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Cited by 274Effects and risks of endocrine disrupting chemicalsHealth, Environment, Cognitive AgingToxic Organic Pollutants Impact

Association of Urinary Concentrations of Bisphenol A and Phthalate Metabolites with Risk of Type 2 Diabetes: A Prospective Investigation in the Nurses’ Health Study (NHS) and NHSII Cohorts

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Sun, Qi, Cornelis, Marilyn C., Townsend, Mary K., Tobias, Deirdre K., Eliassen, A. Heather, Franke, Adrian A., Hauser, Russ, Hu, Frank B.·2014·Environmental Health Perspectives
DOI 10.1289/ehp.1307201PMC PMC4050512
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Abstract

Background: Prospective evidence regarding associations for exposures to bisphenol A (BPA) and phthalates with type 2 diabetes (T2D) is lacking. Objective: We prospectively examined urinary concentrations of BPA and phthalate metabolites with T2D risk. Methods: We measured BPA and eight major phthalate metabolites among 971 incident T2D case–control pairs from the Nurses’ Health Study (NHS) (mean age, 65.6 years) and NHSII (mean age, 45.6 years). Results: In the NHSII, BPA levels were not associated with incident T2D in multivariate-adjusted analysis until body mass index was adjusted: odds ratio (OR) comparing extreme BPA quartiles increased from 1.40 (95% CI: 0.91, 2.15) to 2.08 (95% CI: 1.17, 3.69; ptrend = 0.02) with such an adjustment. In contrast, BPA concentrations were not associated with T2D in the NHS (OR = 0.81; 95% CI: 0.48, 1.38; ptrend = 0.45). Likewise, urinary concentrations of total phthalate metabolites were associated with T2D in the NHSII (OR comparing extreme quartiles = 2.14; 95% CI: 1.19, 3.85; ptrend = 0.02), but not in the NHS (OR = 0.87; 95% CI: 0.49, 1.53; ptrend = 0.29). Summed metabolites of butyl phthalates or di-(2-ethylhexyl) phthalates were significantly associated with T2D only in the NHSII; ORs comparing extreme quartiles were 3.16 (95% CI: 1.68, 5.95; ptrend = 0.0002) and 1.91 (95% CI: 1.04, 3.49; ptrend = 0.20), respectively. Conclusions: These results suggest that BPA and phthalate exposures may be associated with the risk of T2D among middle-aged, but not older, women. The divergent findings between the two cohorts might be explained by menopausal status or simply by chance. Clearly, these results need to be interpreted with caution and should be replicated in future studies, ideally with multiple urine samples collected prospectively to improve the measurement of these exposures with short half-lives. Citation: Sun Q, Cornelis MC, Townsend MK, Tobias DK, Eliassen AH, Franke AA, Hauser R, Hu FB. 2014. Association of urinary concentrations of bisphenol A and phthalate metabolites with risk of type 2 diabetes: a prospective investigation in the Nurses’ Health Study (NHS) and NHSII Cohorts. Environ Health Perspect 122:616–623; http://dx.doi.org/10.1289/ehp.1307201

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  • Epidemiological studies in the US reported that women with higher urinary concentrations of MBP, MiBP, MBzP, and MCPP and those of DEHP metabolites showed increased risk of diagnosis for diabetes compared with those who had lower concentrations.

    “Epidemiological studies in the US [192,193] reported that women with higher urinary concentrations of MBP, MiBP, MBzP, and MCPP and those of DEHP metabolites showed increased risk of diagnosis for diabetes in comparison with those who had lower concentrations of phthalates.”

    From A Review of Biomonitoring of Phthalate Exposures (2019) · cites this paper as [192]

    The Results (page unavailable) report positive associations for MBP and MiBP in NHSII and for MECPP in the combined cohorts. The claim names MCPP instead of MECPP, and the cited Results do not establish the claimed increase for MBzP; they also state that DEHP metabolites as a group were not significantly associated with incident type 2 diabetes. The Discussion (page unavailable) notes no phthalate association in the older NHS women, so the finding should not be generalized to both cohorts. (LLM, conf=0.90)

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Authors
Sun, Q., Cornelis, M. C., Townsend, M. K., Tobias, D. K., Eliassen, A. H., Franke, A. A., Hauser, R., & Hu, F. B.
Affiliations
  • Brigham and Women's Hospital (US)
  • Harvard University (US)
  • University of Hawaii Cancer Center (US)
Corresponding author
Sun, Qi
ORCID
Venue
Environmental Health Perspectives
Publisher
American Chemical Society (ACS)
Published
2014-03-14
Volume
122
Issue
6
Pages
616-623
ISSN
  • 0091-6765 (ISSN-L)
  • 1552-9924
DOI
10.1289/ehp.1307201
PMC
PMC4050512
OpenAlex
W1968705853
Cited by
274
References
2
Citations by year
2026: 15 · 2025: 19 · 2024: 24 · 2023: 25 · 2022: 19 · 2021: 41 · 2020: 21 · 2019: 23 · 2018: 22 · 2017: 16 · 2016: 23 · 2015: 19 · 2014: 5
FWCI
13.81
Type
journal article
Language
en
Open access
Licence
Locations
  • Environmental Health Perspectives (publishedVersion, public-domain)
  • Europe PMC (PubMed Central) (publishedVersion, public-domain)
  • PubMed Central (publishedVersion, public-domain)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
Funders
  • National Institutes of Health (5r01ca049449-18)
  • National Heart, Lung, and Blood Institute (R01HL035464, R00HL098459)
  • National Cancer Institute (CA-49449, CA-87969, U01CA067262, CA67262, P01CA087969, R01‐CA049449, CA50385, R01CA050385, U01CA049449, R01CA067262, P30CA071789)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01DK058785, R56DK058785, R01DK058845, DK-082486, DK 58785, R01DK082486, DK58845)
Topics
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Effects and risks of endocrine disrupting chemicals
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Health, Environment, Cognitive Aging
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Toxic Organic Pollutants Impact
Keywords
type 2 diabetes, bisphenol A, phthalate metabolites, urinary biomarkers, endocrine disruptors, body mass index, DEHP, diabetes risk, Nurses' Health Study, Nurses' Health Study II, prospective cohort
MeSH terms
Bisphenol A Compounds, Aged, Benzhydryl Compounds, Diabetes Mellitus, Type 2, Environmental Exposure, Environmental Pollutants, Female, Humans, Middle Aged, Phenols, Phthalic Acids, Risk Factors, Body Mass Index, Epidemiologic Studies

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