title: Race/ethnicity-specific associations of urinary phthalates with childhood body mass in a nationally representative sample.
abstract: BACKGROUND
  Phthalates have antiandrogenic effects and may disrupt lipid and carbohydrate metabolism. Racial/ethnic subpopulations have been documented to have varying urinary phthalate concentrations and prevalences of childhood obesity.
  
  
  OBJECTIVE
  We examined associations between urinary phthalate metabolites and body mass outcomes in a nationally representative sample of U.S. children and adolescents.
  
  
  METHODS
  We performed stratified and whole-sample cross-sectional analyses of 2,884 children 6-19 years of age who participated in the 2003-2008 National Health and Nutrition Examination Survey. Multivariable linear and logistic analyses of body mass index z-score, overweight, and obesity were performed against molar concentrations of low-molecular-weight (LMW), high-molecular-weight (HMW), and di-2-ethylhexylphthalate (DEHP) metabolites, controlling for sex, television watching, caregiver education, caloric intake, poverty-income ratio, race/ethnicity, serum cotinine, and age group. We used sensitivity analysis to examine robustness of results to removing sample weighting, normalizing phthalate concentrations for molecular weight, and examining different dietary intake covariates.
  
  
  RESULTS
  In stratified, multivariable models, each log unit (roughly 3-fold) increase in LMW metabolites was associated with 21% and 22% increases in odds (95% CI: 1.05-1.39 and 1.07-1.39, respectively) of overweight and obesity, and a 0.090-SD unit increase in BMI z-score (95% CI: 0.003-0.18), among non-Hispanic blacks. Significant associations were not identified in any other racial/ethnic subgroup or in the study sample as a whole after controlling for potential confounders, associations were not significant for HMW or DEHP metabolites, and results did not change substantially with sensitivity analysis.
  
  
  CONCLUSIONS
  We identified a race/ethnicity-specific association of phthalates with childhood obesity in a nationally representative sample. Further study is needed to corroborate the association and evaluate genetic/epigenomic predisposition and/or increased phthalate exposure as possible explanations for differences among racial/ethnic subgroups.
authors: Department of Pediatrics, New York University School of Medicine, New York, New York 10016, USA. Leonardo.trasande@nyumc.org
authors: Leonardo
authors: L
authors: Trasande
authors: Teresa M
authors: TM
authors: Attina
authors: Sheela
authors: S
authors: Sathyanarayana
authors: Adam J
authors: AJ
authors: Spanier
authors: Jan
authors: J
authors: Blustein
mesh_terms: D000293:Adolescent; D001741:Black or African American; D015992:Body Mass Index; D001835:Body Weight / Q000208:ethnology*; D002648:Child; D002851:Chromatography, High Pressure Liquid; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D017058:Mexican Americans; D008962:Models, Theoretical; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology; D050177:Overweight / Q000453:epidemiology* / Q000209:etiology; D010795:Phthalic Acids / Q000737:chemistry / Q000652:urine*; D015995:Prevalence; D012959:Socioeconomic Factors; D053719:Tandem Mass Spectrometry; D044465:White People; D055815:Young Adult
chemical_list: D010795:Phthalic Acids