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. 2023 Mar:248:114102.
doi: 10.1016/j.ijheh.2022.114102. Epub 2022 Dec 15.

Associations of early life phthalate exposures with adolescent lipid levels and insulin resistance: The HOME Study

Taylor M Etzel  1 , Jordan R Kuiper  2 , Xiaobin Wang  3 , Noel T Mueller  4 , Antonia M Calafat  5 , Kim M Cecil  6 , Aimin Chen  7 , Bruce P Lanphear  8 , Kimberly Yolton  9 , Heidi J Kalkwarf  10 , Joseph M Braun  11 , Jessie P Buckley  12
Affiliations

Associations of early life phthalate exposures with adolescent lipid levels and insulin resistance: The HOME Study

Taylor M Etzel et al. Int J Hyg Environ Health. 2023 Mar.

Abstract

Background: Early-life phthalate exposures may disrupt metabolic processes; however few prospective studies have assessed whether these associations extend to cardiometabolic outcomes during adolescence.

Methods: Among 183 mother-adolescent pairs in a prospective cohort study that enrolled pregnant women in Cincinnati, OH (2003-2006), we quantified nine phthalate metabolites in spot urine samples collected twice from mothers during pregnancy and up to seven times from children. At age 12 years, we assessed triglycerides, high-density (HDL) and low-density (LDL) lipoprotein cholesterol, insulin, and glucose from fasting serum samples and calculated homeostatic model assessment of insulin resistance (HOMA-IR). Using multiple informant models, we estimated covariate-adjusted associations between urinary phthalate concentrations at each time period and cardiometabolic biomarkers at age 12 years, including modification by child sex.

Results: Although most associations were weak or null, monoethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), mono-isobutyl phthalate (MiBP), and monobenzyl phthalate (MBzP) concentrations were generally associated with lower LDL at age 12 years. A 10-fold increase in 4- and 12-year MEP was associated with -15.3 mg/dL (95% CI: 27.5, -3.13 mg/dL) and -11.8 mg/dL (-22.0, -1.51 mg/dL) lower LDL, respectively. Discrepant associations were observed in females versus males: a 10-fold increase in 3-year MEP concentrations was associated with 12.0 mg/dL (95% CI: 7.11, 31.1 mg/dL) higher LDL levels in males and -30.4 mg/dL (95% CI: 50.9, -9.8 mg/dL) lower LDL levels in females. Some urinary phthalate concentrations were cross-sectionally associated with HOMA-IR.

Conclusions: Early-life phthalate biomarker concentrations may be inversely associated with LDL during early adolescence in an exposure-period and sex-dependent manner.

Keywords: Children's health; Insulin resistance; Lipids; Metabolic disruptors; Phthalates.

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Conflict of interest statement

Disclosure Summary:

TME, JRK, XW, NTM, AMC, KMC, AC, KY, HJK, and JPB have nothing to declare. Dr. Braun’s institution was financially compensated for his services as an expert witness for plaintiffs in litigation related to PFAS-contaminated drinking water; these funds were not paid to JMB directly. Dr. Lanphear served as an expert witness in cases related to childhood lead poisoning, but he was not personally compensated.

Figures

Figure 1.
Figure 1.
Adjusted differences in cardiometabolic outcomes at age 12 years per 10-fold increase in prenatal and childhood urinary monoethyl phthalate (MEP) concentrations. Differences and 95% confidence intervals (CI) estimated in multiple informants models adjusted for maternal race/ethnicity, smoking during pregnancy, pregnancy weight gain, prenatal vitamin use, prenatal fruit and vegetable consumption; BMI z-score and income level at each visit; and child’s sex, and physical activity at age 12 years.
Figure 2.
Figure 2.
Adjusted differences in cardiometabolic outcomes at age 12 years per 10-fold increase in prenatal and childhood urinary monobenzyl phthalate (MBzP) concentrations. Differences and 95% confidence intervals (CI) estimated in multiple informants models adjusted for maternal race/ethnicity, smoking during pregnancy, pregnancy weight gain, prenatal vitamin use, prenatal fruit and vegetable consumption; BMI z-score and income level at each visit; and child’s sex, and physical activity at age 12 years.
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References

    1. Attina TM, Trasande L. 2015. Association of exposure to di-2-ethylhexylphthalate replacements with increased insulin resistance in adolescents from nhanes 2009-2012. The Journal of clinical endocrinology and metabolism 100:2640–2650. - PMC - PubMed
    1. Berger K, Eskenazi B, Kogut K, Parra K, Lustig RH, Greenspan LC, et al. 2018. Association of prenatal urinary concentrations of phthalates and bisphenol a and pubertal timing in boys and girls. Environmental Health Perspectives 126:097004. - PMC - PubMed
    1. Bernert JT Jr., Turner WE, Pirkle JL, Sosnoff CS, Akins JR, Waldrep MK, et al. 1997. Development and validation of sensitive method for determination of serum cotinine in smokers and nonsmokers by liquid chromatography/atmospheric pressure ionization tandem mass spectrometry. Clin Chem 43:2281–2291. - PubMed
    1. Borch J, Metzdorff SB, Vinggaard AM, Brokken L, Dalgaard M. 2006. Mechanisms underlying the anti-androgenic effects of diethylhexyl phthalate in fetal rat testis. Toxicology 223:144–155. - PubMed
    1. Braun JM, Daniels JL, Poole C, Olshan AF, Hornung R, Bernert JT, et al. 2010. A prospective cohort study of biomarkers of prenatal tobacco smoke exposure: The correlation between serum and meconium and their association with infant birth weight. Environmental Health 9:53. - PMC - PubMed

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