Urinary Phthalate Metabolites Are Associated with Body Mass Index and Waist Circumference in Chinese School Children

Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China.
PLoS ONE (Impact Factor: 3.23). 02/2013; 8(2):e56800. DOI: 10.1371/journal.pone.0056800
Source: PubMed


Lab studies have suggested that ubiquitous phthalate exposures are related to obesity, but relevant epidemiological studies are scarce, especially for children.
To investigate the association of phthalate exposures with body mass index (BMI) and waist circumference (WC) in Chinese school children.
A cross-sectional study was conducted in three primary and three middle schools randomly selected from Changning District of Shanghai City of China in 2011-2012. According to the physical examination data in October, 2011, 124 normal weight, 53 overweight, and 82 obese students 8-15 years of age were randomly chosen from these schools on the basis of BMI-based age- and sex-specific criterion. First morning urine was collected in January, 2012, and fourteen urine phthalate metabolites (free plus conjugated) were determined by ultra-performance liquid chromatography coupled to tandem mass spectrometry. Multiple linear regression was used to explore the associations between naturally log-transformed urine phthalate metabolites and BMI or WC.
The urine specific gravity-corrected concentrations of nine urine phthalate metabolites and five molar sums were positively associated with BMI or WC in Chinese school children after adjustment for age and sex. However, when other urine phthalate metabolites were included in the models together with age and sex as covariables, most of these significant associations disappeared except for mono (2-ethylhexyl) phthalate (MEHP) and monoethyl phthalate (MEP). Additionally, some associations showed sex- or age-specific differences.
Some phthalate exposures were associated with BMI or WC in Chinese school children. Given the cross-sectional nature of this study and lack of some important obesity-related covariables, further studies are needed to confirm the associations.

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Available from: Hexing Wang, Oct 21, 2015
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    • "IJHEH-12857; No. of Pages 13 J.-W. Hou et al. / International Journal of Hygiene and Environmental Health xxx (2015) xxx–xxx 3 and WC in Chinese school children (Wang et al., 2013). MBzP and MEHP act as an obesogen by activating of peroxisome proliferatoractivated receptors (PPARs) (Hurst and Waxman, 2003). "
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    ABSTRACT: Some phthalic acid esters (PAEs) and nonylphenol (NP) are endocrine-disrupting chemicals (EDCs) that are widely used in consumer products. Consequently, the general population is exposed simultaneously to both groups of chemicals. To investigate the single- and co-exposure effects of PAEs (DMP, DEP, DnBP, DiBP, BBzP, and DEHP) and NP on obesity and pubertal maturity to compare the body sizes of general adolescents with the complainants of the phthalate-tainted foods scandal that occurred in Taiwan. This study included 270 general adolescents aged 6.5-15.0 years and 38 complainants aged 6.5-8.5 years. Nine metabolites of the five PAEs and of NP were measured in urine. We used a questionnaire to evaluate pubertal maturity, measured anthropometric indices (APs) to assess body size, and collected urine samples to measure the two groups of chemicals. We found that urinary PAE metabolite concentrations (specifically, metabolites of DEP, DnBP, DiBP, and DEHP) were positively associated with the APs for abdominal obesity (including skinfold thickness, waist circumference, waist-to-height ratio, and waist-to-hip) and indicated a dose-response relationship. Mono-methyl phthalate (MMP) exposure was inversely associated with pubarche among boys. The daily intake of DEHP in general adolescents exceeded the reference doses (RfD-20μg/kgbw/day) and tolerable daily intake (TDI-50μg/kgbw/day) by 3.4% and 0.4%, respectively. No associations were observed between NP exposure or co-exposure and the APs or pubertal maturity. No significant differences were observed between general adolescents and the complainants with regard to weight, height, or BMI. The study suggests that PAE (specifically, DEP, DnBP, DiBP, and DEHP) exposure is associated with abdominal obesity in adolescents and that the APs for abdominal obesity are more sensitive than BMI for measuring obesity among adolescents. We suggest that the RfD and TDI for PAEs should be revised to provide sufficient protection. Copyright © 2015 Elsevier GmbH. All rights reserved.
    International journal of hygiene and environmental health 07/2015; 218(7). DOI:10.1016/j.ijheh.2015.06.004 · 3.83 Impact Factor
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    • "asthma and eczema, attention-deficit/hyperactivity disorder (ADHD), high blood pressure, and increasing body mass index (BMI) and waist circumference (WC) (Kim et al. 2009; Bornehag and Nanberg 2010; Trasande et al. 2013; Wang et al. 2013). So far, ingestion, inhalation, dermal absorption, and intravenous injection have been estimated as the main human exposure pathways to phthalate contaminants (Hauser and Calafat 2005). "
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    ABSTRACT: In 2011, Taiwan authorities reported that two phthalates, including di-(2-ethylhexyl) phthalate and di-iso-nonyl phthalate, were intentionally introduced into a variety of foods and beverages during the course of 15 years. However, little is known about body burdens of phthalate contaminations in local residents, especially children recently living in Taiwan. In the present study, five target phthalate metabolite analytes-including mono-methyl phthalate, mono-ethyl phthalate, mono-n-butyl phthalate (MBP), mono-benzyl phthalate (MBzP), and mono-(2-ethylhexyl) phthalate (MEHP)-in spot urine samples were analyzed by way of high performance liquid chromatography-tandem mass spectrometry-mass spectrometry. All of the urine samples were collected from 225 healthy school children between 12 and 15 years of age (average 13.6) in the Taipei area, Taiwan, between 2009 and 2010. As the dominant urinary phthalate metabolites in Taiwanese school children, MEHP and MBP contributed 61 and 29 % of all of the target analytes, respectively. MEHP had the highest median of 29.8 μg/g creatinine (range of 13.1-72.8), which was greater than those reported for school children in the other countries during the same period, whereas MBP had a median of 14.3 μg/g creatinine (range 7.91-27.8). Statistically, urinary concentrations of MBP, MBzP, and MEHP were determined to have significantly positive correlations with the ages of Taiwanese school children (p < 0.05). Furthermore, urinary levels of MBzP in male children were considerably greater than those in female children (p = 0.006).
    Archives of Environmental Contamination and Toxicology 03/2015; 69(2). DOI:10.1007/s00244-015-0146-7 · 1.90 Impact Factor
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    • "Possibly, at this specific age period (13 to 16 years), some lifestyle habits like food consumption or use of cosmetics may change over a short time period. Also, hormonal pubertal changes or growth spurt may influence the metabolism of some components and thus provoke changes in pre-and postpubertal levels (Chakraborty et al., 2012; Wang et al., 2013). As determinants of socioeconomic position (SEP), educational level of the adolescent (general, technical or vocational), educational level of the parents (primary: both parents did not complete high school, secondary: at least one parent completed high school, or tertiary: at least one parent completed higher education) and equivalent household income (quartiles) were studied (Table 4). "
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    ABSTRACT: As part of the second Flemish Environment and Health Study (FLEHS II), bisphenol-A (BPA) and different phthalate metabolites were analyzed, for the first time, in the urine of 210 adolescents in Flanders, Belgium. All chemicals had a detection frequency above 90%. For all compounds, except the sum of DEHP, highest levels were detected during spring. Average values for the Flemish adolescents were in an agreement with concentrations found in different international studies, all confirming the ubiquity of BPA and phthalate exposure. There was a significant correlation between BPA and the different phthalate metabolites (r between 0.26 and 0.39; p<0.01). Shared sources of exposure to BPA and phthalates, such as food packaging, were suggested to be responsible for this positive correlation. Different determinants of exposure were evaluated in relation to the urinary concentrations of these chemicals. For BPA, a significant association was observed with household income class, smoking and exposure to environmental tobacco smoke. For phthalates, the following significant associations were observed: age (MBzP), educational level of the adolescent (MBzP), equivalent household income (MnBP), use of personal care products (MnBP and MBzP), wall paper in house (MnBP and MBzP) and use of local vegetables (MnBP and MBzP).
    Environmental Research 08/2014; 134C:110-117. DOI:10.1016/j.envres.2014.07.020 · 4.37 Impact Factor
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