhinitis, eczema, food allergy, FEV1 (optional).
– Exposures: lifestyle factors, urban exposures and chemical endocrine disruptors (phenols, phthalates)
– Covariates: cohort, age, sex, birth parameters, ethnicity or country of birth, social (parental education, parental marital status, parental occupation, household income, area-level deprivation index). To confirm through DAGs.
Regarding age at health outcomes assessment, we will seek for the best compromise to limit the variability between the different cohorts included in this analysis.