title: Phthalate exposure associated with self-reported diabetes among Mexican women.
abstract: BACKGROUND
  Phthalates are ubiquitous industrial chemicals used as plasticizers in plastics made of polyvinyl chloride (PVC) to confer flexibility and durability. They are also present in products used for personal-care, industry and in medical devices. Phthalates have been associated with several adverse health effects, and recently it has been proposed that exposure to phthalates, could have an effect on metabolic homeostasis. This exploratory cross-sectional study evaluated the possible association between phthalate exposure and self-reported diabetes among adult Mexican women.
  
  
  METHODS
  As part of an on-going case-control study for breast cancer, only controls were selected, which constituted 221 healthy women matched by age (±5 years) and place of residence with the cases. Women with diabetes were identified by self-report. Urinary concentrations of nine phthalate metabolites were measured by online solid phase extraction coupled to high performance liquid chromatography-isotope-dilution tandem mass spectrometry.
  
  
  RESULTS
  Participants with diabetes had significantly higher concentrations of di(2-ethylhexyl) pththalate (DEHP) metabolites: mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP) and mono(2-ethyl-5-carboxypentyl) phthalate (MECPP) but lower levels of monobenzyl phthalate (MBzP) a metabolite of benzylbutyl phthalate, compared to participants without diabetes. A marginally significant positive associations with diabetes status were observed over tertiles with MEHHP (OR(T3 vs. T1)=2.66; 95% CI: 0.97-7.33; p for trend=0.063) and MEOHP (OR(T3 vs. T1)=2.27; 95% CI; 0.90-5.75; P for trend=0.079) even after adjusting for important confounders.
  
  
  CONCLUSIONS
  The results suggest that levels of some phthalates may play a role in the genesis of diabetes.
authors.affiliation: Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Svensson
authors.forename: Raúl U
authors.initials: RU
authors.lastname: Hernández-Ramírez
authors.forename: Ana
authors.initials: A
authors.lastname: Burguete-García
authors.forename: Mariano E
authors.initials: ME
authors.lastname: Cebrián
authors.forename: Antonia M
authors.initials: AM
authors.lastname: Calafat
authors.forename: Larry L
authors.initials: LL
authors.lastname: Needham
authors.forename: Luz
authors.initials: L
authors.lastname: Claudio
authors.forename: Lizbeth
authors.initials: L
authors.lastname: López-Carrillo
mesh_terms: D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000139:chemically induced* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D010795:Phthalic Acids / Q000633:toxicity* / Q000652:urine
chemical_list: D010795:Phthalic Acids; C032279:phthalic acid