Human urinary/seminal phthalates or their metabolite levels and semen quality: A meta-analysis.
Health concerns surrounding human exposure to phthalates include diminished semen quality. Epidemiological findings remain inconsistent. We have performed a quality appraisal and meta-analysis to quantitatively summarize evidence for associations between phthalate exposures and human semen quality. Pubmed and Web of Science were searched for pertinent studies through October 2014. Cited references were reviewed to identify secondary studies. Studies that reported quantitative estimates of the association between phthalates or their metabolite levels in humans and semen quality were eligible. Random effects models were used to calculate pooled effects estimates. Overall, 20 studies met our inclusion criteria. Subsequently, 14 studies were included in the meta-analysis. Urinary monobutyl phthalate (MBP) and monobenzyl phthalate (MBzP) were associated with reduced sperm concentration (MBP [7.4-25.3 µg/L], pooled odds ratio [OR]=2.60, 95% confidence interval [CI]=1.32-5.15; MBzP [14.0-540.2 µg/L], pooled OR=2.23, 95% CI=1.16-4.30). Both MBP (24.6-14,459.0 µg/L) and MEHP (3.1-208.1 µg/L) were inversely associated with straight line velocity (VSL; MBP, pooled β=-2.51, 95% CI=-4.44, -0.59; MEHP, pooled β=-1.06, 95% CI=-1.99, -0.12). An IQR increase in MBzP and MEP levels (MBzP, IQR=11.35 µg/L; MEP, IQR=449.4 µg/L) was associated with an increase in comet extent (CE; MBzP, pooled β=3.57, 95% CI=0.89-6.25; MEP, pooled β=4.22, 95% CI=1.66-6.77). No associations were observed between monomethyl phthalate and any semen parameters. Our meta-analysis strengthens the evidence that specific phthalates or their metabolite levels may affect semen quality.
Key Laboratory of the Public Health Safety, Ministry of Education, Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, PR China.
Hongquan
H
Cai
Key Laboratory of the Public Health Safety, Ministry of Education, Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, PR China.
Weiwei
W
Zheng
Chinese Medical Association, No. 42 Dongsi Xidajie, Beijing 100710, PR China.
Pai
P
Zheng
Key Laboratory of the Public Health Safety, Ministry of Education, Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, PR China.
Shu
S
Wang
Key Laboratory of the Public Health Safety, Ministry of Education, Department of Childhood and Adolescent, School of Public Health, Fudan University, Shanghai 200032, PR China.
Hui
H
Tan
Key Laboratory of the Public Health Safety, Ministry of Education, Department of Childhood and Adolescent, School of Public Health, Fudan University, Shanghai 200032, PR China.
Gengsheng
G
He
Key Laboratory of the Public Health Safety, Ministry of Education, Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, PR China. Electronic address: wdqu@fudan.edu.cn.
Weidong
W
Qu
D004249:DNA Damage; D004781:Environmental Exposure / Q000032:analysis*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010795:Phthalic Acids / Q000032:analysis / Q000378:metabolism / Q000652:urine*; D011897:Random Allocation; D012661:Semen / Q000737:chemistry* / Q000187:drug effects* / Q000378:metabolism; D055101:Semen Analysis; D013076:Sperm Count; D013081:Sperm Motility / Q000187:drug effects; D013094:Spermatozoa / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D014018:Tissue Distribution
D010795:Phthalic Acids
Epidemiology; Meta-analysis; Phthalates; Semen quality; Urinary metabolite levels