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Peng MQ, Dabelea D, Adgate JL, Perng W, Calafat AM, Kannan K, Starling AP. Associations of urinary biomarkers of phthalates, phenols, parabens, and organophosphate esters with glycemic traits in pregnancy: The Healthy Start Study. ENVIRONMENTAL RESEARCH 2024; 262:119810. [PMID: 39155036 DOI: 10.1016/j.envres.2024.119810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 07/27/2024] [Accepted: 08/15/2024] [Indexed: 08/20/2024]
Abstract
BACKGROUND Certain endocrine-disrupting chemicals (EDCs) are widespread in consumer products and may alter glucose metabolism. However, the impact of EDC exposures on glucose and insulin regulation during pregnancy is incompletely understood, despite potential adverse consequences for maternal and infant health. We estimated associations between 37 urinary biomarkers of EDCs and glucose-insulin traits among pregnant women. METHODS Seventeen phthalate or phthalate substitute metabolites, six environmental phenols, four parabens, and ten organophosphate ester metabolites were quantified in mid-pregnancy urine from 298 participants in the Healthy Start Study. Fasting blood glucose, insulin, and hemoglobin A1c were assessed concurrently, and Homeostasis Model Assessment 2-Insulin Resistance (HOMA2-IR) was calculated. Gestational diabetes diagnoses and screening results were obtained from medical records for a subset of participants. We estimated associations between each EDC and outcome separately using linear and robust Poisson regression models and analyzed EDC mixture effects. RESULTS The EDC mixture was positively associated with glucose, insulin, and HOMA2-IR, although overall associations were attenuated after adjustment for maternal BMI. Two mixture approaches identified di(2-ethylhexyl) phthalate (DEHP) metabolites as top contributors to the mixture's positive associations. In single-pollutant models, DEHP metabolites were positively associated with fasting glucose, fasting insulin, and HOMA2-IR even after adjustment for maternal BMI. For example, each interquartile range increase in log2-transformed mono(2-ethyl-5-oxohexyl) phthalate was associated with 2.4 mg/dL (95% confidence interval (CI): 1.1, 3.6) higher fasting glucose, 11.8% (95%CI: 3.6, 20.5) higher fasting insulin, and 12.3% (95%CI: 4.2, 21.1) higher HOMA2-IR. Few EDCs were associated with hemoglobin A1c or with a combined outcome of impaired glucose tolerance or gestational diabetes. DISCUSSION Exposures to phthalates and particularly DEHP during pregnancy are associated with altered glucose-insulin regulation. Disruptions in maternal glucose metabolism during pregnancy may contribute to adverse pregnancy outcomes including gestational diabetes and fetal macrosomia, and associated long-term consequences for maternal and child health.
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Affiliation(s)
- Mia Q Peng
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Pediatrics, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Pediatrics, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John L Adgate
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Wei Perng
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kurunthachalam Kannan
- Wadsworth Center, New York State Department of Health, Albany, NY, USA; Department of Environmental Health Sciences, State University of New York University at Albany, NY, USA
| | - Anne P Starling
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Chen Y, Feuerstahler L, Martinez-Steele E, Buckley JP, Liu SH. Phthalate mixtures and insulin resistance: an item response theory approach to quantify exposure burden to phthalate mixtures. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024; 34:581-590. [PMID: 36966251 PMCID: PMC10580272 DOI: 10.1038/s41370-023-00535-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 02/27/2023] [Accepted: 03/09/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Molar sums are often used to quantify total phthalate exposure, but they do not capture patterns of exposure to multiple phthalates. OBJECTIVE To introduce an exposure burden score method for quantifying exposure to phthalate metabolites and examine the association between phthalate burden scores and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). METHODS We applied item response theory (IRT) to data from 3474 adults aged 20-60 years in the 2013-2018 National Health and Examination Survey (NHANES) to quantify latent phthalate exposure burden from 12 phthalate metabolites. We compared model fits of three IRT models that used different a priori groupings (general phthalate burden; low molecular weight (LMW) and high molecular weight (HMW) burdens; and LMW, HMW and DEHP burden), and used the best fitting model to estimate phthalate exposure burden scores. Regression models assessed the covariate-adjusted association between phthalate burden scores and HOMA-IR. We compared findings to those using molar sums. In secondary analyses, we examined how the IRT model could be used for data harmonization when a subset of participants are missing some phthalate metabolites, and accounted for measurement error of the phthalate burden scores in estimating associations with HOMA-IR through a resampling approach using plausible value imputation. RESULTS A three correlated factors model (LMW, HMW and DEHP burdens) provided the best fit. One interquartile range (IQR) increase in DEHP burden score was associated with 0.094 (95% CI: 0.022, 0.164, p = 0.010) increase in log HOMA-IR, co-adjusted for LMW and HMW burden scores. Findings were consistent when using log molar sums. Associations of phthalate burden and insulin resistance were also consistent when participants were simulated to be missing some phthalate metabolites, and when we accounted for measurement error in estimating burden scores. CONCLUSION Both phthalate molar sums and burden scores are sensitive to associations with insulin resistance. Phthalate burden scores may be useful for data harmonization.
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Affiliation(s)
- Yitong Chen
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Jessie P Buckley
- Department of Environmental Health and Engineering, John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shelley H Liu
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Mandeville J, Alkhalaf Z, Joannidis C, Ryan M, Nelson D, Quiros-Alcala L, Gribble MO, Pollack AZ. Risk perception and use of personal care products by race and ethnicity among a diverse population. UCL OPEN. ENVIRONMENT 2024; 6:e3038. [PMID: 38757092 PMCID: PMC11098005 DOI: 10.14324/111.444/ucloe.3038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/26/2024] [Indexed: 05/18/2024]
Abstract
Personal care products can contain phthalates, parabens and other endocrine-disrupting chemicals. However, information on perception of risks from personal care product use and how use varies by race and ethnicity is limited. We evaluated differences in personal care product use and risk perception in a diverse sample of participants recruited from a US college campus and online. A self-administered questionnaire captured information on sociodemographic factors, personal care product use trends and perception of risk associated with them. Pearson's chi-square and Fisher's exact tests were used to determine differences in personal care product use and risk perception by race and ethnicity. Ordered logistic regressions were performed to measure associations between personal care product use frequency across racial/ethnic categories. Participant (n = 770) mean age was 22.8 years [standard deviation ± 6.0]. Daily use of make-up (eye = 29.3%; other = 38.0%; all = 33.7%) and skincare products (55%) was most frequently reported among Middle Eastern and North African participants. Non-Hispanic Black participants reported the highest daily use of hairstyling products (52%) and lotion (78%). Daily make-up use was more frequently reported among females (41%) than males (24.6%). Levels of agreement were similar across racial and ethnic groups, that personal care product manufacturers should be required to list all ingredients (≥87%). There were significant associations between the frequency of use of some personal care products and racial/ethnic categories when the use frequencies of participants from other racial/ethnic categories were compared to the use frequency of non-Hispanic White participants. There were significant differences in daily use frequency, levels of trust, perception of safety and health risks associated with personal care products by race and ethnicity, underscoring that there may be different sources of exposure to chemicals in personal care products by race and ethnicity.
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Affiliation(s)
- Julia Mandeville
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
| | - Zeina Alkhalaf
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
| | - Charlotte Joannidis
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
| | - Michelle Ryan
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
| | - Devon Nelson
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
| | - Lesliam Quiros-Alcala
- Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Matthew O. Gribble
- Division of Occupational, Environmental & Climate Medicine, University of California, San Francisco, CA, USA
| | - Anna Z. Pollack
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA, USA
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Guerrelli D, Desai M, Semaan Y, Essa Y, Zurakowski D, Cendali F, Reisz J, D'Alessandro A, Luban N, Posnack NG. Prevalence and clinical implications of heightened plastic chemical exposure in pediatric patients undergoing cardiopulmonary bypass. Transfusion 2024; 64:808-823. [PMID: 38590100 DOI: 10.1111/trf.17821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/30/2024] [Accepted: 03/18/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Phthalate chemicals are used to manufacture plastic medical products, including many components of cardiopulmonary bypass (CPB) circuits. We aimed to quantify iatrogenic phthalate exposure in pediatric patients undergoing cardiac surgery and examine the link between phthalate exposure and postoperative outcomes. STUDY DESIGN AND METHODS The study included pediatric patients undergoing (n=122) unique cardiac surgeries at Children's National Hospital. For each patient, a single plasma sample was collected preoperatively and two additional samples were collected postoperatively upon return from the operating room and the morning after surgery. Concentrations of di(2-ethylhexyl) phthalate (DEHP) and its metabolites were quantified using ultra high-pressure liquid chromatography coupled to mass spectrometry. RESULTS Patients were subdivided into three groups, according to surgical procedure: (1) cardiac surgery not requiring CPB support, (2) cardiac surgery requiring CPB with a crystalloid prime, and (3) cardiac surgery requiring CPB with red blood cells (RBCs) to prime the circuit. Phthalate metabolites were detected in all patients, and postoperative phthalate levels were highest in patients undergoing CPB with an RBC-based prime. Age-matched (<1 year) CPB patients with elevated phthalate exposure were more likely to experience postoperative complications. RBC washing was an effective strategy to reduce phthalate levels in CPB prime. DISCUSSION Pediatric cardiac surgery patients are exposed to phthalate chemicals from plastic medical products, and the degree of exposure increases in the context of CPB with an RBC-based prime. Additional studies are warranted to measure the direct effect of phthalates on patient health outcomes and investigate mitigation strategies to reduce exposure.
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Affiliation(s)
- Devon Guerrelli
- Children's National Heart Institute, Children's National Hospital, Washington, DC, USA
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA
- Department of Biomedical Engineering, The George Washington University School of Engineering and Applied Science, Washington, DC, USA
| | - Manan Desai
- Children's National Heart Institute, Children's National Hospital, Washington, DC, USA
- Division of Cardiac Surgery, Children's National Hospital, Washington, DC, USA
| | - Youssef Semaan
- Children's National Heart Institute, Children's National Hospital, Washington, DC, USA
- Department of Cardiovascular Services - Perfusion, Children's National Hospital, Washington, DC, USA
| | - Yasin Essa
- Children's National Heart Institute, Children's National Hospital, Washington, DC, USA
- Division of Cardiac Surgery, Children's National Hospital, Washington, DC, USA
| | - David Zurakowski
- Department of Anesthesiology, Critical Care and Pain Medicine, Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Francesca Cendali
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Julie Reisz
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Angelo D'Alessandro
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Naomi Luban
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
- Division of Hematology and Laboratory Medicine, Children's National Hospital, Washington, DC, USA
- Department of Pathology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Nikki Gillum Posnack
- Children's National Heart Institute, Children's National Hospital, Washington, DC, USA
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
- Department of Pharmacology and Physiology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Tomsho KS, Quinn MR, Adamkiewicz G, James-Todd T. Development of a Phthalate Environmental Reproductive Health Literacy (PERHL) Scale. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:47013. [PMID: 38669179 PMCID: PMC11050996 DOI: 10.1289/ehp13128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 03/23/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Substantial evidence exists linking phthalate exposure to adverse reproductive health outcomes. Current US federal regulations of consumer product chemicals place the onus on individuals to mitigate their exposure to phthalates, with assumptions of sufficient environmental health literacy (EHL). Few validated scales for people of reproductive age exist to evaluate phthalate-specific EHL. OBJECTIVES Our objective is to develop a multidimensional scale characterizing latent factors of phthalate knowledge, risk perception, and self-efficacy to inform individual-level interventions for reducing phthalate exposure. METHODS We distributed a survey with 31 items to 117 participants in the Environmental Reproductive and Glucose Outcomes (ERGO) cohort who gave birth within the last 5 years. Exploratory factor analysis (EFA) was used to identify underlying latent factors. Internal reliability was assessed via omega hierarchical coefficient. Average sum scores for each latent factor and the overall Phthalate Environmental Reproductive Health Literacy (PERHL) score were calculated. Associations between latent factors, overall PERHL score, and sociodemographic characteristics were explored using linear models. RESULTS Six latent factors were identified as follows: "Awareness of Phthalate Reproductive Health Impacts," "Uncertainty," "Protective Behavior/Risk Control," "Regulatory Interest," "Awareness of Phthalate Exposure Pathways," and "General Phthalate Knowledge." Each factor demonstrated acceptable to strong internal reliability, with coefficients ranging between 0.63 and 0.93. Non-white participants had lower scores for the "Awareness of Phthalate Reproductive Health Impacts" [β : - 0.35 , 95% confidence interval (CI): - 0.63 , - 0.07 ], "Awareness of Phthalate Exposure Pathways" (β : - 0.32 , 95% CI: - 0.57 , - 0.07 ), and "General Phthalate Knowledge" (β : - 0.36 , 95% CI: - 0.66 , - 0.06 ), but no significant difference in scores on "Uncertainty" (β : 0.17, 95% CI: - 0.16 , 0.50), "Protective Behavior/Risk Control" (β : - 0.04 , 95% CI: - 0.36 , 0.28), or "Regulatory Interest" (β : - 0.21 , 95% CI: - 0.51 , 0.09). No associations were seen for age or educational attainment and latent or sum factors. DISCUSSION Six latent factors were identified for the PERHL scale. Non-white race and ethnicity was associated with lower scores for knowledge-related scale factors. https://doi.org/10.1289/EHP13128.
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Affiliation(s)
- Kathryn S. Tomsho
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Marlee R. Quinn
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Gary Adamkiewicz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Ran B, Qin J, Wu Y, Wen F. Associations between mixed exposure to phthalates and latent tuberculosis infection among the general U.S. population from NHANES 2011-2012. Heliyon 2024; 10:e27958. [PMID: 38533017 PMCID: PMC10963332 DOI: 10.1016/j.heliyon.2024.e27958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 02/17/2024] [Accepted: 03/08/2024] [Indexed: 03/28/2024] Open
Abstract
Background People are constantly exposed to phthalates, but few reliable studies have focused on the connection between phthalate exposure and latent tuberculosis infection (LTBI). Methods Data were obtained from the National Health and Nutrition Examination Survey (NHANES) database (2011-2012). The LTBI was assessed by QuantiFERON®-TB Gold-In-Tube (QFT) or tuberculin skin testing (TST). The odds ratios (ORs) and 95% confidence intervals (CIs) per log10 unit change in the concentration of phthalate metabolites were calculated using crude and adjusted logistic regression models. The relationships between mixed phthalate concentrations and LTBI were assessed using Bayesian kernel machine regression (BKMR) models. Results According to the results of the multivariable logistic regression, in a fully adjusted model, only monobenzyl phthalate (MBZP) was negatively associated with LTBI in Q3 (OR (95% CI): 0.485 (0.286,0.823), P = 0.007). According to the restricted cubic spline (RCS) model, there was a linear dose‒response association between all 11 phthalate metabolites and LTBI (p for nonlinearity >0.05). We found a significant positive correlation between mixed phthalate metabolites and LTBI by using fully adjusted BKMR model. Conclusions Our analysis demonstrated that LTBI in the general U.S. population is linearly linked with exposure to single or combined phthalates.
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Affiliation(s)
- Bi Ran
- Department of Respiratory and Critical Care Medicine, West China Hospital and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Sichuan University. Guoxuexiang 37, Chengdu, Sichuan, 610041, China
| | - Jiangyue Qin
- Department of Respiratory and Critical Care Medicine, West China Hospital and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Sichuan University. Guoxuexiang 37, Chengdu, Sichuan, 610041, China
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yanqiu Wu
- Department of Respiratory and Critical Care Medicine, West China Hospital and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Sichuan University. Guoxuexiang 37, Chengdu, Sichuan, 610041, China
| | - Fuqiang Wen
- Department of Respiratory and Critical Care Medicine, West China Hospital and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Sichuan University. Guoxuexiang 37, Chengdu, Sichuan, 610041, China
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Li R, Wang J, Wang Y, Lin X, Sun C, Xu L. Telomere length as a modifier in the relationship between phthalate metabolites exposure and glucose homeostasis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 344:123309. [PMID: 38190874 DOI: 10.1016/j.envpol.2024.123309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/20/2023] [Accepted: 01/04/2024] [Indexed: 01/10/2024]
Abstract
Given the rising concern over the potential impact of environmental factors on metabolic heath, we conducted a cross-sectional analysis among 645 adults aged 20 and older in the National Health and Nutrition Examination Survey (NHANES), examining the association between nine phthalate metabolites (Mono-n-butyl phthalate (MBP), Mono-ethyl phthalate (MEP), Mono-(2-ethyl)-hexyl phthalate (MEHP), Mono-benzyl phthalate (MBzP), Mono-n-methyl phthalate (MnMP), Mono-(3-carboxy propyl) phthalate (MCPP), Mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), Mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), Mono-isobutyl phthalate (MiBP)) and six glucose homeostasis indices (fasting glucose, fasting insulin, hemoglobin A1C (HbA1C), homeostatic model assessment of insulin resistance (HOMA-IR), single Point Insulin Sensitivity Estimator (SPISE), and HOMA-β). Latent Class Analysis identified three phthalate metabolites exposure patterns: high MEP-low MEOHP (n = 282), high MBzP-low MEHHP (n = 214), and high MEHHP, MEOHP (n = 149). The high MBzP-low MEHHP and high MEHHP, MEOHP, versus the high MEP-low MEOHP, exposure groups showed significantly higher levels of fasting insulin (β = 0.126, 95% CI: 0.023-0.228), SPISE (β = 0.091, 95% CI: 0.018-0.164), and HOMA-IR (β = 0.091, 95% CI: 0.018-0.164). In the shorter telomere length group, high MEHHP, MEOHP exposure showed an increase in SPISE levels (β = 0.153, 95% CI: 0.037-0.269), while in the overweight/obese subgroup, high MEHHP, MEOHP exposure was significantly positively associated with HOMA-IR (β = 0.392, 95% CI: 0.150-0.735). Bayesian kernel machine regression analyses showed positive associations between higher combined phthalate exposure and increased glucose homeostasis indices (fasting glucose, HbA1C, fasting insulin, SPISE, and HOMA-IR). The quantile of g-calculation analysis also supported the positive associations with HbA1C, HOMA-IR, and fasting insulin. Our findings indicate that phthalate exposure was positively associated with glucose homeostasis indices, which strengthen the call for proactive measures to reduce phthalate exposure and mitigate potential risks to glucose metabolism.
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Affiliation(s)
- Ruiqiang Li
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jiao Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ying Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaoyi Lin
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ce Sun
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, China; School of Public Health, The University of Hong Kong, Hong Kong, China; Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
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Perez-Diaz C, Uriz-Martínez M, Ortega-Rico C, Leno-Duran E, Barrios-Rodríguez R, Salcedo-Bellido I, Arrebola JP, Requena P. Phthalate exposure and risk of metabolic syndrome components: A systematic review. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 340:122714. [PMID: 37844863 DOI: 10.1016/j.envpol.2023.122714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/13/2023] [Accepted: 10/07/2023] [Indexed: 10/18/2023]
Abstract
Metabolic syndrome is a cluster of conditions that increase the risk of cardiovascular disease, i.e. obesity, insulin resistance, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-c) levels and arterial hypertension. Phthalates are environmental chemicals which might influence the risk of the aforementioned disturbances, although the evidence is still controversial. The objective of this work was to synthesize the evidence on the association between human phthalate exposure and metabolic syndrome or any of its components. In this systematic review, the PRISMA guidelines were followed and the literature was search in PubMed, Web of Science and Scopus. Longitudinal and cross-sectional studies were included, the later only if a subclinical marker of disease was evaluated. The methodological quality was assessed with the Newcastle Ottawa Scale and a checklist for Analytical Cross-Sectional Studies developed in the Joanna Briggs Institute. A total of 58 articles were identified that showed high heterogenicity in the specific phthalates assessed, time-window of exposure and duration of follow-up. The quality of the studies was evaluated as high (n = 46, score >7 points) or medium (n = 12, score 4-6). The most frequently studied phthalates were DEHP-MEHP, MBzP and MEP. The evidence revealed a positive association between prenatal (in utero) exposure to most phthalates and markers of obesity in the offspring, but contradictory results when postnatal exposure and obesity were assessed. Moreover, postnatal phthalate exposure showed positive and very consistent associations with markers of diabetes and, to a lesser extent, with triglyceride levels. However, fewer evidence and contradictory results were found for HDL-c levels and markers of hypertension. The suggested mechanisms for these metabolic effects include transcription factor PPAR activation, antagonism of thyroid hormone function, antiandrogenic effects, oxidative stress and inflammation, and epigenetic changes. Nevertheless, as the inconsistency of some results could be related to differences in the study design, future research should aim to standardise the exposure assessment.
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Affiliation(s)
- Celia Perez-Diaz
- Universidad de Granada. Department of Preventive Medicine and Public Health, Pharmacy School. Campus de Cartuja S/n, 18071, Granada, Spain; Instituto de Investigación Biosanitaria (ibs.GRANADA). Avda. de Madrid, 15. Pabellón de Consultas Externas 2, 2(a) Planta, 18012, Granada, Spain
| | - Maialen Uriz-Martínez
- Universidad de Granada. Department of Preventive Medicine and Public Health, Pharmacy School. Campus de Cartuja S/n, 18071, Granada, Spain
| | - Carmen Ortega-Rico
- Universidad de Granada. Department of Preventive Medicine and Public Health, Pharmacy School. Campus de Cartuja S/n, 18071, Granada, Spain
| | - Ester Leno-Duran
- Universidad de Granada. Department of Obstetrics and Gynaecology, Medicine School. Parque Tecnologico de La Salud, Av. de La Investigación, 11, 18016, Granada, Spain.
| | - Rocío Barrios-Rodríguez
- Universidad de Granada. Department of Preventive Medicine and Public Health, Pharmacy School. Campus de Cartuja S/n, 18071, Granada, Spain; Instituto de Investigación Biosanitaria (ibs.GRANADA). Avda. de Madrid, 15. Pabellón de Consultas Externas 2, 2(a) Planta, 18012, Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5, Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - Inmaculada Salcedo-Bellido
- Universidad de Granada. Department of Preventive Medicine and Public Health, Pharmacy School. Campus de Cartuja S/n, 18071, Granada, Spain; Instituto de Investigación Biosanitaria (ibs.GRANADA). Avda. de Madrid, 15. Pabellón de Consultas Externas 2, 2(a) Planta, 18012, Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5, Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - Juan Pedro Arrebola
- Universidad de Granada. Department of Preventive Medicine and Public Health, Pharmacy School. Campus de Cartuja S/n, 18071, Granada, Spain; Instituto de Investigación Biosanitaria (ibs.GRANADA). Avda. de Madrid, 15. Pabellón de Consultas Externas 2, 2(a) Planta, 18012, Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5, Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - Pilar Requena
- Universidad de Granada. Department of Preventive Medicine and Public Health, Pharmacy School. Campus de Cartuja S/n, 18071, Granada, Spain; Instituto de Investigación Biosanitaria (ibs.GRANADA). Avda. de Madrid, 15. Pabellón de Consultas Externas 2, 2(a) Planta, 18012, Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5, Pabellón 11. Planta 0, 28029 Madrid, Spain
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9
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Chen S, Shi Z, Zhang Q. A physiologically based pharmacokinetic model of diethyl phthalates in humans. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 340:122849. [PMID: 37926418 PMCID: PMC10841618 DOI: 10.1016/j.envpol.2023.122849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/07/2023]
Abstract
Phthalates are a family of industrial and consumer product chemicals, among which diethyl phthalate (DEP) has been widely used. DEP is metabolized into the active metabolite monoethyl phthalate (MEP) and exposure to DEP may induce male reproductive toxicity, developmental toxicity and hepatotoxicity. To better assess the toxicity of DEP and MEP, it is important to understand and predict their internal concentrations, especially in reproductive organs. Here we present a human physiologically based pharmacokinetic (PBPK) model of DEP. Implemented in R, the PBPK model consists of seven tissue compartments, including blood, gut, liver, fat, skin, gonad, and rest of body (RB). In the blood both DEP and MEP partition into free and bound forms, and tissue distribution is considered as blood flow-limited. DEP is metabolized in the gut and liver into MEP which is further glucuronidated and cleared through the urine. The chemical-specific parameters of the model were predicted in silico or estimated based on published human urinary MEP data after exposure to DEP in the air at 250 or 300 μg/m3 for 3 or 6 h through inhalation and dermal absorption. Sensitivity analysis identified important parameters including partition coefficients of DEP for fat, RB, and skin compartments, and the rate constants for glucuronidation of MEP and urinary excretion, with regard to Cmax, area under the curve (AUC), and clearance half-lives of DEP and MEP. A subset of the sensitive parameters was then included in hierarchical population Bayesian Markov chain Monte Carlo (MCMC) simulations to characterize the uncertainty and variability of these parameters. The model is consistent with the notion that dermal absorption represents a significant route of exposure to DEP in ambient air and clothing can be an effective barrier. The developed human PBPK model can be utilized upon further refinement as a quantitative tool for DEP risk assessment.
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Affiliation(s)
- Shiyu Chen
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, GA 30322, USA
| | - Zhenzhen Shi
- The Program for Experimental and Theoretical Modeling, Division of Hepatology, Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Chicago, IL, 60660, USA
| | - Qiang Zhang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, GA 30322, USA.
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10
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Yöntem FD, Ayaz S, Bulut Ş, Aldoğan EH, Ahbab MA. Endoplasmic reticulum stress and pro-inflammatory responses induced by phthalate metabolites monoethylhexyl phthalate and monobutyl phthalate in 1.1B4 pancreatic beta cells. Toxicology 2024; 501:153695. [PMID: 38048874 DOI: 10.1016/j.tox.2023.153695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/25/2023] [Accepted: 11/30/2023] [Indexed: 12/06/2023]
Abstract
In recent years, phthalates and their metabolites have been associated with metabolic diseases such as diabetes mellitus. To investigate the effects of phthalate metabolites exposure on insulin production and release, 1.1B4 pancreatic beta cells were treated with different concentrations (0.001-1000 µM) of monoethylhexyl phthalate (MEHP) and monobutyl phthalate (MBP). For such purpose, the 1.1B4 cells were evaluated for their viability, apoptosis rate, lysosomal membrane permeabilization (LMP), mitochondrial membrane potential (ΔΨm), oxidative stress, ER stress status, in addition to their secretory functions. MEHP, not MBP, exhibited a notable reduction in metabolic viability, particularly at higher concentrations (500 and 1000 µM) following 24-hour exposure. Similarly, both MEHP and MBP induced decreased metabolic viability at high concentrations after 48- and 72-hour exposure. Notably, neither MEHP nor MBP demonstrated a significant impact on apoptosis rates after 24-hour exposure, and MBP induced mild necrosis at 1000 µM concentration. Cell proliferation rates, indicated by PCNA expression, decreased with 10 and 1000 µM MEHP and 0.1 and 10 µM MBP exposures. LMP analysis revealed an increase in 1000 µM MBP group. Exposure to 0.001 µM of both MEHP and MBP significantly reduced cellular glutathione (GSH) levels. No significant change in intracellular reactive oxygen species (ROS) levels and ΔΨm was observed, but MBP-exposed cells exhibited elevated levels of lipid peroxidation. Functional assessments of pancreatic beta cells unveiled reduced insulin secretion at low glucose concentrations following exposure to both MEHP and MBP, with concurrent alterations in the expression levels of key proteins associated with beta cell function, including GLUT1, GCK, PDX1, and MafA. Moreover, MEHP and MBP exposures were associated with alterations in ER stress-related pathways, including JNK, GADD153, and NF-κB expression, as well as PPARα and PPARγ levels. In conclusion, this study provides comprehensive insights into the diverse impacts of MEHP and MBP on 1.1B4 pancreatic beta cells, emphasizing their potential role in modulating cell survival, metabolic function, and stress response pathways.
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Affiliation(s)
- Fulya Dal Yöntem
- Koç University, Faculty of Medicine, Department of Biophysics, Istanbul, Turkey; Koç University Research Center for Translational Medicine (KUTTAM), Istanbul, Turkey
| | - Sinem Ayaz
- Istanbul University, Cerrahpasa, Institute of Graduate Studies, Department of Clinical Microbiology, Istanbul, Turkey; Haliç University, Faculty of Medicine, Department of Clinical Microbiology, Istanbul, Turkey
| | - Şeyma Bulut
- Bezmialem Vakif University, Faculty of Medicine, Department of Medical Biology, Istanbul, Turkey; Bezmialem Vakıf University, Institute of Health Sciences, Department of Biotechnology, Istanbul, Turkey
| | | | - Müfide Aydoğan Ahbab
- University of Health Sciences Türkiye, Hamidiye Vocational School of Health Services, Istanbul, Turkey.
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11
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Ihenacho U, Guillermo C, Wilkens LR, Franke AA, Tseng C, Li Y, Sangaramoorthy M, Derouen MC, Haiman CA, Stram DO, Le Marchand L, Cheng I, Wu AH. Association of Endocrine Disrupting Chemicals With the Metabolic Syndrome Among Women in the Multiethnic Cohort Study. J Endocr Soc 2023; 7:bvad136. [PMID: 38024651 PMCID: PMC10666661 DOI: 10.1210/jendso/bvad136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Indexed: 12/01/2023] Open
Abstract
Metabolic syndrome (MetS) is associated with a high risk of cardiovascular disease, a leading cause of death among women. MetS is a diagnosis of at least 3 of the following: high blood pressure, high fasting glucose, high triglycerides, high waist circumference, and low high-density lipoprotein cholesterol. Epidemiological studies suggest that endocrine disrupting chemical (EDC) exposure is positively associated with individual components of MetS, but evidence of an association between EDCs and MetS remains inconsistent. In a cross-sectional analysis within the Multiethnic Cohort Study, we evaluated the association between 4 classes of urinary EDCs (bisphenol A [BPA], triclosan, parabens, and phthalates) and MetS among 1728 women. Multivariable logistic regression was used to estimate odds ratios and 95% CI for the association between tertiles of each EDC and MetS adjusting for age, body mass index (BMI), racial and ethnic group, and breast cancer status. Stratified analyses by race and ethnicity and BMI were conducted. MetS was identified in 519 (30.0%) women. We did not detect statistically significant associations of MetS with BPA, triclosan, or phthalate metabolite excretion. MetS was inversely associated with total parabens (Ptrend = .002). Although there were suggestive inverse associations between EDCs and MetS among Latino and African American women, and women with BMI < 30 kg/m2, there was no statistically significant heterogeneity in associations by race and ethnicity or BMI. These findings suggest an inverse association between parabens and MetS in larger multiethnic studies. Prospective analyses to investigate suggested differences in associations by race, ethnicity, and BMI are warranted.
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Affiliation(s)
- Ugonna Ihenacho
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Cherie Guillermo
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA
| | - Lynne R Wilkens
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA
| | - Adrian A Franke
- Cancer Biology Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA
| | - Chiuchen Tseng
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Yuqing Li
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94158, USA
| | - Meera Sangaramoorthy
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94158, USA
| | - Mindy C Derouen
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94158, USA
| | - Christopher A Haiman
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
- Center for Genetic Epidemiology, University of Southern California, Los Angeles, CA 90089, USA
| | - Daniel O Stram
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Loïc Le Marchand
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA
| | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA 94158, USA
| | - Anna H Wu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
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12
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Zhang S, Cheng X, Jia C, An J, Zhang X, Li P, Guan Y, Yan Y, Zhao Z, Liu Y, Jing T, He M. Association of serum phthalates exposure with incident type 2 diabetes risk in Chinese population: A nested case-control study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 265:115493. [PMID: 37729699 DOI: 10.1016/j.ecoenv.2023.115493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 08/31/2023] [Accepted: 09/16/2023] [Indexed: 09/22/2023]
Abstract
Prospective epidemiological evidence was lacking on the association of phthalates (PAEs) exposure with incident type 2 diabetes mellitus (T2DM) risk. In present nested case-control study, we identified 1006 T2DM cases and matched 1006 controls based on Dongfeng-Tongji cohort study, and 6 PAEs were detected in baseline serum. The conditional logistic regression model, Bayesian kernel machine regression (BKMR) model and Quantile-based g-computation were applied to evaluate the associations of determined PAEs, either as individuals or as a mixture, with incident T2DM risk. Subgroup analysis was conducted to identify the potential sensitive population of PAEs effects on T2DM. After multiple adjustment, no statistically significant association was observed between single or mixture of PAEs and incident T2DM risk in the whole population. However, serum levels of Di-n-butyl phthalate (DnBP) [OR= 2.06; 95% CI: (1.11-3.96)], Σdibutyl phthalate (ΣDBP) [OR= 1.96; 95% CI: (1.06-3.76)], and Σlow-molecular- weight phthalate (ΣLMW) [OR= 2.27; 95% CI: (1.17-4.57)] were significantly associated with T2DM in current drinker group. Moreover, significant potential interactions were observed among Di-iso-butyl phthalate (DiBP), DnBP, Butyl-benzyl phthalate (BBP), ΣDBP, and ΣLMW with drinking status on T2DM risk (P for interaction = 0.036, 0.005, 0.049. 0.010, and 0.005). We did not find significant associations between serum PAEs levels and T2DM in the whole population. However, current alcohol drinkers expose to higher levels of DnBP, ΣDBP, and ΣLMW had higher risk of T2DM.
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Affiliation(s)
- Shiyang Zhang
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China
| | - Xu Cheng
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China
| | - Chengyong Jia
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China
| | - Jun An
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China
| | - Xin Zhang
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China
| | - Peiwen Li
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China
| | - Youbing Guan
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China
| | - Yan Yan
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China
| | - Zhuoya Zhao
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China
| | - Yuenan Liu
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China
| | - Tao Jing
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China
| | - Meian He
- Department of Occupational and Environmental Health, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, Hubei, China.
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13
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Li SS, Chen JJ, Su MW, Lin CW, Chen CC, Wang YH, Liu CC, Tsai YC, Hsieh TJ, Wu MT, Wu CF. Sex-specific interactive effect of melamine and DEHP on a marker of early kidney damage in Taiwanese adults: A national population-based study from the Taiwan Biobank. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 263:115208. [PMID: 37413945 DOI: 10.1016/j.ecoenv.2023.115208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 06/21/2023] [Accepted: 06/28/2023] [Indexed: 07/08/2023]
Abstract
Taiwan had the high incidence of chronic kidney disease (CKD) worldwide. Our objective was to examine associations between daily exposure of phthalates and melamine, two common nephrotoxins, and kidney damage risk in a well-established nationwide cohort. Study subjects were from Taiwan Biobank (TWB) with existing data of questionnaire and biochemical examinations. Average daily intake (ADI) levels of melamine and seven parental phthalates, including DEHP (di-2-ethylhexylphthalate), DiBP (Dibutyl phthalate), DnBP (Di-n-butyl phthalate), BBzP (Butyl benzyl phthalate), DEP (Diethyl phthalate), and DMP (Dimethyl phthalate) were estimated using a creatinine excretion-based model from urine melamine and 10 phthalate metabolites. Urine microalbumin to creatinine ratio (ACR) was used to represent for the outcome of kidney damage. Two statistical strategies were used: First, a weighted quantile sum (WQS) regression model to select the most important exposure variables of ADI levels of phthalates and melamine associated with ACR; Second, to examine effects of those most important exposure variables on ACR in multivariable linear regression models. In total, 1153 eligible adults were left for analyses. Of them, 591 (51.3%) and 562 (48.7%) were men and women, respectively, with a median age of 49 years old. By WQS, a significant and positive association was found between ADI of melamine and phthalates and ACR (β = 0.14, p = 0.002). ADI levels of melamine had the highest weight (0.57), followed by DEHP (0.13). Next, examining the two most important exposures in association with ACR, we found that the higher the melamine and DEHP intakes, the higher the ACR levels were found. An interaction effect was also found between melamine and DEHP intakes on urine ACR (p = 0.015). This result was more prominent in men (p = 0.008) than in women (p = 0.651). Environmental co-exposure of melamine and DEHP can potentially affect ACR in the community-dwelling Taiwanese adult population.
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Affiliation(s)
- Sih-Syuan Li
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Jia-Jen Chen
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Ming-Wei Su
- Taiwan Biobank, Academia Sinica, Taipei, Taiwan.
| | | | - Chu-Chih Chen
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Taiwan.
| | - Yin-Han Wang
- Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Taiwan.
| | - Chia-Chu Liu
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Yi-Chun Tsai
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Tusty-Jiuan Hsieh
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Ming-Tsang Wu
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Ph.D. Program in Environmental and Occupational Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Chia-Fang Wu
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; International Master Program of Translational Medicine, National United University, Miaoli, Taiwan.
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14
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Chan M, Parikh S, Shyr D, Shamasunder B, Adamkiewicz G, James-Todd T. Evaluating Neighborhood-Level Differences in Hair Product Safety by Environmental Working Group Ratings among Retailers in Boston, Massachusetts. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:97002. [PMID: 37702490 PMCID: PMC10498863 DOI: 10.1289/ehp10653] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 05/01/2023] [Accepted: 08/02/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND Personal care products are a notable source of exposure to endocrine-disrupting chemicals (EDCs). Racial/ethnic differences in the use of hair products containing EDCs are reported, with women and children of color more commonly using hair products that are hormonally active and contain EDCs than other racial/ethnic groups. There is limited research examining the neighborhood-level social and economic factors that may contribute to these reported disparities. OBJECTIVES We aimed to examine the safety of hair products across sociodemographically diverse neighborhoods in Boston, Massachusetts. METHODS Eight neighborhoods were identified based on indicators of race/ethnicity and socioeconomic status (SES). We randomly selected 50 stores and collected data on the hair products for sale and their corresponding Environmental Working Group (EWG) Skin Deep hazard score. The association between neighborhood and EWG hazard category (low, moderate, high) was examined using a multinomial logistic regression. RESULTS A total of 14,019 hair products were identified in the eight neighborhoods. When considering products with EWG hazard scores, Roxbury, a lower income community of color, and Mission Hill, a lower income community, were reported to have a higher percentage of high-hazard hair products in comparison with Beacon Hill [12.2% (163/1,332), 11.4% (65/571) vs. 7.9% (30/382), respectively]. Differences between the safety of hair products were observed, with Roxbury and Mission Hill reporting more than a 2-fold higher risk ratio (RR) of finding hair products with high vs. low EWG scores in comparison with that of Beacon Hill [RR for Roxbury: 2.3, 95% confidence interval (CI): 1.1, 4.6; RR for Mission Hill: 2.3, 95% CI: 1.0, 5.4]. Other neighborhoods were also observed to have an increased RR in comparison with Beacon Hill, however, with 95% CIs that extended beyond the null. DISCUSSION Retail stores in neighborhoods with a higher percentage of residents of color and lower SES were found to be more likely to sell products with high hazard scores than stores in a higher SES and predominately non-Hispanic White neighborhood. https://doi.org/10.1289/EHP10653.
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Affiliation(s)
- Marissa Chan
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Shivani Parikh
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Derek Shyr
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Bhavna Shamasunder
- Department of Urban and Environmental Policy, Occidental College, Los Angeles, California, USA
| | - Gary Adamkiewicz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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15
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Kim D, Oh E, Kim H, Baek SM, Cho J, Kim EH, Choi S, Bian Y, Kim W, Bae ON. Mono-(2-ethylhexyl)-phthalate potentiates methylglyoxal-induced blood-brain barrier damage via mitochondria-derived oxidative stress and bioenergetic perturbation. Food Chem Toxicol 2023; 179:113985. [PMID: 37572985 DOI: 10.1016/j.fct.2023.113985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/30/2023] [Accepted: 08/09/2023] [Indexed: 08/14/2023]
Abstract
Phthalates in contaminated foods and personal care products are one of the most frequently exposed chemicals with a public health concern. Phthalate exposure is related to cardiovascular diseases, including diabetic vascular complications and cerebrovascular diseases, yet the mechanism is still unclear. The blood-brain barrier (BBB) integrity disruption is strongly associated with cardiovascular and neurological disease exacerbation. We investigated BBB damage by di-(2-ethylhexyl) phthalate (DEHP) or its metabolite mono-(2-ethylhexyl) phthalate (MEHP) using brain endothelial cells and rat models. BBB damage by the subthreshold level of MEHP, but not a DEHP, significantly increased by the presence of methylglyoxal (MG), a reactive dicarbonyl compound whose levels increase in the blood in hyperglycemic conditions in diabetic patients. Significant potentiation in apoptosis and autophagy activation, mitochondria-derived reactive oxygen species (ROS) production, and mitochondrial metabolic disturbance were observed in brain ECs by co-exposure to MG and MEHP. N-acetyl cysteine (NAC) restored autophagy activation as well as tight junction protein impairment induced by co-exposure to MG and MEHP. Intraperitoneal administration of MG and MEHP significantly altered mitochondrial membrane potential and tight junction integrity in rat brain endothelium. This study may provide novel insights into enhancing phthalate toxicity in susceptible populations, such as diabetic patients.
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Affiliation(s)
- Donghyun Kim
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, 15588, South Korea
| | - Eujin Oh
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, 15588, South Korea
| | - Haram Kim
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, 15588, South Korea
| | - Seung Mi Baek
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, 15588, South Korea
| | - Junho Cho
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, 15588, South Korea
| | - Eun-Hye Kim
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, 15588, South Korea
| | - Sungbin Choi
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, 15588, South Korea
| | - Yiying Bian
- School of Public Health, China Medical University, Shenyang, 110122, China
| | - Wondong Kim
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, 15588, South Korea
| | - Ok-Nam Bae
- College of Pharmacy Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, 15588, South Korea.
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16
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Lin J, Cheng S, Zhang J, Zhao L, Yuan S, Zhang L, Yin Y. Racial differences in the associations of urinary phthalate metabolites with depression risk. ENVIRONMENTAL RESEARCH 2023; 226:115670. [PMID: 36907347 DOI: 10.1016/j.envres.2023.115670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 02/15/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE This study aimed to investigate the composite effects of different kinds of phthalates on depression risk in the U.S population. METHODS 11731 participants were included from the National Health and Nutrition Examination Survey (NHANES), a national cross-sectional survey. Twelve urinary phthalate metabolites were used to evaluate the level of phthalates exposure. Phthalates levels were devided into four quartiles. High phthalate was defined as having values in the highest quartile. RESULTS Urinary mono-isobutyl phthalate (MiBP) and mono-benzyl phthalate (MBzP) were estimated as the independent risk factors for depression by mutivariate logistic regression analyses. Compared with the lowest quartile group of MiBP or MBzP, an incrementally higher risk of depression and moderate/severe depression was observed in the highest quartile (all Ptrend <0.05). It was observed that incrementally higher risk of depression and moderate/severe depression were associated with more numbers of high phthalates parameter (Ptrend <0.001 and Ptrend = 0.003, respectively). A significant interaction between race (Non-Hispanic Black vs. Mexican American) and 2 parameters (having value in the highest quartile of both MiBP and MBzP) was detected for depression (Pinteraction = 0.023) and moderate/severe depression (Pinteraction = 0.029). CONCLUSION Individuals with more numbers of high phthalates parameter were at higher risk of depression and moderate/severe depression. Non-Hispanic Black participants were more likely to be affected by high levels of MiBP and MBzP exposure than Mexican American participants.
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Affiliation(s)
- Jilei Lin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Siying Cheng
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Zhang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Liebin Zhao
- Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China
| | - Shuhua Yuan
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Zhang
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yong Yin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Engineering Research Center of Intelligence Pediatrics (SERCIP), Shanghai, China; Pediatric AI Clinical Application and Research Center, Shanghai Children's Medical Center, Shanghai, China.
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Yang AM, Lai TS, Lin YL, Wang C, Lin CY. Urinary di-(2-ethylhexyl) phthalate metabolites are independently related to serum neurofilament light chain, a biomarker of neurological diseases, in adults: results from NHANES 2013-2014. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:66417-66425. [PMID: 37097562 DOI: 10.1007/s11356-023-26943-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 04/07/2023] [Indexed: 05/17/2023]
Abstract
Di (2-ethylhexyl) phthalate (DEHP) is a chemical commonly used in the manufacturing of plastics and can pose human health risks, including endocrine disruption, reproductive toxicity, and potential carcinogenic effects. Children may be particularly vulnerable to the harmful effects of DEHP. Early exposure to DEHP has been linked to potential behavioral and learning problems. However, there are no reports to date on whether DEHP exposure in adulthood has neurotoxic effects. Serum neurofilament light chain (NfL), a protein released into the blood after neuroaxonal damage, has been shown to be a reliable biomarker for many neurological diseases. To date, no study has examined the relationship between DEHP exposure and NfL. For the present study, we selected 619 adults (aged ≥ 20 years) from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) to examine the association between urinary DEHP metabolites and serum NfL. We reported higher urinary levels of ln-mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), ln-mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), and ln-mono(2-ethyl-5-carboxypentyl) phthalate (MECPP), and ln-ΣDEHP levels were associated with higher serum levels of ln-NfL (ΣDEHP: β-coefficient = 0. 075; S.E. = 0.026; P = 0.011). When we divided ΣDEHP into quartiles, mean NfL concentrations increased with quartiles of MEHHP (P for trend = 0.023). The association was more pronounced in males, non-Hispanic white race, higher income, and BMI < 25. In conclusion, higher DEHP exposure was positively associated with higher serum NfL in adults from NHANES 2013-2014. If this finding is causal, it is possible that DEHP exposure in adulthood may also induce neurological damage. Although the causality of this observation and the clinical significance are uncertain, our findings suggest that additional research is needed on DEHP exposure, serum NfL, and neurological disease in adults.
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Affiliation(s)
- An-Ming Yang
- Department of Internal Medicine, En Chu Kong Hospital, No. 399, Fuxing Rd., Sanxia Dist., New Taipei City, 237, Taiwan
- Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu, 300, Taiwan
| | - Tai-Shuan Lai
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, 100, Taiwan
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, 100, Taiwan
| | - Yu-Ling Lin
- Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu, 300, Taiwan
- Department of Nephrology, Hsinchu Cathay General Hospital, Hsinchu, 300, Taiwan
| | - ChiKang Wang
- Department of Environmental Engineering and Health, Yuanpei University of Medical Technology, Hsinchu, 300, Taiwan
| | - Chien-Yu Lin
- Department of Internal Medicine, En Chu Kong Hospital, No. 399, Fuxing Rd., Sanxia Dist., New Taipei City, 237, Taiwan.
- Department of Environmental Engineering and Health, Yuanpei University of Medical Technology, Hsinchu, 300, Taiwan.
- School of Medicine, Fu Jen Catholic University, New Taipei City, 242, Taiwan.
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18
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Huang D, Magaoay B, Rosen MP, Cedars MI. Presence of Fibroids on Transvaginal Ultrasonography in a Community-Based, Diverse Cohort of 996 Reproductive-Age Female Participants. JAMA Netw Open 2023; 6:e2312701. [PMID: 37163265 PMCID: PMC10173016 DOI: 10.1001/jamanetworkopen.2023.12701] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
Importance Fibroids are benign uterine tumors that can cause significant morbidity. Knowledge on fibroid prevalence, especially in the asymptomatic population and in Asian and Hispanic or Latina individuals, is limited, and a better understanding of affected groups will improve timely diagnosis and motivate appropriate recruitment in clinical trials to reduce health disparities. Objective To estimate the prevalence of fibroids in a diverse cohort of female individuals. Design, Setting, and Participants This cross-sectional study included female individuals not seeking treatment for fertility or other conditions who were prospectively recruited in an academic medical center in San Francisco, California. Effort was made to recruit an equal proportion of participants from 4 large racial and ethnic groups in the United States (Asian-Chinese, Black or African American, Hispanic or Latina, and White) and across 4 equal age groups between 25 and 45 years. All participants reported regular menses (21-35 days), had not used estrogen- or progestin-containing medications in the 3 months prior to enrollment, and denied history of pelvic surgery. The assessment of ultrasonography results was part of an ongoing longitudinal cohort, with initial recruitment from October 2006 to September 2012. Data analysis was performed in April to September 2022. Main Outcomes and Measures Fibroid presence and burden as assessed by transvaginal ultrasonography. Results A total of 996 female participants were included in the analysis, including 229 (23.0%) Asian-Chinese, 249 (25.0%) Black or African American, 237 (23.8%) Hispanic or Latina, and 281 (28.2%) White individuals. Mean (SD) age was 34.8 (5.7) years in Asian-Chinese participants, 35.4 (6.1) years in Black or African American participants, 34.8 (5.3) years in Hispanic or Latina participants, and 35.3 (5.0) years in White participants. Fibroids were present in 21.8% (95% CI, 16.7%-27.8%) of Asian-Chinese participants, 35.7% (95% CI, 29.8%-42.0%) of Black or African American participants, 12.7% (95% CI, 8.7%-17.6%) of Hispanic or Latina participants, and 10.7% (95% CI, 7.3%-14.9%) of White participants. Black or African American and Asian-Chinese participants were more likely to have fibroids than White participants (Black or African American: adjusted odds ratio [OR], 4.72 [95% CI, 2.72-8.18]; P < .001; Asian-Chinese: adjusted OR, 3.35 [95% CI, 1.95-5.76]; P < .001). In those with fibroids, the proportion with multiple fibroids were 48.3% in Black or African American participants, 33.3% in White participants, 33.3% in Hispanic or Latina participants, and 26.0% in Asian-Chinese participants (P = .06). The largest mean (SD) fibroid diameter was 3.9 (1.9) cm in Black or African American participants, 3.2 (1.6) cm in Asian-Chinese participants, 3.2 (1.6) cm in White participants, and 3.0 (1.4) cm in Hispanic or Latina participants (P = .03). Conclusions and Relevance In this study of female participants in a nonclinical setting, Black or African American and Asian-Chinese participants were disproportionately affected by uterine fibroids. Hispanic or Latina participants had similar fibroid burden to White participants.
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Affiliation(s)
- David Huang
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco
| | - Brady Magaoay
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco
| | - Mitchell P Rosen
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco
| | - Marcelle I Cedars
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco
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19
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Bai J, Ma Y, Zhao Y, Yang D, Mubarik S, Yu C. Mixed exposure to phenol, parabens, pesticides, and phthalates and insulin resistance in NHANES: A mixture approach. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 851:158218. [PMID: 36028038 DOI: 10.1016/j.scitotenv.2022.158218] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/01/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE The effects of environmental chemicals on insulin resistance have attracted extensive attention. Previous studies typically focused on the single chemical effects. This study adopted three different models to analyze the mixed effects of nine common chemicals (one phenol, two parabens, two chlorophenols and four phthalates) on insulin resistance. METHODS Urinary concentrations of chemicals were extracted from National Health and Nutrition Examination Survey (NHANES) 2009-2016. Insulin resistance was assessed using homeostatic model assessment (HOMA) and defined as HOMA-IR >2.6. The generalized linear regression (GLM), weighted quantile sum regression (WQS) and Bayesian kernel machine regression models (BKMR) were applied to assess the relationship between chemical mixture and HOMA-IR or insulin resistance. RESULTS Of the 2067 participants included, 872 (42.19 %) were identified as insulin resistant. In single-chemical GLM model, di-2-ethylhexyl phthalate (DEHP) had the highest parameter (β/OR, 95 % CIs) of 0.21 (quartile 4, 0.12- 0.29) and 1.95 (quartile 4, 1.39- 2.74). Similar results were observed in the multi-chemical models, with DEHP (quartile 4) showing the positive relationship with HOMA-IR (0.18, 0.08- 0.28) and insulin resistance (1.76, 1.17- 2.64). According to WQS models, the WQS indices were significantly positively correlated with both HOMA-IR (β: 0.07, 95 % CI: 0.03- 0.12) and insulin resistance (OR: 1.25, 95 % CI: 1.03- 1.53). DEHP was the top-weighted chemical positively correlated with both HOMA-IR and insulin resistance. In the BKMR model, the joint effect was also positively correlated with both outcomes. DEHP remained the main contributor to the joint effect, consistent with WQS analysis. CONCLUSION Our findings suggested that these chemical mixtures had the positive joint effects on both HOMA-IR and insulin resistance, with DEHP being the potentially predominant driver. The inter-validation of the three models may indicate that reducing the DEHP concentration could improve glucose homeostasis and reduce the risk of insulin resistance. However, further studies are recommended to deepen our findings and elucidate the mechanisms of insulin resistance and chemical mixture.
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Affiliation(s)
- Jianjun Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185# Donghu Road, Wuhan 430072, China
| | - Yudiyang Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185# Donghu Road, Wuhan 430072, China
| | - Yudi Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185# Donghu Road, Wuhan 430072, China
| | - Donghui Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185# Donghu Road, Wuhan 430072, China
| | - Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185# Donghu Road, Wuhan 430072, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, 185# Donghu Road, Wuhan 430072, China; Global Health Institute, Wuhan University, 185# Donghu Road, Wuhan 430072, China.
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20
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Wang H, Zhang Y. Exposure to Polybrominated Diphenyl Ethers and Phthalates in China: A Disease Burden and Cost Analysis. TOXICS 2022; 10:766. [PMID: 36548599 PMCID: PMC9782749 DOI: 10.3390/toxics10120766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
Increasing evidence indicates that endocrine-disrupting chemicals (EDCs) cause a variety of adverse health outcomes and contribute to substantial disease burden. This study summarized the exposure status of polybrominated diphenyl ethers (PBDEs) and phthalates (PAEs) in China and evaluated the disease burden attributable to PBDEs and PAEs in 2015. The results showed that PBDE and PAE concentrations were higher in coastal areas. The disease burden attributable to PBDEs was 0.77 million cases, and the economic costs were CNY 18.92 billion. Meanwhile, 3.02 million individuals suffered from diseases attributable to PAEs, and the economic costs were CNY 49.20 billion. The economic burden caused by PBDEs and PAEs accounted for 0.28% and 0.72% of China's Gross Domestic Product (GDP) in 2015, respectively. When comparing China's results from 2010, it was determined that the GDP ratio of economic costs caused by PAEs in 2015 (0.72%) was lower than in 2010 (1.42%). Finally, compared with the results of the European Union and North America, the GDP ratios of economic costs caused by PAEs in 2015 were 0.19% in Canada (lower than China), 0.29% in the United States (lower than China), and 1.44% in the European Union (higher than China). This study provides important reference values for China's health governance, and further research should be conducted in the future.
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Affiliation(s)
- Hang Wang
- Key Lab of Health Technology Assessment, National Health Commission of the People’s Republic of China (Fudan University), Shanghai 200032, China
- Key Laboratory of Public Health Safety, Ministry of Educational, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yunhui Zhang
- Key Lab of Health Technology Assessment, National Health Commission of the People’s Republic of China (Fudan University), Shanghai 200032, China
- Key Laboratory of Public Health Safety, Ministry of Educational, School of Public Health, Fudan University, Shanghai 200032, China
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21
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Shih YL, Hsieh CJ, Lee TY, Liao PH, Wu HT, Liu CY. Sex Differences between Urinary Phthalate Metabolites and Metabolic Syndrome in Adults: A Cross-Sectional Taiwan Biobank Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610458. [PMID: 36012094 PMCID: PMC9407747 DOI: 10.3390/ijerph191610458] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/04/2022] [Accepted: 08/18/2022] [Indexed: 06/13/2023]
Abstract
BACKGROUND Phthalates are widely used in consumer products, food packaging, and personal care products, so exposure is widespread. Several studies have investigated the association of phthalate exposure with obesity, insulin resistance, and hypertension. However, little is known about the associations of phthalate exposure with sex, age, and menopausal status in metabolic syndrome (MetS). The purpose of this study was to investigate the association between 11 urinary phthalate metabolite concentrations and metabolic syndrome in adults. METHODS We conducted a cross-sectional analysis of 1337 adults aged 30-70 years from the Taiwan Biobank 2016-2020. Prevalence odds ratios (POR) and 95% confidence intervals (CIs) were calculated using logistic regression and stratified by sex, age, and menopausal status. RESULTS Participants with MetS comprised 16.38%. Higher concentrations of MEP metabolites were associated with more than two- to three-fold increased odds of MetS in males and males ≥ 50 years (adj. POR Q3 vs. Q1 = 2.13, 95% CI: 1.01, 4.50; p = 0.047 and adj. POR Q2 vs. Q1 = 3.11, 95% CI: 0.13, 8.63; p = 0.029). When assessed by menopausal status, postmenopausal females with higher ∑DEHP concentrations had more than nine-fold higher odds of MetS compared with postmenopausal females with the lowest ∑DEHP concentrations (adj. POR Q3 vs. Q1 = 9.58, 95% CI: 1.18, 77.75; p = 0.034). CONCLUSIONS The findings suggest differential associations between certain phthalate metabolites and MetS by sex, age, and menopausal status.
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Affiliation(s)
- Ya-Ling Shih
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan
| | - Chia-Jung Hsieh
- School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan
| | - Tso-Ying Lee
- Nursing Research Center of Taipei Medical University Hospital, Taipei 110301, Taiwan
| | - Pei-Hung Liao
- School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan
| | - Hao-Ting Wu
- School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan
- Department of Nursing, Cheng Hsin General Hospital, Taipei 112303, Taiwan
| | - Chieh-Yu Liu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan
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22
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Protective effects of polyphenols against endocrine disrupting chemicals. Food Sci Biotechnol 2022; 31:905-934. [DOI: 10.1007/s10068-022-01105-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/24/2022] [Accepted: 05/16/2022] [Indexed: 11/04/2022] Open
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Does early life phthalate exposure mediate racial disparities in children’s cognitive abilities? Environ Epidemiol 2022; 6:e205. [PMID: 35434463 PMCID: PMC9005259 DOI: 10.1097/ee9.0000000000000205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/01/2022] [Indexed: 11/25/2022] Open
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24
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James-Todd T, Ponzano M, Bellavia A, Williams PL, Cantonwine DE, Calafat AM, Hauser R, Quinn MR, Seely EW, McElrath TF. Urinary phthalate and DINCH metabolite concentrations and gradations of maternal glucose intolerance. ENVIRONMENT INTERNATIONAL 2022; 161:107099. [PMID: 35085932 PMCID: PMC10723583 DOI: 10.1016/j.envint.2022.107099] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/22/2021] [Accepted: 01/12/2022] [Indexed: 05/05/2023]
Abstract
BACKGROUND Studies suggest a link between pregnancy phthalate exposures and gestational diabetes mellitus (GDM). Few studies have evaluated associations between phthalate biomarkers (individual or mixtures) with gradations of maternal glucose intolerance. METHODS In a subset of 606 women participating in LIFECODES pregnancy cohort, a combination of 50-gram 1-h non-fasting glucose load test (GLT) and 100-gram 3-h fasting oral glucose tolerance test was used to determine pregnancy glycemic status (median: 27 weeks gestation): normoglycemia (n = 136), impaired glucose tolerance (IGT) (n = 296), and GDM (n = 174). Nineteen metabolites of phthalates and their replacements were measured during each trimester. We used multivariable logistic regression models to evaluate associations between biomarkers (in quartiles) and maternal glycemic status (GDM v. normoglycemia and IGT v. normoglycemia), adjusting for potential confounders. We also used principal component analysis to evaluate associations jointly accounting for metabolites as chemical mixtures. RESULTS Higher 1st trimester mono-3-carboxypropyl phthalate (MCPP) was associated with decreased odds of GDM (Q4 v. Q1: 0.30; 95% CI: 0.13, 0.67) and IGT (Q4 v. Q1 OR: 0.37; 95% CI: 0.17, 0.79). Higher 2nd trimester mono-isobutyl phthalate (MiBP) was associated with increased IGT (Q4 v. Q1 OR: 2.07; 95% CI: 1.06, 4.07), and 2nd trimester mono-3-hydroxybutyl phthalate (MHBP) was non-monotonically associated with increased GDM (Q2 v. Q1 OR: 3.21; 95% CI: 1.54, 6.87). Mixture analyses showed similar associations (Q4 v. Q1 for 2nd trimester dibutyl phthalates metabotlites mixtures OR: 2.08; 95% CI: 1.04, 4.22). CONCLUSION Some phthalate biomarkershad trimester-specific associations with glycemic outcomes, with long and short term health implications.
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Affiliation(s)
- Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Division of Women's Health, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02120, USA.
| | - Marta Ponzano
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Andrea Bellavia
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Paige L Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - David E Cantonwine
- Division of Maternal Fetal Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Antonia M Calafat
- Division of Laboratory Sciences, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Marlee R Quinn
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Ellen W Seely
- Division of Endocrine, Diabetes, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Thomas F McElrath
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Division of Maternal Fetal Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
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25
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Wu H, Just AC, Colicino E, Calafat AM, Oken E, Braun JM, McRae N, Cantoral A, Pantic I, Pizano-Zárate ML, Tolentino MC, Wright RO, Téllez-Rojo MM, Baccarelli AA, Deierlein AL. The associations of phthalate biomarkers during pregnancy with later glycemia and lipid profiles. ENVIRONMENT INTERNATIONAL 2021; 155:106612. [PMID: 33965768 PMCID: PMC8292182 DOI: 10.1016/j.envint.2021.106612] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/01/2021] [Accepted: 04/28/2021] [Indexed: 06/05/2023]
Abstract
BACKGROUND Pregnancy induces numerous cardiovascular and metabolic changes. Alterations in these sensitive processes may precipitate long-term post-delivery health consequences. Studies have reported associations between phthalates and metabolic complications of pregnancy, but no study has investigated metabolic outcomes beyond pregnancy. OBJECTIVES To examine associations of exposure to phthalates during pregnancy with post-delivery metabolic health. DESIGN We quantified 15 urinary phthalate biomarker concentrations during the second and third trimesters among 618 pregnant women from Mexico City. Maternal metabolic health biomarkers included fasting blood measures of glycemia [glucose, insulin, Homeostatic Model Assessment of Insulin Resistance [HOMA-IR], % hemoglobin A1c (HbA1c%)] and lipids (total, high-density lipoprotein (HDL), low-density lipoprotein (LDL) cholesterol, triglycerides), at 4-5 and 6-8 years post-delivery. To estimate the influence of the phthalates mixture, we used Bayesian weighted quantile sum regression and Bayesian kernel machine regression; for individual biomarkers, we used linear mixed models. RESULTS As a mixture, higher urinary phthalate biomarker concentrations during pregnancy were associated with post-delivery concentrations of plasma glucose (interquartile range [IQR] difference: 0.13 SD, 95%CrI: 0.05, 0.20), plasma insulin (IQR difference: 0.06 SD, 95%CrI: -0.02, 0.14), HOMA-IR (IQR difference: 0.08 SD, 95% CrI: 0.01, 0.16), and HbA1c% (IQR difference: 0.15 SD, 95%CrI: 0.05, 0.24). Associations were primarily driven by mono-2-ethyl-5-carboxypentyl terephthalate (MECPTP) and the sum of dibutyl phthalate biomarkers (∑DBP). The phthalates mixture was associated with lower HDL (IQR difference: -0.08 SD, 95%CrI: -0.16, -0.01), driven by ∑DBP and monoethyl phthalate (MEP), and higher triglyceride levels (IQR difference: 0.15 SD, 95%CrI: 0.08, 0.22), driven by MECPTP and MEP. The overall mixture was not associated with total cholesterol and LDL. However, ∑DBP and MEP were associated with lower and higher total cholesterol, respectively, and MECPTP and ∑DBP were associated with lower LDL. CONCLUSIONS Phthalate exposure during pregnancy is associated with adverse long-term changes in maternal metabolic health. A better understanding of timing of the exact biological changes and their implications on metabolic disease risk is needed.
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Affiliation(s)
- Haotian Wu
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, NY, USA.
| | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Joseph M Braun
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Nia McRae
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, NY, USA
| | | | - Ivan Pantic
- Department of Developmental Neurobiology, National Institute of Perinatology, Mexico City, Mexico
| | - María Luisa Pizano-Zárate
- Division of Community Interventions Research, National Institute of Perinatology, Mexico City, Mexico; UMF 4, 37 South Delegation of the Federal District, Mexican Social Security System (IMSS), Mexico City, Mexico
| | | | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Ministry of Health, Cuernavaca, Mexico
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, NY, USA
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Gao H, Chen D, Zang M. Association between phthalate exposure and insulin resistance: a systematic review and meta-analysis update. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:55967-55980. [PMID: 34498187 DOI: 10.1007/s11356-021-16252-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/26/2021] [Indexed: 05/28/2023]
Abstract
An update on systematic review and meta-analysis was performed to explore effects of phthalate exposure on insulin resistance. A systematic literature search was performed in MEDLINE, Web of Science, and CNKI until March 2021. A conceptual framework was constructed to guide the organization and presentation of results. Besides, beta coefficients with corresponding confidence intervals were extracted from the most adjusted models. Extracted beta coefficients were transformed into correlation, and z Fisher transformation of correlation with the corresponding standard error was included in meta-analysis. Subgroup analyses were performed by age (adult vs. adolescent) and sex (female vs. male) of participants and site of study (America and Europe vs. Asia) to explore potential sources of heterogeneity. Nineteen literatures with 12,533 participants reporting on the association of exposure to specific phthalates and insulin resistance were selected. The majority of included studies revealed positive relationships of insulin resistance with different phthalate metabolites exposure. Meta-analyses were performed on 16 studies. Exposure to MnBP, MBzP, MCPP, MEHP, MEOHP, MEHHP, ∑DEHP, and high-molecular weight phthalate (∑HMWP) was associated with the increase of the homeostasis model assessment of insulin resistance (HOMA-IR) index. The results of sensitivity analyses stratified by age, sex, and site of study remained stable, suggesting the robustness of these meta-analyses. Most of heterogeneity in sensitivity analyses decreased to moderate or low degree. Exposure to MnBP, MBzP, MCPP, MEHP, MEOHP, MEHHP, ∑DEHP, and ∑HMWP was associated with the increased risk of HOMA-IR. Age, sex, and site of study might provide limited source of heterogeneity.
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Affiliation(s)
- Hui Gao
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China.
- MOE Key Laboratory of Population Health Across Cycle, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
| | - Dan Chen
- School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Miao Zang
- School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
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Liu W, Cao H, Liao S, Kudłak B, Williams MJ, Schiöth HB. Dibutyl phthalate disrupts conserved circadian rhythm in Drosophila and human cells. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 783:147038. [PMID: 34088158 DOI: 10.1016/j.scitotenv.2021.147038] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/18/2021] [Accepted: 04/05/2021] [Indexed: 06/12/2023]
Abstract
People are constantly exposed to phthalates, due to their common use in the production of plastics, pharmaceuticals, cosmetics and skin care products. The ability of phthalates to disrupt endocrine signaling, leading to developmental, reproductive and metabolic defects, has been studied, yet how phthalates interfere with these biological functions is still unclear. To uncover DBP interacting molecular pathways, we raised Drosophila melanogaster on food containing dibutyl phthalate (DBP) at various concentrations. Whole transcriptome analysis of adult Drosophila reveals that DBP exposure throughout development disrupts the expression of genes central to circadian rhythm regulation, including increased expression of vrille (vri, human NFIL3), timeless (tim, human TIMELESS) and period (per, human PER3), with decreased expression of Pigment-dispersing factor (Pdf). DBP exposure also alters the expression of the evolutionarily conserved nuclear receptor Hormone receptor-like in 38 (Hr38, human NR4A2), which is known to regulate Pdf expression. Furthermore, behavioral assays determined that exposing Drosophila to DBP throughout development modifies the circadian rhythm of adults. Although DBP inhibits the expression of signaling systems regulating vision, including Rh5 and Rh6, two light-sensing G-protein coupled receptors involved in the daily resetting of circadian rhythm, it does not influence eye development. Circadian rhythm genes are well conserved from flies to humans; therefore, we tested the effect of DBP exposure on human breast cells (MCF10A) and demonstrate that, similar to the fruit fly model, this exposure disrupts circadian rhythm (BMAL1 expression) at doses that promote the proliferation and migration ability of MCF10A cells. Our results are the first to provide comprehensive evidence that DBP interferes with circadian rhythm in both adult Drosophila and human cells, which may help to explain the broad physiological action of phthalates.
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Affiliation(s)
- Wen Liu
- Functional Pharmacology, Department of Neuroscience, Uppsala University, Uppsala, Sweden.
| | - Hao Cao
- Functional Pharmacology, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Sifang Liao
- Functional Pharmacology, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Błażej Kudłak
- Department of Analytical Chemistry, Faculty of Chemistry, Gdańsk University of Technology, Gdańsk, Poland
| | - Michael J Williams
- Functional Pharmacology, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Helgi B Schiöth
- Functional Pharmacology, Department of Neuroscience, Uppsala University, Uppsala, Sweden; Institute of Translational Medicine and Biotechnology, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
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Di(2-ethylhexyl)phthalate exposure exacerbates metabolic disorders in diet-induced obese mice. Food Chem Toxicol 2021; 156:112439. [PMID: 34303773 DOI: 10.1016/j.fct.2021.112439] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/23/2021] [Accepted: 07/21/2021] [Indexed: 12/11/2022]
Abstract
Both phthalate exposure and obesity are positively associated with metabolic disorders. The study aimed to investigate whether DEHP exposure caused metabolic disorders in an obesity-dependent manner. Both lean and diet-induced obese mice were subjected to environmentally relevant DEHP exposure. DEHP-treated obese mice exhibited higher glucose intolerance and insulin resistance than obese mice; the metabolic disorders were accompanied by increased blood levels of leptin, LDL cholesterol, and alanine transaminase. In obese mice, DEHP enhanced macrophage infiltration into epididymal white adipose tissue (eWAT) and hepatic tissue, and promoted hepatic steatosis/steatohepatitis. The DEHP effects were not observed in lean mice. Transcriptomic changes in eWAT and hepatic tissue were determined with microarray analysis. Results indicated that obesity and DEHP synergistically regulated carbohydrate uptake, lipolysis, and abnormality of adipose tissue, via the upstream regulators Pparg, Lipe, Cd44, and Irs1. Meanwhile, obesity and DEHP differentially modulated transcriptomic changes in hepatic tissue. Obesity was associated with lipid/cholesterol synthesis, lipid accumulation, and inflammation in hepatic tissue via the upstream regulators Zbtb20 and Nr1i2. In obese mice, DEHP exposure caused hepatic injury, cell migration, and changes in glycogen quantity mainly via Cd44. Microarray analysis suggested the potential mechanism underlying the early onset of metabolic disorders in DEHP-treated obese mice.
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Preston EV, Chan M, Nozhenko K, Bellavia A, Grenon MC, Cantonwine DE, McElrath TF, James-Todd T. Socioeconomic and racial/ethnic differences in use of endocrine-disrupting chemical-associated personal care product categories among pregnant women. ENVIRONMENTAL RESEARCH 2021; 198:111212. [PMID: 33957140 PMCID: PMC8886956 DOI: 10.1016/j.envres.2021.111212] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/15/2021] [Accepted: 04/20/2021] [Indexed: 05/20/2023]
Abstract
Personal care products (PCPs) are important and modifiable sources of exposure to endocrine disrupting chemicals (EDCs). Research is limited on how EDC-associated PCP use differs by race/ethnicity and socioeconomic status (SES), particularly during the sensitive period of pregnancy. We investigated differences in PCP use by race/ethnicity and SES among 497 participants in the LIFECODES pregnancy cohort (Boston, Massachusetts). Participants self-reported race/ethnicity, SES indicators (maternal education; insurance status), and recent PCP use via questionnaire at ≤4 prenatal visits. We evaluated trimester-specific differences in use of individual PCP categories by race/ethnicity and SES indicators. We used Poisson regression to estimate trimester-specific mean total product categories used by race/ethnicity and SES indicators. In the first trimester, compared to non-Hispanic White women, Hispanic women reported higher use of hair gel (45% vs. 28%), perfume (75% vs. 39%), and "other" hair products (37% vs. 19%). Compared to women with a college degree, women without a college degree reported higher use of perfume (79% vs. 41%) and bar soap (74% vs. 56%); patterns were similar for insurance status. The estimated mean total product categories used was significantly lower in Asian compared to non-Hispanic White women in all trimesters (e.g., Trimester 1: 4.8 vs. 6.7 categories; p<0.001). Patterns of PCP use differed by race/ethnicity and SES, with implications for potentially modifiable differential EDC exposure and associated pregnancy outcomes.
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Affiliation(s)
- Emma V Preston
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Marissa Chan
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Katerina Nozhenko
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Andrea Bellavia
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Marissa C Grenon
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - David E Cantonwine
- Department of Maternal Fetal Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Thomas F McElrath
- Department of Maternal Fetal Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
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Abstract
Almost 2 billion adults in the world are overweight, and more than half of them are classified as obese, while nearly one-third of children globally experience poor growth and development. Given the vast amount of knowledge that has been gleaned from decades of research on growth and development, a number of questions remain as to why the world is now in the midst of a global epidemic of obesity accompanied by the "double burden of malnutrition," where overweight coexists with underweight and micronutrient deficiencies. This challenge to the human condition can be attributed to nutritional and environmental exposures during pregnancy that may program a fetus to have a higher risk of chronic diseases in adulthood. To explore this concept, frequently called the developmental origins of health and disease (DOHaD), this review considers a host of factors and physiological mechanisms that drive a fetus or child toward a higher risk of obesity, fatty liver disease, hypertension, and/or type 2 diabetes (T2D). To that end, this review explores the epidemiology of DOHaD with discussions focused on adaptations to human energetics, placental development, dysmetabolism, and key environmental exposures that act to promote chronic diseases in adulthood. These areas are complementary and additive in understanding how providing the best conditions for optimal growth can create the best possible conditions for lifelong health. Moreover, understanding both physiological as well as epigenetic and molecular mechanisms for DOHaD is vital to most fully address the global issues of obesity and other chronic diseases.
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Affiliation(s)
- Daniel J Hoffman
- Department of Nutritional Sciences, Program in International Nutrition, and Center for Childhood Nutrition Research, New Jersey Institute for Food, Nutrition, and Health, Rutgers, the State University of New Jersey, New Brunswick, New Jersey
| | - Theresa L Powell
- Department of Pediatrics and Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, School of Public Health and Division of Exposure Science and Epidemiology, Rutgers Environmental and Occupational Health Sciences Institute, Rutgers, the State University of New Jersey, New Brunswick, New Jersey
| | - Daniel B Hardy
- Department of Biostatistics and Epidemiology, School of Public Health and Division of Exposure Science and Epidemiology, Rutgers Environmental and Occupational Health Sciences Institute, Rutgers, the State University of New Jersey, New Brunswick, New Jersey
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Ghosh R, Haque M, Turner PC, Cruz-Cano R, Dallal CM. Racial and Sex Differences between Urinary Phthalates and Metabolic Syndrome among U.S. Adults: NHANES 2005-2014. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136870. [PMID: 34206929 PMCID: PMC8297378 DOI: 10.3390/ijerph18136870] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/18/2021] [Accepted: 06/20/2021] [Indexed: 12/25/2022]
Abstract
Phthalates, plasticizers ubiquitous in household and personal care products, have been associated with metabolic disturbances. Despite the noted racial differences in phthalate exposure and the prevalence of metabolic syndrome (MetS), it remains unclear whether associations between phthalate metabolites and MetS vary by race and sex. A cross-sectional analysis was conducted among 10,017 adults from the National Health and Nutritional Examination Survey (2005–2014). Prevalence odds ratios (POR) and 95% confidence intervals (CIs) were estimated for the association between 11 urinary phthalate metabolites and MetS using weighted sex and race stratified multivariable logistic regression. Higher MCOP levels were significantly associated with increased odds of MetS among women but not men, and only remained significant among White women (POR Q4 vs. Q1 = 1.68, 95% CI: 1.24, 2.29; p-trend = 0.001). Similarly, the inverse association observed with MEHP among women, persisted among White women only (POR Q4 vs. Q1 = 0.53, 95% CI: 0.35, 0.80; p-trend = 0.003). However, ΣDEHP metabolites were associated with increased odds of MetS only among men, and this finding was limited to White men (POR Q4 vs. Q1 = 1.54, 95% CI: 1.01, 2.35; p-trend = 0.06). Among Black men, an inverse association was observed with higher MEP levels (POR Q4 vs. Q1 = 0.43, 95% CI: 0.24, 0.77; p-trend = 0.01). The findings suggest differential associations between phthalate metabolites and MetS by sex and race/ethnicity.
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Affiliation(s)
- Rajrupa Ghosh
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD 20742, USA; (R.G.); (M.H.); (R.C.-C.)
| | - Mefruz Haque
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD 20742, USA; (R.G.); (M.H.); (R.C.-C.)
| | - Paul C. Turner
- Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD 20742, USA;
| | - Raul Cruz-Cano
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD 20742, USA; (R.G.); (M.H.); (R.C.-C.)
| | - Cher M. Dallal
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD 20742, USA; (R.G.); (M.H.); (R.C.-C.)
- Correspondence: ; Tel.: +1-301-405-7065
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32
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van der Meer TP, Chung MK, van Faassen M, Makris KC, van Beek AP, Kema IP, Wolffenbuttel BHR, van Vliet-Ostaptchouk JV, Patel CJ. Temporal exposure and consistency of endocrine disrupting chemicals in a longitudinal study of individuals with impaired fasting glucose. ENVIRONMENTAL RESEARCH 2021; 197:110901. [PMID: 33617867 PMCID: PMC9162187 DOI: 10.1016/j.envres.2021.110901] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/29/2021] [Accepted: 02/15/2021] [Indexed: 06/12/2023]
Abstract
Endocrine disrupting chemicals (EDCs) include non-persistent exogenous substances such as parabens, bisphenols and phthalates which have been associated with a range of metabolic disorders and disease. It is unclear if exposure remains consistent over time. We investigated change in indicators of EDC exposure between 2009 and 2016 and assessed its consistency between and within individuals over a median follow-up time of 47 months in a sample of Dutch individuals. Of 500 Dutch individuals, two 24 h urine samples were analysed for 5 parabens, 3 bisphenols and 13 metabolites of in total 8 different phthalates. We calculated per-year differences using meta-analysis and assessed temporal correlations between and within individuals using Spearman correlation coefficients, intra-class correlation coefficients (ICC) and kappa-statistics. We found a secular decrease in concentrations of methyl, ethyl, propyl and n-butyl paraben, bisphenol A, and metabolites of di-ethyl phthalate (DEP), di-butyl phthalate (DBP), di-(2-ethyl-hexyl) phthalate (DEHP), and butylbenzyl phthalate (DBzP) which varied from 8 to 96% (ethyl paraben, propyl paraben) between 2009 and 2016. Within-person temporal correlations were highest for parabens (ICC: 0.34 to 0.40) and poorest for bisphenols (ICC: 0.15 to 0.23). For phthalate metabolites, correlations decreased most between time periods (ICC < 48 months: 0.22 to 0.39; ≥48 months: 0.05 to 0.32). When categorizing EDC concentrations, 33-54% of individuals remained in the lowest or highest category and temporal correlations were similar to continuous measurements. Exposure to most EDCs decreased between 2009 and 2016 in a sample of individuals with impaired fasting glucose from the Dutch population. Temporal consistency was generally poor. The inconsistency in disease associations may be influenced by individual-level or temporal variation exhibited by EDCs. Our findings call for the need for repeated measurements of EDCs in observational studies before and during at-risk temporal windows for the disease.
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Affiliation(s)
- Thomas P van der Meer
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA; Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Ming K Chung
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Martijn van Faassen
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Konstantinos C Makris
- Water and Health Laboratory, Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Irinis 95, 3041, Limassol, Cyprus
| | - André P van Beek
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Ido P Kema
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Bruce H R Wolffenbuttel
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Jana V van Vliet-Ostaptchouk
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Genomics Coordination Center, Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Chirag J Patel
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.
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Huang HB, Siao CY, Lo YTC, Shih SF, Lu CH, Huang PC. Mediation effects of thyroid function in the associations between phthalate exposure and glucose metabolism in adults. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 278:116799. [PMID: 33743268 DOI: 10.1016/j.envpol.2021.116799] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 02/04/2021] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
The mediating influence of thyroid function on the association of phthalate exposure with glucose metabolism, including insulin resistance, remains unclear. We explored the mediating influence of thyroid hormone levels on the phthalate exposure-insulin resistance association. This cross-sectional study of 217 Taiwanese adults assessed insulin resistance (Homeostatic Model Assessment for Insulin Resistance, HOMA-IR scores) and the levels of 11 urinary phthalate metabolites and 5 thyroid hormones. Multiple regression models were used to analyze the associations among serum thyroid hormone levels, urinary phthalate metabolite levels, and HOMA-IR scores. The mediation analysis assessed the influence of thyroid function on the phthalate exposure-HOMA-IR association. Our data indicated urinary mono-ethylhexyl phthalate (MEHP) levels was negatively associated with free thyroxine (T4) (β = -0.018; 95% confidence interval [CI]: -0.031, -0.005) and positively associated with HOMA-IR scores (β = 0.051, 95% CI: 0.012, 0.090). The study also revealed urinary mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) levels was negatively associated with free T4 (β = -0.036, 95% CI: -0.056, -0.017) and HOMA-IR (β = 0.070, 95% CI: 0.013, 0.126). Free T4 and HOMA-IR had a negative association (β = -0.757, 95% CI: -1.122, -0.392). In the mediation analysis, free T4 mediated 24% and 35% of the associations of urinary MEHP and MEOHP with HOMA-IR, respectively. Our findings revealed the mediating role of thyroid function in the phthalate exposure-glucose metabolism association in adults.
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Affiliation(s)
- Han-Bin Huang
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Ying Siao
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Yuan-Ting C Lo
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Shu-Fang Shih
- Department of Health Administration, College of Health Professions, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Chieh-Hua Lu
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Po-Chin Huang
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Safety, Health and Environmental Engineering, National United University, Miaoli, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
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34
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James-Todd T, Connolly L, Preston EV, Quinn MR, Plotan M, Xie Y, Gandi B, Mahalingaiah S. Hormonal activity in commonly used Black hair care products: evaluating hormone disruption as a plausible contribution to health disparities. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:476-486. [PMID: 33958708 PMCID: PMC8812815 DOI: 10.1038/s41370-021-00335-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 05/11/2023]
Abstract
BACKGROUND Certain types of hair products are more commonly used by Black women. Studies show hair products contain several endocrine-disrupting chemicals that are associated with adverse health outcomes. As chemical mixtures of endocrine disruptors, hair products may be hormonally active, but this remains unclear. OBJECTIVE To assess the hormonal activity of commonly used Black hair products. METHODS We identified six commonly used hair products (used by >10% of the population) from the Greater New York Hair Products Study. We used reporter gene assays (RGAs) incorporating natural steroid receptors to evaluate estrogenic, androgenic, progestogenic, and glucocorticoid hormonal bioactivity employing an extraction method using bond elution prior to RGA assessment at dilutions from 50 to 500. RESULTS All products displayed hormonal activity, varying in the amount and effect. Three samples showed estrogen agonist properties at levels from 12.5 to 20 ng/g estradiol equivalent concentrations All but one sample showed androgen antagonist properties at levels from 20 to 25 ng/g androgen equivalent concentrations. Four samples showed antagonistic and agonistic properties to progesterone and glucocorticoid. SIGNIFICANCE Hair products commonly used by Black women showed hormonal activity. Given their frequent use, exposure to hormonally active products could have implications for health outcomes and contribute to reproductive and metabolic health disparities.
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Affiliation(s)
- Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Division of Women's Health, Department of Medicine, Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Lisa Connolly
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Emma V Preston
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marlee R Quinn
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Monika Plotan
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Yuling Xie
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Bharathi Gandi
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Shruthi Mahalingaiah
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Massachusetts General Hospital, Boston, MA, USA
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35
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Allotey JA, Boyle M, Sapkota A, Zhu L, Peng RD, Garza MA, Quirós-Alcalá L. Determinants of phthalate exposure among a U.S.-based group of Latino workers. Int J Hyg Environ Health 2021; 234:113739. [PMID: 33836349 PMCID: PMC8096699 DOI: 10.1016/j.ijheh.2021.113739] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Phthalates are endocrine disrupting compounds linked to various adverse health effects. U.S. national biomonitoring data indicate that select minority subgroups may suffer disparate exposures to phthalates. Still, exposures and their respective determinants among these subgroups are not well characterized. OBJECTIVE We sought to examine determinants of phthalate exposure in a subsample of US-based Latino adults. METHODS We conducted a cross-sectional study on 94 Latino immigrant adults in Maryland. Participants were >18 years of age and working in a service-based industry. We administered an interviewer-administered questionnaire to capture information on potential exposure determinants (e.g., demographic characteristics, consumer product use, and workplace exposures and behaviors) and using HPLC/MS-MS we quantified concentrations of 9 urinary phthalate metabolites: monoethyl phthalate (MEP, diethyl phthalate metabolite); mono-n-butyl phthalate (MBP, di-n-butyl phthalate metabolite); mono-isobutyl phthalate (MiBP, di-isobutyl phthalate metabolite; monobenzyl phthalate (MBzP, benzylbutyl phthalate metabolite); molar sum of di-2-ethylhexyl phthalate or DEHP metabolites [mono-2-ethylhexyl phthalate (MEHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), and mono-(2-ethyl-5-carboxypentyl) phthalate (MECCP)]; and mono(3-carboxypropyl) phthalate (MCPP, a non-specific metabolite of several phthalates including di-n-butyl phthalate and di-n-octyl phthalate). DEHP was analyzed as the molar sum of four metabolites (ΣDEHP = MEHP + MEHHP + MECPP + MEOHP). Spearman correlations, Wilcoxon-Mann-Whitney, and Kruskal-Wallis tests were conducted to assess bivariate associations between metabolite concentrations and potential exposure determinants. Covariates associated with metabolites at p < 0.10 in bivariate analyses were included in multivariable linear regression models to assess the independent effects of predictors on metabolite concentrations. RESULTS Uncorrected median phthalate metabolite concentrations were lower in our study population (50% of samples ranged between 1.4 and 23.6 μg/L. While we observed some significant associations with select predictors in our bivariate analysis, select associations were attenuated in multivariable regression models. In our final multivariable linear regression models, we found that use of bleach (β = 1.15, 95%CI:0.30, 2.00) and consumption pasta/rice/noodles (β = 0.87, 95%CI: 0.27, 1.46) was positively associated with MBzP concentrations. MEP concentrations were inversely associated with use of furniture polish (β = -1.17, 95%CI: 2.21, -0.12) and use of scented dryer sheets (β = -1.08, 95%CI: 2.01, -0.14). Lastly, ΣDEHP concentrations were inversely associated with use of degreaser (ßDEHP = -0.65, 95%CI: 1.25, -0.05). CONCLUSIONS In this predominantly U.S.-based Central American subsample of adults, we observed lower metabolite concentrations than those previously reported in other U.S. studies and other countries. Our findings could be due, in part, to temporal trends in phthalate exposures and cultural differences related to exposure-related behaviors. While some exposure determinants were identified in our bivariate analyses, results from multivariable regression models did not provide clear results as many associations were attenuated. Environmental exposures may vary within minority subgroups and should be explored further in future studies to further inform exposure mitigation strategies.
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Affiliation(s)
- Janice A Allotey
- Johns Hopkins University, Bloomberg School of Public Health, Department of Environmental Health & Engineering, Baltimore, MD, USA
| | - Meleah Boyle
- Maryland Institute of Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD, USA
| | - Amir Sapkota
- Maryland Institute of Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD, USA
| | - Linyan Zhu
- Maryland Institute of Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD, USA
| | - Roger D Peng
- Johns Hopkins University, Bloomberg School of Public Health, Department of Biostatistics, Baltimore, MD, USA
| | - Mary A Garza
- California State University, Fresno, College of Health and Human Services, Department of Public Health, Fresno, CA, USA
| | - Lesliam Quirós-Alcalá
- Johns Hopkins University, Bloomberg School of Public Health, Department of Environmental Health & Engineering, Baltimore, MD, USA; Maryland Institute of Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD, USA.
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Zamora AN, Jansen EC, Tamayo-Ortiz M, Goodrich JM, Sánchez BN, Watkins DJ, Tamayo-Orozco JA, Téllez-Rojo MM, Mercado-García A, Baylin A, Meeker JD, Peterson KE. Exposure to Phenols, Phthalates, and Parabens and Development of Metabolic Syndrome Among Mexican Women in Midlife. Front Public Health 2021; 9:620769. [PMID: 33718320 PMCID: PMC7952420 DOI: 10.3389/fpubh.2021.620769] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/02/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Evidence suggests exposure to endocrine-disrupting chemicals (EDCs) can influence Metabolic Syndrome (MetS) risk in adults, but it is unclear if EDCs impact women during midlife. We examined if EDCs measured in adult women were predictive of MetS and its components 9 years later. Methods: We measured urinary phthalate metabolites, phenols, and parabens collected in 2008 among 73 females from the ELEMENT study. MetS and its components (Abdominal Obesity, Hypertriglyceridemia, Cholesterolemia, Hypertension, and Hyperglycemia) were assessed in 2017. We regressed log-transformed EDC concentrations on MetS and MetS components using logistic regression, adjusting for age and physical activity. Results: At follow-up, the mean (SD) age was 46.6 (6.3) years; the prevalence of MetS was 34.3%. Sum of dibutyl phthalate metabolites (ΣDBP), monobenzyl phthalate (MBzP), and monoethyl phthalate (MEP) were associated with an increased odds of hypertriglyceridemia. 2,5-dichlorophenol (2,5 DCP) and 2,4-dichlorophenol (2,4 DCP) were associated with increased odds of hypertriglyceridemia. The odds of hypertension were 4.18 (95% CI: 0.98, 17.7, p < 0.10) and 3.77 (95% CI: 0.76, 18.62, p < 0.10) times higher for every IQR increase in MCOP and propyl paraben, respectively. The odds of hyperglycemia were 0.46 (95% CI: 0.18, 1.17 p < 0.10) times lower for every IQR increase in the sum of di-2-ethylhexyl phthalate metabolites (ΣDEHP), and the odds of abdominal obesity were 0.70 (95% CI: 0.40, 1.21, p < 0.10) lower for every IQR increase in the concentration of triclosan. Conclusion: We found EDCs measured in 2008 were marginally predictive of hypertriglyceridemia and hypertension 9 years later. Results suggest that lower exposure to certain toxicants was related to lower markers of metabolic risk among midlife women.
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Affiliation(s)
- Astrid N. Zamora
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Erica C. Jansen
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Marcela Tamayo-Ortiz
- Occupational Health Research Unit, Mexican Social Security Institute, Mexico City, Mexico
| | - Jaclyn M. Goodrich
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Brisa N. Sánchez
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, United States
| | - Deborah J. Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | | | | | | | - Ana Baylin
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - John D. Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Karen E. Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
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Callaghan MA, Alatorre-Hinojosa S, Connors LT, Singh RD, Thompson JA. Plasticizers and Cardiovascular Health: Role of Adipose Tissue Dysfunction. Front Pharmacol 2021; 11:626448. [PMID: 33716730 PMCID: PMC7947604 DOI: 10.3389/fphar.2020.626448] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 12/22/2020] [Indexed: 12/12/2022] Open
Abstract
Since the 1950s, the production of plastics has increased 200-fold, reaching 360 million tonnes in 2019. Plasticizers, additives that modify the flexibility and rigidity of the product, are ingested as they migrate into food and beverages. Human exposure is continuous and widespread; between 75 and 97% of urine samples contain detectable levels of bisphenols and phthalates, the most common plasticizers. Concern over the toxicity of plasticizers arose in the late 1990s, largely focused around adverse developmental and reproductive effects. More recently, many studies have demonstrated that exposure to plasticizers increases the risk for obesity, type 2 diabetes, and cardiovascular disease (CVD). In the 2000s, many governments including Canada, the United States and European countries restricted the use of certain plasticizers in products targeted towards infants and children. Resultant consumer pressure motivated manufacturers to substitute plasticizers with analogues, which have been marketed as safe. However, data on the effects of these new substitutes are limited and data available to-date suggest that many exhibit similar properties to the chemicals they replaced. The adverse effects of plasticizers have largely been attributed to their endocrine disrupting properties, which modulate hormone signaling. Adipose tissue has been well-documented to be a target of the disrupting effects of both bisphenols and phthalates. Since adipose tissue function is a key determinant of cardiovascular health, adverse effects of plasticizers on adipocyte signaling and function may underlie their link to cardiovascular disease. Herein, we discuss the current evidence linking bisphenols and phthalates to obesity and CVD and consider how documented impacts of these plasticizers on adipocyte function may contribute to the development of CVD.
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Affiliation(s)
- Mikyla A Callaghan
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada.,Libin Cardiovascular Institute, Calgary, AB, Canada
| | | | - Liam T Connors
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada.,Libin Cardiovascular Institute, Calgary, AB, Canada
| | - Radha D Singh
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada.,Libin Cardiovascular Institute, Calgary, AB, Canada
| | - Jennifer A Thompson
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada.,Libin Cardiovascular Institute, Calgary, AB, Canada.,Alberta Children's Health Research Institute, Calgary, AB, Canada
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Yang L, Yin W, Li P, Hu C, Hou J, Wang L, Yuan J, Yu Z. Seasonal exposure to phthalates and inflammatory parameters: A pilot study with repeated measures. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 208:111633. [PMID: 33396153 DOI: 10.1016/j.ecoenv.2020.111633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/02/2020] [Accepted: 11/05/2020] [Indexed: 06/12/2023]
Abstract
Exposure to phthalates poses potential to damage multiple organs and system in the body. However, limited data are available regarding effects of seasonal exposure levels of phthalates and indicators reflecting inflammatory response. We designed a pilot study with repeated measures. We recruited 106 eligible habitants from Wuhan city, China. They completed questionnaires, physical examinations and provided urine specimens in winter and summer seasons. We found that urinary levels of low-molecular-weight phthalate metabolites were higher in summer than in winter (all P < 0.01). In winter, an interquartile range increase (1.264 μg/L) in 3-day moving average of high-molecular-weight phthalate metabolites corresponded to a 13.634% (95% CI: -22.331, -3.941) decrease in mean platelet volume, 25.879% (95% CI: -37.424, -12.204) for lymphocyte count or 10.862% (95% CI: -18.716, -2.125) for platelet count (P < 0.05 or P < 0.01). However, in summer, an interquartile range increase (1.215 μg/L) in urinary levels of high-molecular-weight phthalate metabolites corresponded to an 8.743% (95% CI: 4.217, 13.467) increase in platelet distribution width value or a 4.597% (95% CI: 2.335, 6.780) for mean platelet volume value at 3-day lag (both P < 0.01). In conclusion, phthalate exposure exhibited the potential for the activation of platelet function, particularly in winter. Seasonal variations of phthalate exposure should be considered when assessing health risk.
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Affiliation(s)
- Luoyao Yang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13 Wuhan 430030, PR China; Key Laboratory of Environment & Health (Huazhong University of Science and Technology), Ministry of Education, State Environmental Protection Key Laboratory of Environment and Health (Wuhan) and State Key Laboratory of Environment Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Wenjun Yin
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13 Wuhan 430030, PR China; Key Laboratory of Environment & Health (Huazhong University of Science and Technology), Ministry of Education, State Environmental Protection Key Laboratory of Environment and Health (Wuhan) and State Key Laboratory of Environment Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China; Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan 430015, Hubei, PR China
| | - Pei Li
- State Key Laboratory of Organic Geochemistry, Guangdong Key Laboratory of Environment and Resources, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou 510640, PR China
| | - Chen Hu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13 Wuhan 430030, PR China; Key Laboratory of Environment & Health (Huazhong University of Science and Technology), Ministry of Education, State Environmental Protection Key Laboratory of Environment and Health (Wuhan) and State Key Laboratory of Environment Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Jian Hou
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13 Wuhan 430030, PR China; Key Laboratory of Environment & Health (Huazhong University of Science and Technology), Ministry of Education, State Environmental Protection Key Laboratory of Environment and Health (Wuhan) and State Key Laboratory of Environment Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Lin Wang
- Key Laboratory of Environment & Health (Huazhong University of Science and Technology), Ministry of Education, State Environmental Protection Key Laboratory of Environment and Health (Wuhan) and State Key Laboratory of Environment Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China
| | - Jing Yuan
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13 Wuhan 430030, PR China; Key Laboratory of Environment & Health (Huazhong University of Science and Technology), Ministry of Education, State Environmental Protection Key Laboratory of Environment and Health (Wuhan) and State Key Laboratory of Environment Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Hangkong Road 13, Wuhan 430030, Hubei, PR China.
| | - Zhiqiang Yu
- State Key Laboratory of Organic Geochemistry, Guangdong Key Laboratory of Environment and Resources, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou 510640, PR China.
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Lin CY, Lee HL, Hwang YT, Wang C, Hsieh CJ, Wu C, Sung FC, Su TC. The association between urine di-(2-ethylhexyl) phthalate metabolites, global DNA methylation, and subclinical atherosclerosis in a young Taiwanese population. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 265:114912. [PMID: 32540595 DOI: 10.1016/j.envpol.2020.114912] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 05/04/2020] [Accepted: 05/29/2020] [Indexed: 06/11/2023]
Abstract
Di-(2-ethylhexyl) phthalate (DEHP) has been utilized in many products for years. DEHP exposure has been linked to cardiovascular diseases (CVD) and its risk factors. Recent evidence has found a crucial role for epigenetics, including DNA methylation, in CVD. Moreover, DEHP exposure has proved to alter DNA methylation in epidemiological studies. However, the interplay between DEHP exposure, global DNA methylation, and atherosclerosis has never been reported. In this current study, we enrolled 793 participants (12-30 years) from a Taiwanese population to investigate the association between concentrations of DEHP metabolites, 5mdC/dG (global DNA methylation marker) and the carotid intima-media thickness (CIMT). The results showed urine mono-2-ethylhexyl phthalate (MEHP) level was positively correlated with 5mdC/dG and CIMT, respectively. In logistic regression models, the odds ratios (OR) of thicker CIMT (greater than 75th percentile) with one unit increase in ln-MEHP level was higher when levels of 5mdC/dG were above 50%. In structural equation model, the result showed urine MEHP levels are directly associated with CIMT. Moreover, MEHP had an indirect association with CIMT through the 5mdC/dG after adjusting other confounding effects. In the current study, urine DEHP metabolite levels were positively correlated with 5mdC/dG, and CIMT. Our results showed DEHP had a direct and indirect association with CIMT through the 5mdC/dG. The finding implies that DNA methylation may mediate the association between DEHP exposures and subclinical atherosclerosis in this young population. Future effort is needed to elucidate the causal relationship between DEHP exposure, DNA methylation and CVD.
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Affiliation(s)
- Chien-Yu Lin
- Department of Internal Medicine, En Chu Kong Hospital, New Taipei City, 237, Taiwan; School of Medicine, Fu Jen Catholic University, New Taipei City, 242, Taiwan; Department of Environmental Engineering and Health, Yuanpei University of Medical Technology, Hsinchu, 300, Taiwan
| | - Hui-Ling Lee
- Department of Chemistry, Fu Jen Catholic University, New Taipei City, 242, Taiwan
| | - Yi-Ting Hwang
- Department of Statistics, National Taipei University, New Taipei City, 237, Taiwan
| | - Chikang Wang
- Department of Environmental Engineering and Health, Yuanpei University of Medical Technology, Hsinchu, 300, Taiwan
| | - Chia-Jung Hsieh
- Department of Public Health, Tzu Chi University, Hualian County, 970, Taiwan
| | - Charlene Wu
- Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Fung-Chang Sung
- Department of Health Services Administration, College of Public Health, China Medical University, Taichung, 404, Taiwan
| | - Ta-Chen Su
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, 100, Taiwan; Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei, 100, Taiwan; Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, 100, Taiwan.
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Exposure to Endocrine Disrupting Chemicals in the Dutch general population is associated with adiposity-related traits. Sci Rep 2020; 10:9311. [PMID: 32518352 PMCID: PMC7283255 DOI: 10.1038/s41598-020-66284-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 05/13/2020] [Indexed: 12/25/2022] Open
Abstract
Endocrine Disrupting Chemicals (EDCs) have been linked to a variety of cardiometabolic diseases. Yet, few studies have investigated the exposure to EDCs and cardiometabolic health taking lifestyle into account. We aimed to assess exposure to five parabens, three bisphenols and thirteen metabolites of in total eight phthalates in a general Dutch population and to investigate their association with cardiometabolic traits. In 662 adult subjects from the population-based Lifelines cohort, 21 EDC analytes were measured in 24-hour urine collected in 2012, using LC-MS/MS. Association analyses between cardiometabolic traits and EDC concentrations were performed using multivariate linear models adjusting for age, sex, education, smoking, diabetes, physical activity and caloric intake. Quartile analyses were performed to assess linearity. Bisphenol A, four parabens and eight phthalate metabolites were detected in 84-100% of the samples. Adjusted associations for MiBP and MBzP and adiposity-related traits were robust for multiple testing (Beta’s, BMI: 1.12, 2.52; waist circumference: 0.64, 1.56, respectively; FDR < 0.009). Associations for triglyceride, HDL-cholesterol, glucose and blood pressure were not. Linearity was confirmed for significant associations. Exposure to EDCs in the Dutch population is ubiquitous. We found direct associations between phthalates and adiposity-related traits. Prospective studies are needed to confirm these findings.
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Basak S, Das MK, Duttaroy AK. Plastics derived endocrine-disrupting compounds and their effects on early development. Birth Defects Res 2020; 112:1308-1325. [PMID: 32476245 DOI: 10.1002/bdr2.1741] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 12/14/2022]
Abstract
Despite the fact that the estrogenic effects of bisphenols were first described 80 years ago, recent data about its potential negative impact on birth outcome parameters raises a strong rationale to investigate further. The adverse health effects of plastics recommend to measure the impacts of endocrine-disrupting compounds (EDCs) such as bisphenols (BPA, BPS, BPF), bis(2-ethylhexyl) phthalate, and dibutyl phthalate (DBP) in human health. Exposure to these compounds in utero may program the diseases of the testis, prostate, kidney and abnormalities in the immune system, and cause tumors, uterine hemorrhage during pregnancy and polycystic ovary. These compounds also control the processes of epigenetic transgenerational inheritance of adult-onset diseases by modulating DNA methylation and epimutations in reproductive cells. The early developmental stage is the most susceptible window for developmental and genomic programming. The critical stages of the events for a normal human birth lie between the many transitions occurring between spermatogenesis, egg fertilization and the fully formed fetus. As the cells begin to grow and differentiate, there are critical balances of hormones, and protein synthesis. Data are emerging on how these plastic-derived compounds affect embryogenesis, placentation and feto-placental development since pregnant women and unborn fetuses are often exposed to these factors during preconception and throughout gestation. Impaired early development that ultimately influences fetal outcomes is at the center of many developmental disorders and contributes an independent risk factor for adult chronic diseases. This review will summarize the current status on the impact of exposure to plastic derived EDCs on the growth, gene expression, epigenetic and angiogenic activities of the early fetal development process and their possible effects on birth outcomes.
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Affiliation(s)
- Sanjay Basak
- Molecular Biology Division, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, India
| | - Mrinal K Das
- Department of Molecular Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Asim K Duttaroy
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
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Tang S, He C, Thai P, Vijayasarathy S, Mackie R, Toms LML, Thompson K, Hobson P, Tscharke B, O'Brien JW, Mueller JF. Concentrations of phthalate metabolites in Australian urine samples and their contribution to the per capita loads in wastewater. ENVIRONMENT INTERNATIONAL 2020; 137:105534. [PMID: 32007687 DOI: 10.1016/j.envint.2020.105534] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/26/2020] [Accepted: 01/26/2020] [Indexed: 06/10/2023]
Abstract
Exposure to phthalates is a public health concern. In this study, we collected both urine and wastewater samples from 2012 to 2017 and analysed for 14 phthalate metabolites to assess human exposure to phthalates in Southeast Queensland (SEQ), and for associations between phthalate metabolites in urine and wastewater samples. Twenty-four pooled urine samples were prepared from 2400 individual specimens every two years (stratified by age, gender and collection year). Wastewater samples were collected from the three major wastewater treatment plants (WWTPs) representing locations in the SEQ region including a regional city, part of the state capital city and a third major urban WWTP in the region. Over the period, decreases for most phthalate metabolites, i.e. mono-butyl phthalate (MBP), mono-isobutyl phthalate (MiBP), monobenzyl phthalate (MBzP), monocyclohexyl phthalate (MCHP), mono(3-carboxypropyl) phthalate (MCPP), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), and monomethyl phthalate (MMP), but an increase in monoethyl phthalate (MEP, particularly in young children) were observed in urine. In general, temporal changes were smaller in urine pools representing older age groups. We also found substantial variation in per capita mass loads of phthalate metabolites between samples from the three WWTPs with generally higher concentrations of most phthalates in the metropolitan areas. Per capita mass loads of most phthalate metabolites in wastewater were higher than would be expected from the per-capita excretion in urine, suggesting there are additional sources contributing to the majority of the observed phthalate metabolites in wastewater. For MEHHP and MEOHP we estimate that the urinary excretion accounts for a substantial fraction (average about 50%) of the mass load observed in the wastewater hence wastewater data may provide useful for monitoring trends in exposure.
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Affiliation(s)
- Shaoyu Tang
- Research Center for Eco-Environmental Engineering, Dongguan University of Technology, 523808 Dongguan, China; QAEHS, Queensland Alliance for Environmental Health Science, The University of Queensland, 4102 Brisbane, Australia
| | - Chang He
- QAEHS, Queensland Alliance for Environmental Health Science, The University of Queensland, 4102 Brisbane, Australia.
| | - Phong Thai
- QAEHS, Queensland Alliance for Environmental Health Science, The University of Queensland, 4102 Brisbane, Australia
| | - Soumini Vijayasarathy
- QAEHS, Queensland Alliance for Environmental Health Science, The University of Queensland, 4102 Brisbane, Australia
| | - Rachel Mackie
- QAEHS, Queensland Alliance for Environmental Health Science, The University of Queensland, 4102 Brisbane, Australia
| | - Leisa-Maree L Toms
- School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, 4059 Kelvin Grove, QLD, Australia
| | - Kristie Thompson
- QAEHS, Queensland Alliance for Environmental Health Science, The University of Queensland, 4102 Brisbane, Australia
| | - Peter Hobson
- Sullivan Nicolaides Pathology, 4006 Bowen Hills, Australia
| | - Ben Tscharke
- QAEHS, Queensland Alliance for Environmental Health Science, The University of Queensland, 4102 Brisbane, Australia
| | - Jake W O'Brien
- QAEHS, Queensland Alliance for Environmental Health Science, The University of Queensland, 4102 Brisbane, Australia
| | - Jochen F Mueller
- QAEHS, Queensland Alliance for Environmental Health Science, The University of Queensland, 4102 Brisbane, Australia
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M. Nilsen F, Frank J, S. Tulve N. A Systematic Review and Meta-Analysis Investigating the Relationship between Exposures to Chemical and Non-Chemical Stressors during Prenatal Development and Childhood Externalizing Behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072361. [PMID: 32244397 PMCID: PMC7177257 DOI: 10.3390/ijerph17072361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 12/19/2022]
Abstract
Childhood behavioral outcomes have been linked to low quality intrauterine environments caused by prenatal exposures to both chemical and non-chemical stressors. The effect(s) from the many stressors a child can be prenatally exposed to may be influenced by complex interactive relationships that are just beginning to be understood. Chemical stressors influence behavioral outcomes by affecting the monoamine oxidase A (MAOA) enzyme, which is involved in serotonin metabolism and the neuroendocrine response to stress. Non-chemical stressors, particularly those associated with violence, have been shown to influence and exacerbate the externalizing behavioral outcomes associated with low MAOA activity and slowed serotonin metabolism. The adverse developmental effects associated with high stress and maternal drug use during pregnancy are well documented. However, research examining the combined effects of other non-chemical and chemical stressors on development and childhood outcomes as a result of gestational exposures is scarce but is an expanding field. In this systematic review, we examined the extant literature to explore the interrelationships between exposures to chemical and non-chemical stressors (specifically stressful/traumatic experiences), MAOA characteristics, and childhood externalizing behaviors. We observed that exposures to chemical stressors (recreational drugs and environmental chemicals) are significantly related to externalizing behavioral outcomes in children. We also observed that existing literature examining the interactions between MAOA characteristics, exposures to chemical stressors, and traumatic experiences and their effects on behavioral outcomes is sparse. We propose that maternal stress and cortisol fluctuations during pregnancy may be an avenue to link these concepts. We recommend that future studies investigating childhood behaviors include chemical and non-chemical stressors as well as children’s inherent genetic characteristics to gain a holistic understanding of the relationship between prenatal exposures and childhood behavioral outcomes.
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Affiliation(s)
- Frances M. Nilsen
- Oak Ridge Institute for Science and Education, U.S. Environmental Protection Agency, Office of Research and Development, 109 TW Alexander Dr., Research Triangle Park, NC 27709, USA;
- Correspondence:
| | - Jessica Frank
- Oak Ridge Institute for Science and Education, U.S. Environmental Protection Agency, Office of Research and Development, 109 TW Alexander Dr., Research Triangle Park, NC 27709, USA;
| | - Nicolle S. Tulve
- U.S. Environmental Protection Agency, Office of Research and Development, 109 TW Alexander Dr., Research Triangle Park, NC 27709, USA;
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Filardi T, Panimolle F, Lenzi A, Morano S. Bisphenol A and Phthalates in Diet: An Emerging Link with Pregnancy Complications. Nutrients 2020; 12:nu12020525. [PMID: 32092855 PMCID: PMC7071371 DOI: 10.3390/nu12020525] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 02/17/2020] [Accepted: 02/18/2020] [Indexed: 12/11/2022] Open
Abstract
Endocrine-disrupting chemicals (EDCs) are exogenous substances that are able to interfere with hormone action, likely contributing to the development of several endocrine and metabolic diseases. Among them, Bisphenol A (BPA) and phthalates contaminate food and water and have been largely studied as obesogenic agents. They might contribute to weight gain, insulin resistance and pancreatic β-cell dysfunction in pregnancy, potentially playing a role in the development of pregnancy complications, such as gestational diabetes mellitus (GDM), and adverse outcomes. Pregnancy and childhood are sensitive windows of susceptibility, and, although with not univocal results, preclinical and clinical studies have suggested that exposure to BPA and phthalates at these stages of life might have an impact on the development of metabolic diseases even many years later. The molecular mechanisms underlying this association are largely unknown, but adipocyte and pancreatic β-cell dysfunction are suspected to be involved. Remarkably, transgenerational damage has been observed, which might be explained by epigenetic changes. Further research is needed to address knowledge gaps and to provide preventive measure to limit health risks connected with exposure to EDCs.
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Golestanzadeh M, Riahi R, Kelishadi R. Association of exposure to phthalates with cardiometabolic risk factors in children and adolescents: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:35670-35686. [PMID: 31728953 DOI: 10.1007/s11356-019-06589-7] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 09/24/2019] [Indexed: 06/10/2023]
Abstract
Recent studies revealed controversial results on the association of exposure to phthalates with cardiometabolic risk factors in children and adolescents. Therefore, this systematic review and meta-analysis was conducted in this regard. At first, we searched English-language papers in Scopus, Web of Science, and PubMed databases, with no restriction of time, till the end of the year 2018. We performed a comprehensive literature search for association between phthalate exposure and cardiometabolic risk factors including obesity, hypertension, hyperglycemia, and dyslipidemia. Among 99 published papers found in scientific databases, 17 cohort, 15 cross-sectional, and three case-control studies were included in the meta-analysis. We observed a significant association between the concentrations of phthalates and their metabolites with body mass index (BMI), BMI z-score, waist circumference (WC), and low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and glucose in serum. In addition, significant association was observed between prenatal phthalate exposure and birth weight. To the best of our knowledge, this is the first meta-analysis of its kind. It shows positive association between phthalate exposure and some cardiometabolic risk factors in children and adolescents. Therefore, prevention of exposure to phthalates and reduction of their use should be underscored in strategies for primordial prevention of cardiovascular diseases. Recent studies revealed controversial results on the association of exposure to phthalates with cardiometabolic risk factors in children and adolescents. Therefore, this systematic review and meta-analysis was conducted in this regard.
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Affiliation(s)
- Mohsen Golestanzadeh
- Environment Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Riahi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
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Li MC, Mínguez-Alarcón L, Bellavia A, Williams PL, James-Todd T, Hauser R, Chavarro JE, Chiu YH. Serum beta-carotene modifies the association between phthalate mixtures and insulin resistance: The National Health and Nutrition Examination Survey 2003-2006. ENVIRONMENTAL RESEARCH 2019; 178:108729. [PMID: 31521963 PMCID: PMC6759414 DOI: 10.1016/j.envres.2019.108729] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/16/2019] [Accepted: 09/04/2019] [Indexed: 05/28/2023]
Abstract
Animal models suggest a protective role of antioxidants against the adverse effect of di-2-ethylhexyl phthalate (DEHP) on insulin resistance. However, no epidemiologic study has examined the effects observed in the animal model. We conduct a study to examine associations of urinary concentrations of phthalate metabolites (individually and as a mixture) with insulin resistance, along with potential effect modification by serum antioxidant concentrations. This cross-sectional study included 1605 participants (51% males) aged 12-85 from the National Health and Nutrition Examination Surveys (2003-2006). Urinary concentrations of 9 phthalate metabolites were measured from spot urine samples. Antioxidant (vitamin A, C, E, and carotenoids) concentrations were measured from a fasting serum sample. We used Bayesian Kernel Machine Regression (BKMR) to evaluate associations between phthalate metabolite mixtures and insulin resistance, and examined whether serum antioxidant levels modified these associations, while accounting for the correlations of multiple concurrent exposures. A change in urinary ΣDEHP concentrations from the 25th to the 75th percentile was associated with a higher log HOMA-IR of 0.07 (95% CI = 0.01, 0.14) (4.85% increase in HOMA-IR). In contrast, the same change in urinary monoethyl phthalate (MEP) was associated with a lower HOMA-IR of -0.07 (95% CI = -0.14, -0.02) (6.68% decrease in HOMA-IR). The positive association between ΣDEHP and HOMA-IR became weaker at higher concentrations of serum β-carotene. The relationship between MEP and HOMA-IR, however, was not modified by the serum antioxidants examined. The remaining phthalate metabolites were unrelated to HOMA-IR. In this cross-sectional study, the positive association between DEHP exposure and insulin resistance weakened among participants with higher concentrations of serum β-carotene. As this is the first human report on the protective role of serum β-carotene on DEHP induced insulin resistance, future studies are needed.
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Affiliation(s)
- Ming-Chieh Li
- Department of Public Health, China Medical University College of Public Health, Taichung, 40402, Taiwan
| | - Lidia Mínguez-Alarcón
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Andrea Bellavia
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Paige L Williams
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA; Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Jorge E Chavarro
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard, Medical School, Boston, MA, 02115, USA
| | - Yu-Han Chiu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
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Radke EG, Galizia A, Thayer KA, Cooper GS. Phthalate exposure and metabolic effects: a systematic review of the human epidemiological evidence. ENVIRONMENT INTERNATIONAL 2019; 132:104768. [PMID: 31196577 PMCID: PMC9472300 DOI: 10.1016/j.envint.2019.04.040] [Citation(s) in RCA: 106] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 04/15/2019] [Accepted: 04/17/2019] [Indexed: 05/15/2023]
Abstract
OBJECTIVE We performed a systematic review of the epidemiology literature to identify the metabolic effects associated with phthalate exposure. DATA SOURCES AND STUDY ELIGIBILITY CRITERIA Six phthalates were included in the review: di(2‑ethylhexyl) phthalate (DEHP), diisononyl phthalate (DINP), dibutyl phthalate (DBP), diisobutyl phthalate (DIBP), butyl benzyl phthalate (BBP), and diethyl phthalate (DEP). The initial literature search (of PubMed, Web of Science, and Toxline) included all studies of metabolic effects in humans, and outcomes were selected for full systematic review based on data availability. STUDY EVALUATION AND SYNTHESIS METHODS Studies of diabetes and insulin resistance were evaluated using criteria defined a priori for risk of bias and sensitivity by two reviewers using a domain-based approach; studies identified with a pre-defined critical deficiency were excluded. Evidence was synthesized by outcome and phthalate and strength of evidence was summarized using a structured framework. Studies of obesity and renal effects received "screening level" reviews to determine whether full systematic review was warranted. RESULTS The primary outcomes reviewed here are (number of included/excluded studies in parentheses): type 2 diabetes (1/3), insulin resistance (13/3), and impaired glucose tolerance and blood glucose in pregnancy (4/2). For DEHP exposure, there was consistency among studies of insulin resistance and coherence with the single included study of diabetes, as well as an observed exposure-response gradient observed in a study of insulin resistance. This evidence is considered moderate. Similarly, for DBP and DIBP exposure, the evidence is considered moderate due to strong positive associations in the diabetes study and coherent results for insulin resistance. For DINP, BBP, and DEP, the evidence is considered slight. No association was reported in the single study of diabetes with BBP and DEP exposure (DINP was not investigated). The available evidence does indicate an association between exposure to these phthalates and insulin resistance, but the small number of studies and the lack of coherence with diabetes decreases confidence. The screening level reviews for obesity and renal effects determined that the currently available evidence is inadequate to assess the associations between these outcomes and phthalate exposure. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS Overall, these results support that phthalate exposure at levels seen in human populations may have metabolic effects. Given the mechanistic support, the large effect sizes for incident diabetes in the single available study, and the coherence with insulin resistance, the association between phthalate exposure and diabetes risk should be considered when assessing the risks and costs of exposure to specific phthalates in humans. The views expressed are those of the authors and do not necessarily represent the views or policies of the U.S. EPA.
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Lee I, Kim S, Park S, Mok S, Jeong Y, Moon HB, Lee J, Kim S, Kim HJ, Choi G, Choi S, Kim SY, Lee A, Park J, Choi K. Association of urinary phthalate metabolites and phenolics with adipokines and insulin resistance related markers among women of reproductive age. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 688:1319-1326. [PMID: 31726561 DOI: 10.1016/j.scitotenv.2019.06.125] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 06/07/2019] [Accepted: 06/07/2019] [Indexed: 05/10/2023]
Abstract
Chemicals such as phthalates and phenolics have been associated with metabolic markers in humans. However, most studies have only looked at a limited number of chemicals, and little is known about their potential effects on adipokines in humans. In the present study, the associations between dozens of urinary chemicals, including phthalate metabolites and phenolics, and markers related to insulin resistance as well as major adipokines, were assessed among the women of reproductive age (n = 459, between 20 and 48 years of age) recruited from major cities in Korea between 2015 and 2016. Adipokines such as adiponectin and leptin, and insulin resistance related markers such as glucose and insulin, were analyzed in serum. Associations between urinary chemicals and the adipokines or insulin resistance related markers were assessed in two steps. First, ordinary least squares (OLS) regression was used to assess the association of each urinary chemical with the adipokines or insulin resistance related markers (single-pollutant model). Second, several chemicals were selected using elastic net regression and were subsequently analyzed with OLS regression model (multi-pollutant model), considering simultaneous exposure to multiple chemicals. In both single- and multi-pollutant models, several urinary chemicals consistently showed significant associations with adipokines or the insulin resistance related markers. The sum of di-(2-ethylhexyl) phthalate metabolites (ΣDEHPm) and ethyl paraben (EtP) were associated with increased serum adiponectin levels. Urinary ΣDEHPm levels also showed positive associations with fasting glucose. Moreover, urinary mono-methyl phthalate (MMP), mono-isobutyl phthalate (MiBP), and bisphenol S (BPS) levels showed positive associations with the homeostasis model assessment for insulin resistance (HOMA-IR). Interestingly, urinary propyl paraben (PrP) levels showed a negative association with HOMA-IR, in both models. Our observations show that among many consumer chemicals, phthalates may affect serum adipokines, and thus glucose, and insulin resistance in adult females. Further confirmation is warranted in other populations.
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Affiliation(s)
- Inae Lee
- Department of Environmental Health Sciences, Seoul National University, Seoul, Republic of Korea
| | - Sunmi Kim
- Department of Environmental Health Sciences, Seoul National University, Seoul, Republic of Korea
| | - Suhyeon Park
- Department of Environmental Health Sciences, Seoul National University, Seoul, Republic of Korea
| | - Sori Mok
- Department of Marine Sciences and Convergent Technology, Hanyang University, Ansan, Republic of Korea
| | - Yunsun Jeong
- Department of Marine Sciences and Convergent Technology, Hanyang University, Ansan, Republic of Korea
| | - Hyo-Bang Moon
- Department of Marine Sciences and Convergent Technology, Hanyang University, Ansan, Republic of Korea
| | - Jangwoo Lee
- Department of Environmental Health Sciences, Seoul National University, Seoul, Republic of Korea
| | - Sungkyoon Kim
- Department of Environmental Health Sciences, Seoul National University, Seoul, Republic of Korea
| | - Hai-Joong Kim
- College of Medicine, Korea University, Ansan, Republic of Korea
| | - Gyuyeon Choi
- College of Medicine, Soonchunhyang University, Seoul, Republic of Korea
| | - Sooran Choi
- College of Medicine, Inha University, Incheon, Republic of Korea
| | - Su Young Kim
- College of Medicine, Jeju National University, Jeju, Republic of Korea
| | - Aram Lee
- College of Natural Science, Soonchunhyang University, Asan, Republic of Korea
| | - Jeongim Park
- College of Natural Science, Soonchunhyang University, Asan, Republic of Korea
| | - Kyungho Choi
- Department of Environmental Health Sciences, Seoul National University, Seoul, Republic of Korea.
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Sargis RM, Simmons RA. Environmental neglect: endocrine disruptors as underappreciated but potentially modifiable diabetes risk factors. Diabetologia 2019; 62:1811-1822. [PMID: 31451869 PMCID: PMC7462102 DOI: 10.1007/s00125-019-4940-z] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/14/2019] [Indexed: 12/18/2022]
Abstract
Type 2 diabetes prevalence is increasing dramatically across the globe, imposing a tremendous toll on individuals and healthcare systems. Reversing these trends requires comprehensive approaches to address both classical and emerging diabetes risk factors. Recently, environmental toxicants acting as endocrine-disrupting chemicals (EDCs) have emerged as novel metabolic disease risk factors. EDCs implicated in diabetes pathogenesis include various inorganic and organic molecules of both natural and synthetic origin, including arsenic, bisphenol A, phthalates, polychlorinated biphenyls and organochlorine pesticides. Indeed, evidence implicates EDC exposures across the lifespan in metabolic dysfunction; moreover, specific developmental windows exhibit enhanced sensitivity to EDC-induced metabolic disruption, with potential impacts across generations. Importantly, differential exposures to diabetogenic EDCs likely also contribute to racial/ethnic and economic disparities. Despite these emerging links, clinical practice guidelines fail to address this underappreciated diabetes risk factor. Comprehensive approaches to stem the tide of diabetes must include efforts to address its environmental drivers.
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Affiliation(s)
- Robert M Sargis
- Division of Endocrinology, Diabetes, and Metabolism Department of Medicine, University of Illinois at Chicago, 835 S. Wolcott, Suite E625; M/C 640, Chicago, IL, 60612, USA.
- ChicAgo Center for Health and EnvironmenT (CACHET), University of Illinois at Chicago, Chicago, IL, USA.
| | - Rebecca A Simmons
- Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Center for Research on Reproduction and Women's Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center of Excellence in Environmental Toxicology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Ko NY, Lo YTC, Huang PC, Huang YC, Chang JL, Huang HB. Changes in insulin resistance mediate the associations between phthalate exposure and metabolic syndrome. ENVIRONMENTAL RESEARCH 2019; 175:434-441. [PMID: 31158561 DOI: 10.1016/j.envres.2019.04.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 04/19/2019] [Accepted: 04/20/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Information on the relationships between phthalate exposure, insulin resistance, and metabolic syndrome (MetS) in younger adults is limited. It is still unclear whether changes in insulin resistance represent an intermediate biological mechanism linking phthalate exposure and MetS. OBJECTIVE To investigate the associations between cumulative risk of phthalates (such as daily intake [DI] and hazard index [HI]), insulin resistance, and MetS in younger adults and to examine the mediating role of insulin resistance in the associations between phthalate exposure and MetS. METHODS Urinary phthalate metabolite levels, insulin resistance (by using the Homeostatic Model Assessment of estimated Insulin Resistance [HOMA-IR]), and MetS status were determined in 435 military personnel in Taiwan. We estimated the DI of five phthalates: dimethyl phthalate (DMP), diethyl phthalate, dibutyl phthalate, benzyl butyl phthalate (BBzP), and di (2-ethylhexyl) phthalate and the HI based on urinary phthalate metabolite levels. Cross-sectional associations between DI and HI, HOMA-IR, and the indicators of MetS were explored using logistic regression models. Mediation analysis was conducted to assess the role of insulin resistance in the associations between phthalate exposure and MetS. RESULTS Higher DIDMP was associated with an increased odds of high HOMA-IR and MetS (odds ratio [OR], 1.686; 95% confidence interval [CI], 1.079-2.634 for high HOMA-IR; OR, 2.329; 95% CI, 1.263-4.295 for MetS). The mediation analysis indicated that 43% of the association between higher DIDMP and MetS was mediated by HOMA-IR. Higher DIBBzP and HI were associated with an increased odds of abdominal obesity (OR, 1.816; 95% CI, 1.180-2.797 for the high DIBBzP group; OR, 1.700, 95% CI, 1.105-2.614 for the high HI groups). CONCLUSIONS Exposure to environmental phthalates may be positively associated with insulin resistance and MetS. Insulin resistance may mediate these associations between exposure to certain phthalates and MetS.
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Affiliation(s)
- Nai-Yueh Ko
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Yuan-Ting C Lo
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Po-Chin Huang
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli and Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Yi-Chen Huang
- Department of Nutrition, China Medical University, Taichung, Taiwan
| | - Junn-Liang Chang
- Department of Pathology & Laboratory Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
| | - Han-Bin Huang
- School of Public Health, National Defense Medical Center, Taipei, Taiwan.
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