Journal
ENVIRONMENTAL HEALTH PERSPECTIVES
Volume 120, Issue 9, Pages 1307-1313Publisher
US DEPT HEALTH HUMAN SCIENCES PUBLIC HEALTH SCIENCE
DOI: 10.1289/ehp.1104717
Keywords
diabetes; di(2-ethylhexyl) phthalate; monobenzyl phthalate; mono-(3-carboxypropyl) phthalate; monoethyl phthalate; mono-isobutyl phthalate; mono-n-butyl phthalate; women
Funding
- American Diabetes Association Mentor-based Minority Postdoctoral Fellowship Award [7-09-MI-06]
- National Institute of Environmental Health Sciences [R0 1ES018872]
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BACKGROUND: Previous studies have shown that women have higher urinary concentrations of several phthalate metabolites than do men, possibly because of a higher use of personal care products. Few studies have evaluated the association between phthalate metabolites, diabetes, and diabetes-related risk factors among women. OBJECTIVE: We explored the association between urinary phthalate metabolite concentrations and diabetes among women who participated in a cross-sectional study. METHODS: We used urinary concentrations of phthalate metabolites, analyzed by the Centers for Disease Control and Prevention, and self-reported diabetes of 2,350 women between 20 and 79 years of age who participated in the NHANES (2001-2008). We used multiple logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) and adjusted for urinary creatinine, sociodemographic characteristics, dietary factors, and body size. A secondary analysis was conducted for women who did not have diabetes to evaluate the association between phthalate metabolite concentrations and fasting blood glucose (FBG), homeostasis model assessment estimated insulin resistance, and glycosylated hemoglobin A1c. RESULTS: After adjusting for potential confounders, women with higher levels of mono-n-butyl phthalate (MnBP), mono-isobutyl phthalate (MiBP), monobenzyl phthalate (MBzP), mono-(3-carboxypropyl) phthalate (MCPP), and three di-(2-ethylhexyl) phthalate metabolites (Sigma DEHP) had an increased odds of diabetes compared with women with the lowest levels of these phthalates. Women in the highest quartile for MBzP and MiBP had almost twice the odds of diabetes [OR = 1.96 (95% Cl: 1.11, 3.47) and OR = 1.95 (95% CI: 0.99, 3.85), respectively] compared with women in the lowest quartile. Nonmonotonic, positive associations were found for MnBP and Sigma DEHP, whereas MCPP appeared to have a threshold effect. Certain phthalate metabolites were positively associated with FBG and insulin resistance. DISCUSSION: Urinary levels of several phthalates were associated with prevalent diabetes. Future prospective studies are needed to further explore these associations to determine whether phthalate exposure can alter glucose metabolism and increase the risk of insulin resistance and diabetes.
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