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J Clin Endocrinol Metab. 2015 Jul;100(7):2640-50. doi: 10.1210/jc.2015-1686. Epub 2015 May 20.

Association of Exposure to Di-2-Ethylhexylphthalate Replacements With Increased Insulin Resistance in Adolescents From NHANES 2009-2012.

Author information

1
Departments of Pediatrics (T.M.A., L.T.), Environmental Medicine (L.T.), and Population Health (L.T.), New York University School of Medicine, New York, New York 10016; New York University Wagner School of Public Service (L.T.), New York, New York 10012; New York University Steinhardt School of Culture, Education and Human Development, Department of Nutrition, Food & Public Health (L.T.), New York, New York 10003; and New York University Global Institute of Public Health (L.T.), New York, New York 10003.

Abstract

CONTEXT:

Di-isononyl phthalate (DINP) and di-isodecyl phthalate (DIDP) are environmental chemicals increasingly used to replace di-2-ethylhexylphthalate (DEHP) and commonly found in processed foods. Phthalate exposures, in particular DEHP, have been associated with insulin resistance in adolescents, but there are no data regarding the two substitutes, DINP and DIDP.

OBJECTIVE:

This study aimed to examine associations of DINP, DIDP, and DEHP with insulin resistance outcomes.

DESIGN, SETTING, AND PARTICIPANTS:

This was a cross-sectional analysis of 2009-2012 National Health and Nutrition Examination Surveys (NHANES) composed of 356 fasting 12-19-year-olds.

MAIN OUTCOME MEASURES:

Insulin resistance as a categorical outcome expressed as homeostatic model assessment of insulin resistance (HOMA-IR), using a cut point of 4.39 to define insulin resistance. We also examined continuous HOMA-IR as an outcome in secondary analyses.

RESULTS:

Controlling for demographic and behavioral factors, diet, age, body mass index, and urinary creatinine, for each log increase in DINP metabolite, a 0.08 (P = .001) increase in HOMA-IR was identified. Compared with the first tertile of DINP (23.4% adjusted prevalence), the third tertile was associated with a 34.4% prevalence (95% confidence interval [CI], 27.3-41.6%; P = .033) of insulin resistance. Similarly, compared with the first tertile of DEHP (20.5% adjusted prevalence), the third tertile had 37.7% prevalence (95% CI 29.8-45.6%; P = .003).

CONCLUSIONS:

Urinary DINP concentrations were associated with increased insulin resistance in this cross-sectional study of adolescents. The previously identified association of DEHP with insulin resistance was also confirmed. Further, longitudinal studies are needed to confirm these associations, with the possibility to assess opportunities for intervention.

PMID:
25993640
PMCID:
PMC4490310
DOI:
10.1210/jc.2015-1686
[Indexed for MEDLINE]
Free PMC Article

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