Associations between urinary phthalate metabolites and diabetes in the general US adult population Open Access

Abstract

OBJECTIVE: Phthalates are ubiquitous endocrine-disrupting chemicals found in the environment and have been thought to alter adipocyte differentiation which leads to obesity and increase in insulin resistance. We investigated whether urinary phthalate metabolites are associated with diabetes in a cross-sectional subset of the adult US population

 

RESEARCH DESIGN AND METHODS: A total of 2,993 subjects aged 20 to 70 years who met all the inclusion criteria were investigated using NHANES 2-year cycle datasets (2003 – 2014). This is an ongoing survey by the National Center for Health Statistics at the Centers for Disease Control and Prevention. Exposure variable was urinary phthalate metabolites with diabetes and prediabetes as outcome variables. Demographic variables, physical activity, body mass index and dietary factors were considered as potential confounders. Using multivariate logistic regression, we estimated the prevalence odds ratios (ORs) and 95% confidence intervals (CIs) adjusting for urinary creatinine and the potential confounders.

 

RESULTS: A total of 162 subjects representing 5.41% of the study population had diabetes. Following adjustment for potential confounders, MnBP was shown to be statistically significantly associated with increased odds of prevalent diabetes. Higher than median levels of MEP, MBzP and ∑DEHP were associated with increased odds of diabetes with uniform increases in ORs observed across all quartiles for MCPP and MEP.

 

DISCUSSION: Our findings show that urinary phthalate metabolites are associated with diabetes across the subset of the adult US population. Future longitudinal studies are needed to understand this association further.

Table of Contents

Aims and Hypothesis………………………………………………………………………………………………………………………….1

 

Introduction…………………………………………………………………………………………………………………………………….1

 

Research design and Methods

Study design……………………………………………………………………………………………………………………………………..5

Study population……………………………………………………………………………………………………………………………….5

Measurement of phthalate metabolites…………………………………………………………………………………………………..5

Exposure and outcome variables……………………………………………………………………………………………………………6

Covariates…………………………………………………………………………………………………………………………………………7

Datasets……………………………………………………………………………………………………………………………………………8

Statistical analysis………………………………………………………………………………………………………………………………9

 

Results……………………………………………………………………………………………………………………………………………..10

 

Discussion………………………………………………………………………………………………………………………………………...16

 

References………………………………………………………………………………………………………………………………………...18

About this Master's Thesis

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School	Rollins School of Public Health
Department	Environmental Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Environmental Health
Keyword	phthalates diabetes
Committee Chair / Thesis Advisor	Dana Boyd Barr, PhD, Emory University

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