Urinary phthalate metabolite concentrations and diabetes among women in the National Health and Nutrition Examination Survey (NHANES) 2001-2008.

Abstract

BACKGROUND:

Previous studies have shown that women have higher urinary concentrations of several phthalate metabolites than do men, possibly because of a higher use of personal care products. Few studies have evaluated the association between phthalate metabolites, diabetes, and diabetes-related risk factors among women.

OBJECTIVE:

We explored the association between urinary phthalate metabolite concentrations and diabetes among women who participated in a cross-sectional study.

METHODS:

We used urinary concentrations of phthalate metabolites, analyzed by the Centers for Disease Control and Prevention, and self-reported diabetes of 2,350 women between 20 and 79 years of age who participated in the NHANES (2001-2008). We used multiple logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) and adjusted for urinary creatinine, sociodemographic characteristics, dietary factors, and body size. A secondary analysis was conducted for women who did not have diabetes to evaluate the association between phthalate metabolite concentrations and fasting blood glucose (FBG), homeostasis model assessment-estimated insulin resistance, and glycosylated hemoglobin A1c.

RESULTS:

After adjusting for potential confounders, women with higher levels of mono-n-butyl phthalate (MnBP), mono-isobutyl phthalate (MiBP), monobenzyl phthalate (MBzP), mono-(3-carboxypropyl) phthalate (MCPP), and three di-(2-ethylhexyl) phthalate metabolites (ΣDEHP) had an increased odds of diabetes compared with women with the lowest levels of these phthalates. Women in the highest quartile for MBzP and MiBP had almost twice the odds of diabetes [OR = 1.96 (95% CI: 1.11, 3.47) and OR = 1.95 (95% CI: 0.99, 3.85), respectively] compared with women in the lowest quartile. Nonmonotonic, positive associations were found for MnBP and ΣDEHP, whereas MCPP appeared to have a threshold effect. Certain phthalate metabolites were positively associated with FBG and insulin resistance.

DISCUSSION:

Urinary levels of several phthalates were associated with prevalent diabetes. Future prospective studies are needed to further explore these associations to determine whether phthalate exposure can alter glucose metabolism and increase the risk of insulin resistance and diabetes.

• Authors: Tamarra James-Todd, Richard Stahlhut, John D Meeker, Sheena-Gail Powell, Russ Hauser, Tianyi Huang, Janet Rich-Edwards
• Journal: Environmental health perspectives (Environ Health Perspect) Vol. 120 Issue 9 Pg. 1307-13 (Sep 2012) ISSN: 1552-9924 [Electronic] United States
• PMID: 22796563 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Environmental Pollutants
• Phthalic Acids

Topics

• Adult
• Aged
• Cross-Sectional Studies
• Diabetes Mellitus (chemically induced, epidemiology)
• Environmental Exposure
• Environmental Monitoring
• Environmental Pollutants (urine)
• Female
• Humans
• Logistic Models
• Middle Aged
• Nutrition Surveys
• Phthalic Acids (urine)
• Risk Factors
• United States (epidemiology)
• Young Adult