A middle-aged Caucasian woman with elevated levels of several breakdown products Phthalic ester — A class of Endocrine Disruptors (EDCs) or “forever chemicals” that act as plasticizers — Significantly higher risk of occurrence type 2 diabetes 6 years more than other similar women.
However, this association was not found in black or Asian middle-aged women.
These findings from a study of women’s health in the National Multiple Pollutant Survey (SWAN-MPS) by Mia Q. Peng, PhD, MPH, and colleagues, publish online in the Journal of Clinical Endocrinology & Metabolism.
“Overall, our study adds some evidence to support a potential diabetogenic effect of phthalates, although much is still unknown about the metabolic effects of these chemicals. emphasized,” summarizes the group.
“Clear racial/ethnic differences in the association between phthalates and onset diabetes should be investigated in future studies,” they warn.
Recruiting young participants and observing them longer “will help us understand the effects of phthalates on different stages of the diabetes-forming process, including whether increased body fat is an important mediator.” also helps,” they suggest.
Phthalates are all around us
Low-molecular-weight phthalates are frequently added as solvents, plasticizers, and fixatives to personal care products such as fragrances, nail polish, and some feminine hygiene products, the researchers explained.
High molecular weight phthalates are also frequently added as plasticizers to polyvinyl chloride plastic products such as plastic food packaging, clothing, and vinyl flooring.
Phthalates have been hypothesized to contribute to the development of diabetes, but longitudinal evidence in humans has been limited.
“Given the widespread exposure to phthalates and the enormous cost of diabetes to individuals and society, continued investment in research on the metabolic effects of phthalates is justified,” the researchers concluded. I’m here.
Racial Differences in Phthalates and the Development of Diabetes
“The new finding is that we have observed that some phthalates are associated with an increased risk of developing diabetes, especially in Caucasian women. [that] It was not seen in black or Asian women,” said senior author Sung Kyun Park, ScD, MPH, University of Michigan School of Public Health, Ann Arbor. Medscape Medical News on mail.
“I was surprised to see the racial/ethnic differences,” added Peng, a former University of Michigan graduate now at the Center for Life Course Epidemiology Obesity and Diabetes at the University of Colorado Anschutz Medical Campus.
A possible explanation is that “compared to white women, black women develop diabetes at a younger age and have higher levels of exposure to several phthalates.” Women who already had diabetes by 20 years were excluded.
“Although our study was conducted in a cohort of women, we hope that our findings are not interpreted as suggesting that only women should be concerned with phthalates. The results add to the current literature that phthalates may be a potential risk factor for type 2 diabetes.”
“Certain phthalates are banned in children’s toys and baby care items,” Peng noted. US Consumer Product Safety Commission. moreover, bill was submitted Congress to ban phthalates in food contact materials.
“When phthalates are removed from plastics and other consumer products, care must be taken in the process to avoid replacing them with other potentially harmful chemicals,” she warned.
A well-known example of this type of ‘disappointing substitute’ is ‘BPA-free’ plastics in which bisphenol A is replaced with other bisphenols such as bisphenol F (BPF) and bisphenol S (BPS). Although labeled “BPA free”, the chemical it replaced was found to be equally toxic. It will take some time to determine if it can replace the
Studies also show that diets rich in meat, fat, and ultra-processed foods are associated with increased exposure to some phthalates. Fast food, Peng observed. Additionally, some phthalates are added to personal care products such as fragrances.
“As a first step, we believe that reducing consumption of ultra-processed foods packaged in plastic will help reduce phthalate exposure.”
The Endocrine Society and International Pollutants Elimination Network (IPEN) 2020 report titledPlastics, EDC, and Healthsummarizes studies on bisphenol A, perfluoroalkyl and polyfluoroalkyl substances (PFAS), phthalates, and other EDCs leaching from plastics. website There is also a link to 2 page summary.
Levels of 12 phthalate metabolites
Previously, researchers reported How PFAS, another class of ‘forever chemicals’, are associated with risk high blood pressure In a 17-year follow-up of middle-aged women in the SWAN study.
In the current study, we analyzed data from 1308 women with SWAN-MPS recruited at five study sites (Oakland, CA; Los Angeles, CA; Detroit, MI; Pittsburgh, PA; and Boston, MA).
The women were between 42 and 52 years old in 1996-1997 and identified as white, black, Chinese, or Japanese.
They were diabetes-free in 1999-2000 and had adequate urine samples for phthalate evaluation at that time and during the 6-year follow-up.
From 1999 to 2000, the median age for women was 49 years. About half were white, 20% black, 13% Chinese, and 15% Japanese.
The researchers found that levels of the 12 selected metabolites were reduced because parent phthalates are widely used in industry and commerce and exposure to these phthalates is a national biomonitoring priority. was analyzed.
The measured phthalates are:
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Three metabolites of low molecular weight phthalates:
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Monoethyl phthalate (MEP)
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mono-n-butyl phthalate (MnBP)
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Monoisobutyl phthalate (MiBP)
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Four metabolites of high molecular weight di(2-ethylhexyl) phthalate (DEHP) that are of particular public health interest.
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Mono(2-ethylhexyl) phthalate (MEHP)
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Mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP)
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Mono(2-ethyl-5-oxohexyl) phthalate (MEOHP)
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Mono(2-ethyl-5-carboxypentyl) phthalate (MECPP)
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Five metabolites of other high molecular weight phthalates
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Monobenzyl phthalate (MBzP)
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Monoisononyl phthalate (MiNP)
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Monocarboxyoctyl phthalate (MCOP)
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Monocarboxyisononyl phthalate (MCNP)
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mono(3-carboxypropyl) phthalate (MCPP)
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The researchers detected MiNP in less than 1% of urine samples and excluded it from all analyses.
Various phthalate metabolites were detected in 84.8% (MEHP) to 100% (MnBP and MECPP) of the samples.
young women, blacks, current smokers, or obesity In general, the concentrations of phthalate metabolites were high.
Over a 6-year period, 61 women developed diabetes (incidence rate of 8.1 per 1000 person-years).
Compared with other women, women who developed diabetes had significantly higher concentrations of all phthalate metabolites except DEHP metabolites and MCPP.
Phthalates were not associated with diabetes development in black or Asian women.
However, in Caucasian women, each doubling of the concentrations of MiBP, MBzP, MCOP, MCNP, and MCCP was associated with a 30% to 63% higher incidence of diabetes (HR for MCNP, 1.30; HR for MiBP, 1.63; ).
The SWAN study was supported by the National Institutes of Health (NIH), Department of Health and Human Services, National Institute on Aging (NIA), National Institute of Nursing Research, and NIH Office of Women’s Research.‘■ Health, and SWAN repositories. The current research was supported by the National Center for Research Resources, the National Center for Advanced Translational Sciences, the NIH, the National Institute of Environmental Health, and the Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health. Peng was supported by interdisciplinary research training on health and aging grants from the NIA.writers No related financial relationships have been reported.
J Clin Endocrinol Metab. Published online on February 8, 2023. article
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