title: Urinary phthalate monoesters and endometriosis in infertile Japanese women.
abstract: Phthalates may act as an estrogen and are a potential risk factor for estrogen-related diseases such as endometriosis. We assessed the association between phthalate exposure and endometriosis in 166 consecutive women who presented at a university hospital for consultation regarding infertility. The subjects were interviewed and provided a urine specimen prior to a laparoscopic diagnosis of endometriosis. They were then categorized by the severity of endometriosis as controls (stages 0-I) and cases (stages II-IV). Urinary concentrations of the phthalate metabolites monoethyl phthalate, mono-n-butyl phthalate, monobenzyl phthalate, mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-oxohexyl) phthalate, and mono(2-ethyl-5-hydroxyhexyl) phthalate were measured in 57 cases and 80 controls using high-performance liquid chromatography isotope-dilution tandem mass spectrometry. Adjusted odds ratios for endometriosis in relation to dichotomized individual phthalate metabolites (standardized for creatinine) were calculated. No significant association between endometriosis and any urinary creatinine-adjusted phthalate monoester was seen. Adjusted odds ratio (95% confidence interval) for higher dichotomized MEHP by endometriosis was 1.57 (0.74-3.30). No monotonic trend was seen in urinary creatinine-adjusted concentration of phthalate metabolites by endometriosis stage (p=0.23-0.90). Our results do not support the hypothesis that higher urinary concentrations of phthalate metabolites are associated with the risk of endometriosis in infertile Japanese women.
authors.affiliation: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Itoh
authors.forename: Motoki
authors.initials: M
authors.lastname: Iwasaki
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Hanaoka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sasaki
authors.forename: Tadao
authors.initials: T
authors.lastname: Tanaka
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Tsugane
mesh_terms: D000328:Adult; D002851:Chromatography, High Pressure Liquid; D003404:Creatinine / Q000378:metabolism / Q000652:urine; D004715:Endometriosis / Q000139:chemically induced* / Q000378:metabolism / Q000652:urine*; D004785:Environmental Pollutants / Q000378:metabolism / Q000633:toxicity* / Q000652:urine*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000139:chemically induced* / Q000378:metabolism / Q000652:urine*; D013058:Mass Spectrometry; D010795:Phthalic Acids / Q000378:metabolism / Q000652:urine*; D012016:Reference Values; D018570:Risk Assessment
chemical_list: D004785:Environmental Pollutants; D010795:Phthalic Acids; D003404:Creatinine; C028577:monobutyl phthalate