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. 2023 Apr 12;131(4):047009. doi: 10.1289/EHP11896

Figure 1.

Figure 1 is an illustration with three parts. On the top, the illustration is titled Population and has four steps. Step 1: Under Survey, there are 72 older adults aged 60 to 69 years with 353 measurements. From visits 1 to 5, blood and urine samples were collected. Step 2: organophosphate esters Step 3: Glycometabolism markers, including fasting plasma glucose, glycated serum protein, fasting insulin, and homeostatic model assessment for insulin resistance. Step 4: Transcriptome and metabolome, including genes and metabolites. In the middle, the illustration is titled Exposure–Outcome Association Analysis and has two steps. Step 1: Linear mixed-effects model: organophosphate esters include fasting plasma glucose, glycated serum protein, fasting insulin, and homeostatic model assessment for insulin resistance. Step 2: Quantile g-computation At the bottom, the illustration titled Multi-omics Integration has three steps. Step 1: Key organophosphate esters Step 2: The blood transcriptome, serum metabolome, and urine metabolome lead to causal inference tests plus Ingenuity Pathway Analysis. Step 3: Glycometabolism markers.

Overview of the study design. Diagram of the present study design. Internal OPE exposure of 76 healthy older Chinese adults 60–69 years of age with five monthly longitudinal sample (blood and urine) collections was characterized previously. Glycometabolic markers (FPG, GSP, FINS, and HOMA-IR) were measured, and multi-omics profiling (peripheral blood transcriptome, serum metabolome, and urine metabolome) was conducted. Exposure–health outcome associations and multi-omics integrative analyses were further used to identify the key OPEs and to interpret the biological mechanisms underlying the perturbations of glycometabolic markers, respectively. Note: CIT, causal inference test; FINS, fasting insulin; FPG, fasting plasma glucose; GSP, glycated serum protein; HOMA-IR, homeostatic model assessment for insulin resistance; IPA, Ingenuity Pathway Analysis; LMM, linear mixed-effects model; OPE, organophosphate ester; qgcomp, quantile g-computation.