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Journal Article 
Phthalate ester concentrations in blood serum, urine and endometrial tissues of Chinese endometriosis patients 
Sun, J; Chen, Bo; Zhang, L; Zhao, D; Li, ShuG 
International Journal of Clinical and Experimental Medicine
ISSN: 1940-5901 
Objective: To explore differences of phthalic acid ester (PAE) concentrations in serum and urine as well as endometrial tissues in patients diagnosed with endometriosis (EM) compared to healthy controls in Shanghai. Patients and methods: We designed a single-center case-control study based on the measurement of PAE concentrations in serum and urine of patients and controls as well as in pathological tissues from EM patients which were measured using either high performance liquid and/or gas chromatography. A total of 289 female subjects were included in the study (115 cases diagnosed with EM and 174 healthy women as controls). Results: Positive detection rates of Dibutyl phthalate (DBP) and Di (2-ethylhexyl) phthalate (DEHP) were > 90% in both measured groups for all measurements, but for diethyl phthalate (DEP) the range was from 0-16.4%. The serum DBP and DEHP concentrations in patients with EM were significantly higher than in healthy women (P < 0.05). The urine concentration of primary DEHP metabolites (Sigma DEHP) was also higher in EM patients (P < 0.05). In patients diagnosed with EM, DBP and DEHP concentrations in pathological tissues were 4 and 14.4 times higher respectively, as those in serum. Conclusion: Significantly enhanced blood serum DBP and DEHP concentrations and significant increases of their primary metabolites in urine of EM patients compared to the controls indicated that PAE affected EM. In addition, the high concentration of DBP and DEHP in resected endometrial tissues of EM patients supported this finding. 
Endometriosis; phthalic acid ester; DEHP; DBP; DEHP metabolite 
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