Health & Environmental Research Online (HERO)


Print Feedback Export to File
1293447 
Journal Article 
Urinary phthalate metabolite concentrations and diabetes among women in the National Health and Nutrition Examination Survey (NHANES) 2001-2008 
James-Todd, T; Stahlhut, R; Meeker, JD; Powell, SG; Hauser, R; Huang, T; Rich-Edwards, J 
2012 
Yes 
Environmental Health Perspectives
ISSN: 0091-6765
EISSN: 1552-9924 
120 
1307-1313 
English 
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. 
diabetes; di(2-ethylhexyl) phthalate; monobenzyl phthalate; mono-(3-carboxypropyl) phthalate; monoethyl phthalate; mono-isobutyl phthalate; mono-n-butyl phthalate; women 
IRIS
• BBP (Butyl benzyl phthalate)
• Dibutyl Phthalate (DBP)
     Database Searches
          Pubmed
          Web of Science
     LitSearch Nov 2012
          PubMed
          WOS
          Merged reference set
     LitSearch Dec 2012 - June 2013
          Web of Science
     Studies with Health Effects Data
          Human health effects studies
• Diethyl phthalate (DEP)
     Additional Strategies
     Primary source of health effects
          Human health effects studies
• Diisobutyl Phthalate (DIBP) Final
     Database Searches
          March 2014 Database Search
               PubMed
               Toxline
               Web of Science
          September 2014 update
               Toxline
               Web of Science
          June 2015 Update
               Toxline
               Web of Science
          December 2015 Update
               Web of Science
          June 2016 Update
               Toxline
          January 2017 Update
     Additional Search Strategies
     Primary Source of Health Effects Studies
          Human health effects studies
     Cited in September 2014 DIBP Preliminary Materials
• Diisononyl Phthalate (DINP)
• Phthalates – Targeted Search for Epidemiological Studies
     Source – all searches
          Pubmed
          WOS
          Toxnet
     Included
          DEHP
          DBP
          DiBP
          BBP
          DEP
     Source – no date limit through June 2013 (Private)
          Pubmed
          WOS
          ToxNet