ALT "... These effects on cardiovascular and endocrine systems are likely to be multifactorial, but both population-based and experimental studies point to inflammation, oxidative stress, and hormone imbalances as potential mediators. Chemical compounds that are usually present in the composition of plastics have been seen to have endocrine-disrupting properties and can alter both hormone homeostasis and signal transduction pathways [26], thereby increasing the risk of adverse health outcomes. So, from cellular and endocrine signal disruption, chronic exposure may lead to relevant and manifest clinical outcomes as found in our study's population. Regarding kidney disease, again our results seem to be in agreement with what is actually known about plastic exposure and the higher prevalence of kidney health issues."

ALT "Moreover, as well as cardiovascular diseases, a recent systematic review and meta-analysis showed that, also in kidney diseases, bisphenol A has been counted among possible risk factors . An in vitro study showed that MNPs can enter the cells through endocytosis, causing damage to cellular microstructures and an increase in the expression of JNK1/2/3 and TNF-a, a pathway involved in cancer-related pathways [28]. Regarding the gastrointestinal tract (GIT), we found an increased likelihood between the assumption of BW and the presence of gastric or duodenal ulcers. Some animal models have shown MNPs can cause intestinal barrier dysfunction by epithelial cell apoptosis through ROS production [29], and other studies have found that the presence of several types of plastic particles can alter the gut microbial composition, diversity, and metabolic pathways, which may disrupt nutrient metabolism, ultimately breaking gut homeostasis and promoting inflammation [30]."