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Phthalates associated with chronic disease in men

Men with higher concentrations of total phthalates had a greater risk for CVD, type 2 diabetes and high BP, according to a study published in Environmental Research.

“[Noncommunicable diseases] are often associated with chronic low-grade inflammation, and the proinflammatory effects of phthalates have recently been a focus of attention... Continuous exposure to phthalates may be proinflammatory, with the potential to interact with other risk factors worsening [noncommunicable disease] outcomes,” Peter Y. Bai, from the University of Adelaide in Australia, and colleagues wrote. “However, epidemiological studies in the area are limited.”

Bai and colleagues conducted a cohort study of South Australian urban-dwelling, community-based men between the ages of 39 and 84 years to examine the associations between concentrations of phthalates, chronic low-grade inflammation and noncommunicable diseases. The men were recruited from the Men Androgen Inflammation Lifestyle Environment and Stress study and those who provided a urinary sample at their follow-up visit were included (n = 1,504). The researchers used the fasting morning urine samples to quantify total phthalate concentration. They directly measured chronic diseases through standardized clinical and laboratory procedures or evaluated risk using data from self-reported questionnaires. They used enzyme-linked immunosorbent assay or spectroscopy to analyze inflammatory biomarkers and applied multivariable linear and logistic regression models to establish the association between log-transformed urinary phthalate concentration and inflammation and chronic disease.

Data revealed that 99.6% of urinary samples contained total phthalates (geometric mean = 114.1 g/g creatinine; 95% CI, 109.5-118.9). Greater levels of high sensitive C-reactive protein, interleukin-6 and tumor necrosis factor-alpha were linked to higher total phthalate levels (P < .05); however, myeloperoxidase was not. Incidence of CVD (prevalence ratio = 1.78; 95% CI, 1.17-2.71), type 2 diabetes (prevalence ratio = 1.84; 95% CI, 1.34-2.51) and hypertension (prevalence ratio = 1.14; 95% CI, 1.01-1.29) increased in men with higher urinary total phthalate concentrations. There was no significant association between total phthalates and asthma and depression.

“While we still don’t understand the exact reasons why phthalates are independently linked to disease, we do know the chemicals impact on the human endocrine system, which controls hormone release that regulate the body’s growth, metabolism, and sexual development and function,” Zumin Shi, from the University of Adelaide’s Adelaide Medical School and the Freemasons Foundation Center for Men’s Health, said in a related press release.

“In addition to chronic diseases, higher phthalate levels were associated with increased levels of a range of inflammatory biomarkers in the body,” he said.

“Importantly, while 82% of the men we tested were overweight or obese — conditions known to be associated with chronic diseases — when we adjusted for this in our study, the significant association between high levels of phthalates and disease was not substantially altered,” he added.

“In addition, when we adjusted for socio-economic and lifestyle factors such as smoking and alcohol, the association between high levels of phthalates and disease was unchanged,” he continued.

These findings are likely to be relevant to women as well, according to Shi.

The researchers noted that higher levels of phthalates are also associated with age and Western diets that include more processed and packaged foods and carbonated soft drinks.

“While further research is required, reducing environmental phthalates exposure where possible, along with the adoption of healthier lifestyles, may help to reduce the risk of chronic disease,” Shi said. – by Alaina Tedesco

Disclosure: The authors report no relevant financial disclosures.