doi:10.1289/ehp.1104717
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Urinary Phthalate Metabolite Concentrations and Diabetes among Women in the National Health and Nutrition Examination Survey (NHANES) 2001-2008

       
       
        Tamarra James-Todd, Richard Stahlhut, John D. Meeker, Sheena-Gail Powell, Russ Hauser, Tianyi Huang, Janet Rich-Edwards
       
        Background: Previous studies show women to have higher urinary concentrations of several phthalate metabolites compared to men, possibly due to higher use of personal care products. Few studies have evaluated the association between phthalate metabolites, diabetes, and diabetes-related risk factors in women.
       
        Objective: Explore the association between urinary phthalate metabolite concentrations and diabetes among women in a cross-sectional study.
       
        Methods: We utilized data from CDC-analyzed urinary concentrations of phthalate metabolites and self-reported diabetes in 2,350 women ages 20-<80 participating in the NHANES (2001-2008). We used multiple logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI), adjusting for urinary creatinine, sociodemographic and dietary factors, and body size. A secondary analysis was conducted in women without diabetes to evaluate the association between phthalate metabolite concentrations and fasting blood glucose, HOMA-IR, and hemoglobin A1c.
       
        Results: After adjusting for potential confounders, women with higher levels of MnBP, MiBP, MBzP, MCPP, and ∑DEHP had an increased odds of diabetes compared to 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% CI: 1.11, 3.47 and OR 1.95, 95% CI: 0.99, 3.85, respectively) compared to women in the lowest quartile. Non-monotonic, positive associations existed for MnBP and ∑DEHP, while MCPP appeared to have a threshold effect. Certain phthalate metabolites were positively associated with fasting glucose 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.
       
       
来源：中国日报网