Urinary Phthalate Metabolite Concentrations and Diabetes among Women in the National Health and Nutrition Examination Survey (NHANES) 2001-2008

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 diabetesrelated risk...

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Published in:	Environmental health perspectives 2012-09, Vol.120 (9), p.1307-1313
Main Authors:	James-Todd, Tamarra, Stahlhut, Richard, Meeker, John D., Powell, Sheena-Gail, Hauser, Russ, Huang, Tianyi, Rich-Edwards, Janet
Format:	Article
Language:	eng
Subjects:	Adult Aged Ales Analysis Biological and medical sciences Chemical properties Cross-Sectional Studies Demographic aspects Diabetes Diabetes Mellitus - chemically induced Diabetes Mellitus - epidemiology Diabetes. Impaired glucose tolerance Endocrine pancreas. Apud cells (diseases) Endocrinopathies Environment. Living conditions Environmental Exposure Environmental health Environmental Monitoring Environmental Pollutants - urine Etiopathogenesis. Screening. Investigations. Target tissue resistance Female Health and beauty aids Health aspects Humans Hygiene products Insulin resistance Logistic Models Medical sciences Middle Aged Nutrition Surveys Phthalates Phthalic Acids - urine Public health. Hygiene Public health. Hygiene-occupational medicine Risk Factors Toxicology Type 1 diabetes mellitus Type 2 diabetes mellitus United States - epidemiology Urine Waist circumference Womens health Young Adult
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Summary:	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 diabetesrelated 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 assessmentestimated 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 (∑DEHP) 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 ∑DEHP, 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.
ISSN:	0091-6765 1552-9924