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Environ Health. 2019 Mar 12;18(1):20. doi: 10.1186/s12940-019-0458-6.

Urinary concentrations of phthalate biomarkers and weight change among postmenopausal women: a prospective cohort study.

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Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, 411 Arnold House, 715 North Pleasant Street, Amherst, MA, 01003, USA.
Department of Biology, University of Massachusetts Amherst, Amherst, MA, USA.
Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and the Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Program in Public Health, Department of Family Population and Preventive Medicine, Stony Brook University, Stony Brook, USA.
Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, 411 Arnold House, 715 North Pleasant Street, Amherst, MA, 01003, USA.



Some phthalates are endocrine disrupting chemicals used as plasticizers in consumer products, and have been associated with obesity in cross-sectional studies, yet prospective evaluations of weight change are lacking. Our objective was to evaluate associations between phthalate biomarker concentrations and weight and weight change among postmenopausal women.


We performed cross-sectional (N = 997) and longitudinal analyses (N = 660) among postmenopausal Women's Health Initiative participants. We measured 13 phthalate metabolites and creatinine in spot urine samples provided at baseline. Participants' weight and height measured at in-person clinic visits at baseline, year 3, and year 6 were used to calculate body mass index (BMI). We fit multivariable multinomial logistic regression models to explore cross-sectional associations between each phthalate biomarker and baseline BMI category. We evaluated longitudinal associations between each biomarker and weight change using mixed effects linear regression models.


In cross-sectional analyses, urinary concentrations of some biomarkers were positively associated with obesity prevalence (e.g. sum of di (2-ethylhexyl) phthalate metabolites [ΣDEHP] 4th vs 1st quartile OR = 3.29, 95% CI 1.80-6.03 [p trend< 0.001] vs normal). In longitudinal analyses, positive trends with weight gain between baseline and year 3 were observed for mono-(2-ethyl-5-oxohexyl) phthalate, monoethyl phthalate (MEP), mono-hydroxybutyl phthalate, and mono-hydroxyisobutyl phthalate (e.g. + 2.32 kg [95% CI 0.93-3.72] for 4th vs 1st quartile of MEP; p trend < 0.001). No statistically significant associations were observed between biomarkers and weight gain over 6 years.


Certain phthalates may contribute to short-term weight gain among postmenopausal women.


Endocrine disruption; Obesity; Phthalates; Postmenopause; Weight change; Women

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