title: Urinary triclosan is associated with elevated body mass index in NHANES.
abstract: BACKGROUND
  Triclosan-a ubiquitous chemical in toothpastes, soaps, and household cleaning supplies-has the potential to alter both gut microbiota and endocrine function and thereby affect body weight.
  
  
  METHODS
  We investigated the relationship between triclosan and body mass index (BMI) using National Health and Nutrition Examination Surveys (NHANES) from 2003-2008. BMI and spot urinary triclosan levels were obtained from adults. Using two different exposure measures-either presence vs. absence or quartiles of triclosan-we assessed the association between triclosan and BMI. We also screened all NHANES serum and urine biomarkers to identify correlated factors that might confound observed associations.
  
  
  RESULTS
  Compared with undetectable triclosan, a detectable level was associated with a 0.9-point increase in BMI (p<0.001). In analysis by quartile, compared to the lowest quartile, the 2nd, 3rd and 4th quartiles of urinary triclosan were associated with BMI increases of 1.5 (p<0.001), 1.0 (p = 0.002), and 0.3 (p = 0.33) respectively. The one strong correlate of triclosan identified in NHANES was its metabolite, 2,4-dichlorophenol (ρ = 0.4); its association with BMI, however, was weaker than that of triclosan. No other likely confounder was identified.
  
  
  CONCLUSIONS
  Triclosan exposure is associated with increased BMI. Stronger effect at moderate than high levels suggests a complex mechanism of action.
authors.affiliation: Department of Electrical Engineering, Stanford University, Stanford, California, United States of America ; Department of Medicine, Stanford University School of Medicine, Stanford, California, United States of America.
authors.forename: Joanna
authors.initials: J
authors.lastname: Lankester
authors.forename: Chirag
authors.initials: C
authors.lastname: Patel
authors.forename: Mark R
authors.initials: MR
authors.lastname: Cullen
authors.forename: Catherine
authors.initials: C
authors.lastname: Ley
authors.forename: Julie
authors.initials: J
authors.lastname: Parsonnet
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000652:urine*; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D009749:Nutrition Surveys; D014260:Triclosan / Q000652:urine*
chemical_list: D015415:Biomarkers; D014260:Triclosan