Associations of urinary di(2-ethylhexyl) phthalate metabolites with lipid profiles among US general adult population

Xu Zhu; Iokfai Cheang; Ziqi Chen; Mengsha Shi; Qingqing Zhu; Xin Yue; Yuan Tang; Hui Pang; Shengen Liao; Yanli Zhou; Xinli Li

doi:10.1016/j.heliyon.2023.e20343

Associations of urinary di(2-ethylhexyl) phthalate metabolites with lipid profiles among US general adult population

Heliyon. 2023 Sep 21;9(10):e20343. doi: 10.1016/j.heliyon.2023.e20343. eCollection 2023 Oct.

Authors

Xu Zhu¹, Iokfai Cheang¹, Ziqi Chen¹, Mengsha Shi¹, Qingqing Zhu¹, Xin Yue¹, Yuan Tang¹, Hui Pang¹, Shengen Liao¹, Yanli Zhou¹, Xinli Li¹

Affiliation

¹ Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China.

Abstract

Background: Di(2-ethylhexyl) phthalate (DEHP) a parent compound that is metabolized into 4 phthalate metabolites, which correlate to adverse cardio-metabolic risk factors. This study aimed to explore the links between urinary DEHP metabolites and serum lipids in the U.S. general adult population.

Methods: In this cross-sectional study, data on 11 urinary phthalate metabolites from the 2005-2018 National Health and Nutrition Examination Surveys (NHANES) were analyzed. Multivariate linear regression and restricted cubic spline (RCS) were used to examine the relationship between phthalate metabolites [specific DEHPs: mono-(2-ethyl-5-carboxy-pentyl) phthalate (MECPP), mono-(2-ethyl-5-hydroxy-hexyl) phthalate (MEHHP), mono-(2-ethylhexyl) phthalate (MEHP), mono-(2-ethyl-5-oxo-hexyl) phthalate (MEOHP)] and serum lipids (triglycerides [TG], total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], and high-density lipoprotein cholesterol [HDL-C]). To identify mixed exposure effects of phthalate metabolites, quantile g-computation (QG-C) and weighted quantile sum (WQS) regression were employed for the lipid profiles.

Results: A total of 9141 adults were included in the analysis. MECPP, MEHHP, MEHP, and MEOHP in the highest quartile had a negative relationship with HDL-C compared to the lowest quartile (All P for trend <0.05). TG showed a significant positive relation with MECPP, MEHHP, and MEOHP (All P for trend <0.05), but there was no notable association with MEHP. RCS demonstrated a linear relationship of DEHP metabolites with HDL-C, TC, TG, and LDL-C (all P for nonlinearity >0.05). The WQS index of DEHP metabolites showed independent correlations with HDL-C [β = -0.26, 95%CI (-0.43, -0.09), P = 0.002], TC [β = 0.55, 95%CI (0.13, 0.98), P = 0.011], and TG [β = 2.40, 95%CI (0.85, 3.96), P = 0.003].

Conclusion: Our study suggests that environmental DEHP exposure may affect serum HDL-C and TG levels in the general adult population. Further research is warranted to confirm these findings and illuminate the underlying mechanisms of DEHP exposure on lipids.

Keywords: Di(2-ethylhexyl) phthalate (DEHP); NHANES; Phthalate; Serum lipid; WQS.