title: Serum levels of monobenzylphthalate (MBzP) is related to carotid atherosclerosis in the elderly.
abstract: OBJECTIVE
  Background exposure to environmental contaminants has recently emerged as a new risk factor for cardiovascular disease in general and to atheroclerosis in particular. This cross-sectional study was performed to evaluate if serum concentrations of the phthalate metabolite monobenzylphthalate (MBzP) are related to atheroclerosis in the carotid arteries.
  
  
  METHODS
  In the population-based Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study (1003 subjects all aged 70) the prevalence of overt plaques and echogenicity (gray-scale median, GSM) of carotid artery plaques were recorded by ultrasound in both of the carotid arteries. The intima-media thickness (IMT) and echogenicity (IM-GSM) of the intima-media complex were also measured. The phthalate metabolite MBzP was analyzed in serum by a liquid chromatograph/tandem mass spectrometer.
  
  
  RESULTS
  The circulating level of the phthalate MBzP was related to intima-media thickness (IMT) when adjusting for gender, blood pressure, body mass index (BMI), waist circumference, HDL- and LDL-cholesterol, serum triglycerides, blood glucose and smoking (p=0.034). High levels of MBzP were also strongly associated with an echogenic IM-GSM and plaque GSM (p=0.0001 for both outcomes after adjustment) but not to plaque prevalence (p=0.42).
  
  
  CONCLUSIONS
  The phthalate metabolite MBzP was strongly related to the echogenicity of intima-media and plaques and also to IMT, independently of traditional CV risk factors. This suggests a role for the phthalate MBzP in the development of atherosclerosis.
authors.affiliation: Department of Public Health and Caring Sciences/Geriatrics, Uppsala University Hospital, SE-751 85 Uppsala, Sweden. Electronic address: bernice.wiberg@akademiska.se.
authors.forename: Bernice
authors.initials: B
authors.lastname: Wiberg
authors.affiliation: Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
authors.forename: P Monica
authors.initials: PM
authors.lastname: Lind
authors.affiliation: Department of Medicine, Uppsala University, Uppsala, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Lind
mesh_terms: D000368:Aged; D002340:Carotid Artery Diseases / Q000097:blood*; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D004785:Environmental Pollutants / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D010795:Phthalic Acids / Q000097:blood*
chemical_list: D004785:Environmental Pollutants; D010795:Phthalic Acids
keywords: Atherosclerosis; Carotids; Endocrine disruptor; Intima media thickness; Phthalate