Urinary phthalates and increased insulin resistance in adolescents.

Abstract

BACKGROUND:

Di-2-ethylhexylphthalate (DEHP) is an environmental chemical commonly found in processed foods. Phthalate exposures, in particular to DEHP, have been associated with insulin resistance in adults, but have not been studied in adolescents.

METHODS:

Using cross-sectional data from 766 fasting 12- to 19-year-olds in the 2003-2008 NHANES, we examined associations of phthalate metabolites with continuous and categorical measures of homeostatic model assessment of insulin resistance (HOMA-IR).

RESULTS:

Controlling for demographic and behavioral factors, diet, continuous age, BMI category, and urinary creatinine, for each log (roughly threefold) increase in DEHP metabolites, a 0.27 increase (95% confidence interval 0.14-0.40; P < .001) in HOMA-IR was identified. Compared with the first tertile of DEHP metabolite in the study population (14.5% insulin resistant), the third tertile had 21.6% prevalence (95% confidence interval 17.2%-26.0%; P = .02). Associations persisted despite controlling for bisphenol A, another endocrine-disrupting chemical commonly found in foods, and HOMA-IR and insulin resistance were not significantly associated with metabolites of lower molecular weight phthalates commonly found in cosmetics and other personal care products.

CONCLUSIONS:

Urinary DEHP concentrations were associated with increased insulin resistance in this cross-sectional study of adolescents. This study cannot rule out the possibility that insulin-resistant children ingest food with higher phthalate content, or that insulin-resistant children excrete more DEHP.

• Authors: Leonardo Trasande, Adam J Spanier, Sheela Sathyanarayana, Teresa M Attina, Jan Blustein
• Journal: Pediatrics (Pediatrics) Vol. 132 Issue 3 Pg. e646-55 (Sep 2013) ISSN: 1098-4275 [Electronic] United States
• PMID: 23958772 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Environmental Pollutants
• Phthalic Acids
• Diethylhexyl Phthalate

Topics

• Adolescent
• Child
• Cross-Sectional Studies
• Diabetes Mellitus, Type 2 (chemically induced, urine)
• Diethylhexyl Phthalate (toxicity, urine)
• Environmental Pollutants (toxicity, urine)
• Female
• Humans
• Insulin Resistance (physiology)
• Male
• Nutrition Surveys
• Phthalic Acids (toxicity, urine)
• Risk Factors
• Socioeconomic Factors
• Young Adult