The Association between Phthalate Metabolite Concentrations and the Risk of Metabolic Syndrome and Type 2 Diabetes- A Population-based Cohort Study.

Abstract

Previous studies have suggested an association between phthalate exposure and metabolic syndrome (MetS); however, prospective evidence remains limited. This cohort study investigated the association between phthalate exposure and MetS, its components, and incident type 2 diabetes mellitus (T2DM). Data were drawn from the Taiwan Biobank. Eligible participants had baseline urinary phthalate metabolite measurements and no pre-existing MetS. Urinary concentrations of 10 phthalate metabolites were quantified using liquid chromatography-tandem mass spectrometry. Changes in waist circumference, blood pressure, blood glucose, and lipid profiles between baseline and follow-up were calculated. Incident T2DM was identified by linking participants' medical records. Multivariable linear regression, logistic regression and Cox proportional hazard regression models were performed. Over a mean follow-up of 4.25 years, 102 of 790 participants (12.9%) developed MetS. Each ln-unit increase in baseline MiBP was associated with greater increases in HbA1c (0.04%). The association between MiBP and increase in triglycerides and total cholesterol , and between DEHP metabolites and increased HbA1c and decreased HDL-c did not remain statistically significant after false-discovery-rate (FDR) correction. No association was observed with the MetS prevalence. Among 556 participants without pre-existing T2DM, 22 (3.96%) developed T2DM. Each ln-unit increase in baseline MnBP was associated with 1.82-fold higher risks of incident T2DM after adjustment although this association did not remain significant after FDR correction. Neither sex nor agesignificantly modify these associations. This prospective study suggested that DBP was associated with deterioration of HbA1c and lipid profiles, whereas a potential association between DBP and increased risk of T2DM requires further confirmation.