Sex Differences in the Association of Urinary Concentrations of Phthalates Metabolites with Self-Reported Diabetes and Cardiovascular Diseases in Shanghai Adults

Dong, Ruihua; Zhao, Shanzhen; Zhang, Han; Chen, Jingsi; Zhang, Meiru; Wang, Min; Wu, Min; Li, Shuguang; Chen, Bin

doi:10.3390/ijerph14060598

Cited by 40 publications

(21 citation statements)

References 62 publications

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“…We detected an inverse association between MEHP and triglycerides, which did not remain significant after adjusting for multiple testing. Although Dong et al showed higher urinary levels of MMP to be associated with hyperlipidemia, they also found an inverse association between MEHP and hyperlipidemia in line with our findings 34 . In contrast, James-Todd et al found DEHP to be associated with hypertriglyceridemia 6 .…”

Section: Discussionsupporting

confidence: 92%

Exposure to Endocrine Disrupting Chemicals in the Dutch general population is associated with adiposity-related traits

Meer

Faassen

Beek

et al. 2020

Sci Rep

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endocrine Disrupting chemicals (eDcs) have been linked to a variety of cardiometabolic diseases. Yet, few studies have investigated the exposure to eDcs and cardiometabolic health taking lifestyle into account. We aimed to assess exposure to five parabens, three bisphenols and thirteen metabolites of in total eight phthalates in a general Dutch population and to investigate their association with cardiometabolic traits. In 662 adult subjects from the population-based Lifelines cohort, 21 EDC analytes were measured in 24-hour urine collected in 2012, using LC-MS/MS. Association analyses between cardiometabolic traits and eDc concentrations were performed using multivariate linear models adjusting for age, sex, education, smoking, diabetes, physical activity and caloric intake. Quartile analyses were performed to assess linearity. Bisphenol A, four parabens and eight phthalate metabolites were detected in 84-100% of the samples. Adjusted associations for MiBP and MBzP and adiposity-related traits were robust for multiple testing (Beta's, BMI: 1.12, 2.52; waist circumference: 0.64, 1.56, respectively; FDR < 0.009). Associations for triglyceride, HDL-cholesterol, glucose and blood pressure were not. Linearity was confirmed for significant associations. Exposure to EDCs in the Dutch population is ubiquitous. We found direct associations between phthalates and adiposity-related traits. Prospective studies are needed to confirm these findings. During the past decades, cardiovascular diseases (CVD) and type 2 diabetes (T2D) have risen to epidemic proportions 1,2. These diseases are responsible for severe complications including myocardial infarction, stroke, blindness, lower limb amputation and renal failure, and are strongly correlated with a collection of asymptomatic cardiometabolic abnormalities such as (central) obesity, impaired glucose tolerance, elevated triglycerides, a low HDL-cholesterol, and hypertension 3,4. A combination of at least three of the above stated cardiovascular abnormalities defines the metabolic syndrome (MetS) 1. Risk factors include a combination of genetic predisposition and lifestyle (e.g. lack of physical activity, imbalanced diet). Meanwhile, a wide variety of synthetic chemicals have been introduced in our environment, some of which have been shown to cause metabolic disruptions in animal and human studies 5. Endocrine Disrupting Chemicals (EDCs) such as parabens, phenols and phthalates have been shown to be associated with the MetS 6,7 , obesity 8,9 and T2D 10,11. These EDCs have in common that they are widely used as preservatives and plasticizers and can therefore be found in a wide variety of consumer products. Exposure occurs through ingestion, inhalation, and dermal contact 12,13. Although parabens, phenols and phthalates have in common that they are metabolized and excreted fairly quickly (i.e. half-lives <24 h) and therefore are considered non-persistent 14-16 , exposure is ubiquitous throughout life and reported to be global 17-20. However, to date little is known about exposure...

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Section: Discussionsupporting

confidence: 92%

Exposure to Endocrine Disrupting Chemicals in the Dutch general population is associated with adiposity-related traits

Meer

Faassen

Beek

et al. 2020

Sci Rep

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“…In this study, MECCP (3rd and 4th quartiles) and MEHHP (2nd and 4th quartiles) had significantly higher diabetes people than those of 1st quartile. Higher urinary phthalate metabolites were also associated with hyperlipidemia and stroke [ 11 ]. In the 2001–2008 study of diabetes prevalence in women in the U.S. National Health and Nutrition Survey, MBzP (3rd and 4th quartiles) had significantly higher diabetes people than those of 1st quartile [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…In studies conducted in countries such as China, the United States and the Middle East, the higher urinary phthalate metabolites, the higher the prevalence of diabetes. [ 11 12 13 ]…”

Section: Introductionmentioning

confidence: 99%

Relationship between urinary phthalate metabolites and diabetes: Korean National Environmental Health Survey (KoNEHS) cycle 3 (2015–2017)

Nam

Kim

Yang

et al. 2020

Ann Occup Environ Med

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Background We aimed to determine relationship diabetes according to urinary phthalate metabolites using adult data from Korean National Environmental Health Survey cycle 3 (2015–2017). Method This study was conducted on 3,781 adults aged 19 years and older (1,648 men and 2,133 women) based on KoNEHS cycle 3. Participants' data were analyzed by gender; Relationship between phthalate metabolites in the urine and diabetes was analyzed by dividing the sociodemographic variables, health behavior-related variables, and urinary phthalate metabolite concentrations into quartiles. To determine the relationship between urinary phthalate metabolites and the prevalence of diabetes, the odds ratio (OR) was calculated using logistic regression analysis. Results Based on the 1st quartile of each metabolite, the ORs for di-2-ethylhexyl phthalate (DEHP) (4th quartile), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) (2nd quartile, 3rd quartile and 4th quartile), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) (4th quartile), mono-(2-ethyl-5-carboxypentyl) phthalate (MECCP) (4th quartile), mono-n-butyl phthalate (MnBP) (3rd quartile and 4th quartile), mono-benzyl phthalate (MBzP) (2nd quartile) and 4th quartile), and mono (3-carboxypropyl) phthalate (MCPP) (3rd quartile and 4th quartile) were significantly higher after the adjustment in men. The ORs for DEHP (2nd quartile, 3rd quartile and 4th quartile), MEHHP (2nd quartile, 3rd quartile and 4th quartile), MEOHP (4th quartile), MECCP (4th quartile), MBzP (4th quartile), and MCPP (4th quartile) were significantly higher after the adjustment in women. Conclusion This study investigated relationship between urinary phthalate metabolites and diabetes. The higher urinary phthalate metabolites, the higher the prevalence of diabetes. Further regulation of phthalate may be needed, and further studies are warranted to confirm the association between phthalate concentration and other chronic diseases (such as hypertension, hyperlipidemia, and cardiovascular disease).

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“…Several epidemiological studies have demonstrated that regular exposure to phthalates is associated with an increased risk of non-communicable chronic diseases including cardiovascular diseases and diabetes (Dong et al 2017; Bai et al 2017). Limited information is known about the association between phthalates exposure and the prevalence of asthma (Benjamin et al 2017), with available evidence producing inconsistent results.…”

Section: Introductionmentioning

confidence: 99%

Phthalates and asthma in children and adults: US NHANES 2007–2012

Odebeatu

Taylor

Fleming

et al. 2019

Environ Sci Pollut Res

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Environmental exposure to phthalates may contribute to an increased risk of asthma in children and adults. We aimed to assess the direction and strength of the association between urinary phthalates metabolites and current asthma in children and adults that participated in the National Health and Nutrition Examination Survey (NHANES) 2007–2012. Data on ten urinary phthalate metabolites, self-reported questionnaires, spirometry measures, and covariates were obtained from 7765 participants (28.1% were children aged 6–17 years) taking part in the NHANES 2007–2012. Asthma was assessed using self-reported questionnaires for children and adults, and via spirometry measures for adults alone. We used crude and adjusted logistic regression models to estimate the odds ratios (ORs) and 95% confidence interval (CI) per one log10 unit change in the concentration of phthalate metabolites. We further modeled the effect modification by sex. Out of 10 metabolites, only mono-benzyl phthalate (MBzP) was positively associated with the prevalence of self-reported asthma in children, after adjusting for a range of potential confounders (odds ratio 1.54; 95% confidence interval 1.05–2.27). No significant relationship was observed for adults. The association of mono-ethyl phthalate (MEP) was modified by sex, with significantly increased odds of asthma among males [boys (2.00; 1.14–3.51); adult males (1.32; 1.04–1.69)]. While no other phthalates showed a positive relationship with current asthma in males, mono-(carboxynonyl) phthalate (MCNP) and mono-(3-carboxylpropyl) phthalate (MCPP) were inversely associated with spirometrically defined asthma in adult females. A sex-specific relationship in adults was evident when spirometry, but not self-reported measures were used to define asthma. We found no clear association between exposure to phthalates and current asthma, except for a significant relationship between MBzP metabolites and self-reported asthma in children. As a result, exposure to phthalates and asthma development and/or exacerbations remains controversial, suggesting a need for a well-designed longitudinal study.Electronic supplementary materialThe online version of this article (10.1007/s11356-019-06003-2) contains supplementary material, which is available to authorized users.

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Sex Differences in the Association of Urinary Concentrations of Phthalates Metabolites with Self-Reported Diabetes and Cardiovascular Diseases in Shanghai Adults

Cited by 40 publications

References 62 publications

Exposure to Endocrine Disrupting Chemicals in the Dutch general population is associated with adiposity-related traits

Exposure to Endocrine Disrupting Chemicals in the Dutch general population is associated with adiposity-related traits

Relationship between urinary phthalate metabolites and diabetes: Korean National Environmental Health Survey (KoNEHS) cycle 3 (2015–2017)

Phthalates and asthma in children and adults: US NHANES 2007–2012

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