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3466584 
Journal Article 
Increased Urinary Phthalate Levels in Women with Uterine Leiomyoma: A Case-Control Study 
Kim, YA; Kho, Y; Chun, KC; Koh, JW; Park, JW; Bunderson-Schelvan, M; Cho, YH 
2016 
Yes 
International Journal of Environmental Research and Public Health
ISSN: 1661-7827
EISSN: 1660-4601 
MDPI AG 
BASEL 
13 
12 
1247 
English 
27983712 
WOS:000392280100018 
We assessed the urinary concentration of 16 phthalate metabolites in 57 women with and without uterine leiomyoma (n = 30 and 27; respectively) to determine the association between phthalate exposure and uterine leiomyoma. To evaluate exposure to di-(2-ethylhexyl) phthalate (DEHP); we calculated the molar sum of DEHP metabolites; ∑3-DEHP (combining mono-(2-ethylhexyl) phthalate (MEHP); mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP); and mono-(2-ethyl-5-oxohexyl) phthalate); ∑4-DEHP (∑3-DEHP plus mono-(2-ethyl-5-carboxypentyl) phthalate); and ∑5-DEHP (∑4-DEHP plus mono (2-(carboxylmethyl)hexyl) phthalate (2cx-MMHP)). The log transformed urinary levels of MEHP; MEHHP; 2cx-MMHP; ∑3-DEHP; ∑4-DEHP; and ∑5-DEHP in the leiomyoma group were significantly higher than those of controls. When we adjusted for age; waist circumference; and parity using multiple logistic regression analyses; we found log ∑3-DEHP (OR = 10.82; 95% CI = 1.25; 93.46) and ∑4-DEHP (OR = 8.78; 95% CI = 1.03; 75.29) were significantly associated with uterine leiomyoma. Our findings suggest an association between phthalate exposure and uterine leiomyoma. However; larger studies are needed to investigate potential interactions between phthalate exposure and uterine leiomyoma. 
Adult; Case-Control Studies; Diethylhexyl Phthalate/urine; Environmental Exposure; Leiomyoma/urine; Middle Aged; Phthalic Acids/metabolism/urine; Pregnancy; Uterine Neoplasms/urine; phthalates; uterine leiomyoma; ∑3-DEHP; ∑4-DEHP; 6O7F7IX66E; C42K0PH13C 
IRIS
• Dibutyl Phthalate (DBP)
     Additional Strategies
          March 2017 Search strategy results
     Studies with Health Effects Data
          Human health effects studies
• Diisobutyl Phthalate (DIBP) Final
     Additional Search Strategies
          WoS forward search
     Primary Source of Health Effects Studies
          Human health effects studies
• Phthalates – Targeted Search for Epidemiological Studies
     Source – all searches
          Pubmed
     Included
          DEHP
          DBP
          DiBP
          DiNP
          BBP
          DEP
          DiDP
     Source - Dec 2016 Update (Private)
          Pubmed