Association Between Urinary Concentrations of Polycyclic Aromatic Hydrocarbons and Risk of Endometriosis in the NHANES 2003–2006

To explore the association between exposure to polycyclic aromatic hydrocarbons (PAHs) and endometriosis risk. Data were obtained from the 2003–2006 National Health and Nutrition Examination Survey database. Urinary concentrations of PAHs were divided into quartiles, and weighted multivariate logistic regression, restricted cubic spline, and subgroup analyses were performed. An extreme gradient boosting (XGBoost) algorithm was used to screen the most important PAHs. After multivariable adjustments, 9-fluorene, 1-phenanthrene, 2-phenanthrene, and 4-phenanthrene exposure were significantly associated with a risk of endometriosis. Specifically, compared with the reference group, the odds ratios (ORs) of endometriosis for the fourth quartile were 3.52 (95