Urinary Phthalate Biomarkers and Bone Mineral Density in Postmenopausal Women.

Abstract

CONTEXT:

Phthalates are endocrine-disrupting chemicals that could disrupt normal physiologic function, triggering detrimental impacts on bone.

OBJECTIVE:

We evaluated associations between urinary phthalate biomarkers and BMD in postmenopausal women participating in the prospective Women's Health Initiative (WHI).

METHODS:

We included WHI participants enrolled in the BMD substudy and selected for a nested case-control study of phthalates and breast cancer (N = 1255). We measured 13 phthalate biomarkers and creatinine in 2 to 3 urine samples per participant collected over 3 years, when all participants were cancer free. Total hip and femoral neck BMD were measured at baseline and year 3, concurrent with urine collection, via dual-energy x-ray absorptiometry. We fit multivariable generalized estimating equation models and linear mixed-effects models to estimate cross-sectional and longitudinal associations, respectively, with stratification on postmenopausal hormone therapy (HT) use.

RESULTS:

In cross-sectional analyses, mono-3-carboxypropyl phthalate and the sum of di-isobutyl phthalate metabolites were inversely associated with total hip BMD among HT nonusers, but not among HT users. Longitudinal analyses showed greater declines in total hip BMD among HT nonusers and with highest concentrations of mono-3-carboxyoctyl phthalate (-1.80%; 95% CI, -2.81% to -0.78%) or monocarboxynonyl phthalate (-1.84%; 95% CI, -2.80% to -0.89%); similar associations were observed with femoral neck BMD. Among HT users, phthalate biomarkers were not associated with total hip or femoral neck BMD change.

CONCLUSION:

Certain phthalate biomarkers are associated with greater percentage decreases in total hip and femoral neck BMD. These findings suggest that phthalate exposure may have clinically important effects on BMD, and potentially fracture risk.

• Authors: Katherine W Reeves, Gabriela Vieyra, Nydjie P Grimes, Jaymie Meliker, Rebecca D Jackson, Jean Wactawski-Wende, Robert Wallace, R Thomas Zoeller, Carol Bigelow, Susan E Hankinson, JoAnn E Manson, Jane A Cauley, Antonia M Calafat
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 106 Issue 7 Pg. e2567-e2579 (06 16 2021) ISSN: 1945-7197 [Electronic] United States
• PMID: 33754148 (Publication Type: Evaluation Study, Journal Article, Research Support, N.I.H., Extramural)
• Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: [email protected].

Chemical References

• Biomarkers
• Endocrine Disruptors
• Phthalic Acids
• phthalic acid
• Creatinine

Topics

• Absorptiometry, Photon
• Aged
• Biological Monitoring
• Biomarkers (urine)
• Bone Density
• Case-Control Studies
• Creatinine (urine)
• Cross-Sectional Studies
• Endocrine Disruptors (urine)
• Environmental Exposure (analysis)
• Estrogen Replacement Therapy
• Female
• Femur Neck (diagnostic imaging)
• Humans
• Longitudinal Studies
• Middle Aged
• Osteoporosis, Postmenopausal (complications, diagnostic imaging, prevention & control)
• Osteoporotic Fractures (etiology, prevention & control)
• Pelvic Bones (diagnostic imaging)
• Phthalic Acids (urine)
• Postmenopause (urine)
• Prospective Studies
• Risk Factors
• Women's Health