Sex Differences in the Association of Urinary Concentrations of Phthalates Metabolites with Self-Reported Diabetes and Cardiovascular Diseases in Shanghai Adults
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population and Sampling
2.2. Identification of Diabetes (DM) and Cardiovascular Diseases (CVD)
2.3. Assessment of Phthalate Metabolites in Urine
2.4. Statistical Analysis
2.5. Ethics Approval and Consent to Participate
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Characteristic | Category | Total) |
---|---|---|
Age, median (IQR), year | - | 53 (41, 64) |
Nationality, n (%) | Han | 2308 (99.1) |
Others | 22 (0.9) | |
Sex | Male | 1108 (47.6) |
Female | 1222 (52.4) | |
Education, n (%) | ≤Primary school | 519 (22.5) |
Middle school/technical, secondary school | 1398 (60.5) | |
≥College graduate | 392 (17.0) | |
Marriage, n (%) | Married | 1950 (85.8) |
Others | 322 (14.2) | |
Smoking, n (%) | Never smoker | 1743 (74.8) |
Current/past smoker | 587 (3.9) | |
Total calories, median (IQR), kcal | - | 1631 (1219, 1888) |
Total fat, median (IQR), g | - | 54.3 (32.9, 69.2) |
Height, median (IQR), m | - | 1.65 (1.59, 1.70) |
Weight, median (IQR), kg | - | 64.0 (55.0, 70.0) |
BMI, median (IQR), kg/m2 | - | 23.5 (21.3, 25.7) |
DM, n (%) | no | 2150 (92.3) |
yes | 180 (7.7) | |
CVD, n (%) | no | 2187 (93.9) |
yes | 130 (6.1) | |
Hypertension, n (%) | no | 1699 (72.9) |
yes | 631 (27.1) | |
Hyperlipidemia, n (%) | no | 2167 (93.6) |
yes | 148 (6.4) | |
CHD, n (%) | no | 2203 (95.1) |
yes | 114 (4.9) | |
Stroke, n (%) | no | 2300 (99.3) |
yes | 16 (0.7) |
n > LOD (%) | Percentiles | ||||||
---|---|---|---|---|---|---|---|
5th | 25th | 50th | 75th | 95th | GM | ||
MMP | 2076 (89.1) | 0.02 | 1.01 | 2.93 | 6.42 | 19.91 | 1.84 |
MEP | 2113 (90.7) | 0.20 | 3.30 | 8.82 | 20.80 | 82.56 | 7.29 |
MnBP | 1731 (74.3) | 0.02 | 0.17 | 12.92 | 37.10 | 111.49 | 4.01 |
MiBP | 1915 (82.2) | 0.03 | 1.91 | 8.42 | 19.38 | 62.77 | 3.95 |
MBzP | 1637 (70.3) | 0.21 | 0.84 | 2.07 | 4.10 | 22.36 | 1.95 |
MEHP | 2255 (96.8) | 0.83 | 4.42 | 8.84 | 18.21 | 70.95 | 8.56 |
MEOHP | 2136 (91.7) | 0.07 | 2.66 | 4.67 | 8.05 | 20.57 | 3.66 |
MECPP | 2325 (99.8) | 4.24 | 8.30 | 13.95 | 24.14 | 68.51 | 14.71 |
MEHHP | 2323 (99.7) | 0.29 | 4.26 | 11.64 | 22.57 | 70.24 | 8.11 |
MCMHP | 2250 (96.6) | 3.71 | 10.84 | 17.56 | 30.03 | 79.53 | 16.91 |
Phthalates Metabolites | DM | Hypertension | Hyperlipidemia | CHD | Stroke | CVD | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
N | n (%) | OR (95% CI) a | n (%) | OR (95% CI) | n (%) | OR (95% CI) | n (%) | OR (95% CI) | n (%) | OR (95% CI) | n (%) | OR (95% CI) | ||
MMP | Q1 | 569 | 38 (6.7%) | 1 | 142 (25.0%) | 1 | 23 (4.1%) | 1 | 25 (4.4%) | 1 | 2 (0.4%) | 1 | 27 (4.8%) | 1 |
Q2 | 582 | 37 (6.4%) | 0.95 (0.57, 1.58) | 140 (24.1%) | 0.94 (0.68, 1.30) | 31 (5.4%) | 1.29 (0.69, 2.41) | 27 (4.7%) | 1.05 (0.57, 1.94) | 5 (0.9%) | 2.34 (0.44, 12.43) | 32 (5.5%) | 1.17 (0.66, 2) | |
Q3 | 588 | 37 (6.3%) | 0.90 (0.54, 1.51) | 155 (26.4%) | 0.98 (0.71, 1.35) | 35 (6.0%) | 1.34 (0.72, 2.49) | 20 (3.4%) | 0.69 (0.35, 1.36) | 2 (0.3%) | 1.09 (0.15, 7.91) | 22 (3.8%) | 0.96 (0.69, 1.32) | |
Q4 | 584 | 68 (11.6%) | 1.54 (0.96, 2.45) | 194 (33.2%) | 1.20 (0.87, 1.65) | 59 (10.2%) | 2.38 (1.35, 4.17) * | 42 (7.2%) | 1.28 (0.72, 2.28) | 7 (1.2%) | 4.06 (0.77, 21.40) | 49 (8.4%) | 1.32 (0.96, 1.81) | |
p b | 0.085 | 0.254 | 0.002 | 0.560 | 0.209 | 0.408 | ||||||||
MEP | Q1 | 568 | 39 (6.9%) | 1 | 150 (26.4%) | 1 | 32 (5.7%) | 1 | 25 (4.4%) | 1 | 0 (0.0%) | 1 | 25 (4.4%) | 1 |
Q2 | 583 | 40 (6.9%) | 1.29 (0.79, 2.12) | 146 (25.0%) | 1.13 (0.82, 1.54) | 25 (4.3%) | 0.78 (0.43, 1.43) | 27 (4.7%) | 1.27 (0.69, 2.33) | 4 (0.7%) | 1.10 (0.72, 1.83) | 31 (5.4%) | 1.48 (0.83, 2.66) | |
Q3 | 579 | 39 (6.7%) | 1.09 (0.65, 1.83) | 155 (26.8%) | 1.14 (0.83, 1.56) | 35 (6.1%) | 0.91 (0.51, 1.63) | 23 (4.0%) | 0.76 (0.39, 1.50) | 5 (0. 9%) | 1.04 (0.65, 1.68) | 28 (4.9%) | 1.00 (0.53, 1.89) | |
Q4 | 593 | 62 (10.5%) | 1.60 (0.99, 2.58) | 180 (30.4%) | 1.26 (0.92, 1.72) | 56 (9.5%) | 1.66 (0.99, 2.77) | 39 (6.6%) | 1.36 (0.76, 2.44) | 7 (1.2%) | 1.38 (0.87, 2.22) | 46 (7.8%) | 1.73 (0.98, 3.05) | |
p | 0.013 | 0.246 | 0.035 | 0.538 | 0.021 | 0.166 | ||||||||
MiBP | Q1 | 583 | 44 (7.5%) | 1 | 165 (28.3%) | 1 | 27 (4.6%) | 1 | 25 (4.3%) | 1 | 2 (0.3%) | 1 | 27 (4.6%) | 1 |
Q2 | 593 | 46 (7.8%) | 1.18 (0.74, 1.91) | 157 (26.5%) | 0.84 (0.62, 1.15) | 43 (7.3%) | 1.66 (0.94, 2.93) | 35 (5.9%) | 1.56 (0.87, 2.81) | 5 (0.8%) | 2.41 (0.46, 12.73) | 40 (6.8%) | 1.69 (0.97, 2.94) | |
Q3 | 579 | 45 (7.8%) | 1.32 (0.81, 2.17) | 138 (23.8%) | 0.80 (0.58, 1.11) | 35 (6.1%) | 1.33 (0.73, 2.43) | 22 (3.8%) | 0.85 (0.43, 1.69) | 1 (0.2%) | 0.60 (0.05, 6.84) | 23 (4.0%) | 0.80 (0.41, 1.55) | |
Q4 | 568 | 45 (7.9%) | 1.04 (0.63, 1.71) | 171 (30.1%) | 0.91 (0.66, 1.26) | 43 (6.4%) | 1.52 (0.85, 2.69) | 32 (5.7%) | 1.19 (0.64, 2.22) | 8 (1.4%) | 4.90 (0.95, 25.20) | 40 (7.1%) | 1.42 (0.79, 2.53) | |
p | 0.786 | 0.522 | 0.305 | 0.965 | 0.119 | 0.698 | ||||||||
MnBP | Q1 | 581 | 47 (8.1%) | 1 | 170 (29.3%) | 1 | 28 (4.8%) | 1 | 32 (5.5%) | 1 | 2 (0.3%) | 1 | 34 (5.9%) | 1 |
Q2 | 579 | 34 (5.9%) | 0.84 (0.51, 1.38) | 147 (25.4%) | 0.85 (0.62, 1.16) | 38 (6.6%) | 1.69 (0.97, 2.95) | 20 (3.5%) | 0.73 (0.39, 1.36) | 3 (0.5%) | 1.79 (0.29, 11.13) | 23 (4.0%) | 0.76 (0.42, 1.36) | |
Q3 | 584 | 44 (7.5%) | 1.19 (0.74, 1.93) | 146 (25.0%) | 0.80 (0.58, 1.10) | 42 (7.3%) | 1.31 (0.73, 2.33) | 28 (4.8%) | 0.82 (0.45, 1.51) | 5 (0.9%) | 2.97 (0.55, 15.92) | 33 (5.7%) | 0.95 (0.54, 1.68) | |
Q4 | 579 | 55 (9.5%) | 1.09 (0.68, 1.75) | 168 (29.0%) | 0.76 (0.55, 1.05) | 40 (7.0%) | 1.20 (0.67, 2.12) | 34 (5.9%) | 0.86 (0.48, 1.53) | 6 (1.0%) | 3.99 (0.71, 22.42) | 40 (7.0%) | 1.02 (0.59, 1.75) | |
p | 0.469 | 0.084 | 0.823 | 0.711 | 0.103 | 0.797 | ||||||||
MBzP | Q1 | 557 | 46 (8.3%) | 1 | 164 (29.4%) | 1 | 34 (6.1%) | 1 | 31 (5.6%) | 1 | 4 (0.7%) | 1 | 35 (6.3%) | 1 |
Q2 | 596 | 34 (5.7%) | 0.67 (0.40, 1.13) | 140 (23.5%) | 0.78 (0.56, 1.08) | 30 (5.1%) | 0.88 (0.49, 1.58) | 20 (3.4%) | 0.67 (0.35, 1.29) | 7 (1.2%) | 2.15 (0.53, 8.63) | 27 (4.6%) | 0.81 (0.45, 1.47) | |
Q3 | 584 | 49 (8.4%) | 0.93 (0.57, 1.51) | 158 (27.1%) | 0.76 (0.55, 1.06) | 43 (7.4%) | 1.03 (0.58, 1.80) | 26 (4.5%) | 0.71 (0.38, 1.34) | 2 (0.3%) | 0.61 (0.10, 3.77) | 28 (4.8%) | 0.72 (0.39, 1.31) | |
Q4 | 586 | 51 (8.7%) | 1.06 (0.66, 1.69) | 169 (28.8%) | 0.97 (0.71, 1.33) | 41 (7.0%) | 1.31 (0.77, 2.24) | 37 (6.3%) | 1.26 (0.72, 2.23) | 3 (0.5%) | 0.87 (0.17, 4.46) | 40 (6.8%) | 1.27 (0.74, 2.17) | |
p | 0.491 | 0.922 | 0.228 | 0.284 | 0.410 | 0.398 | ||||||||
MEHP | Q1 | 579 | 44 (7.6%) | 1 | 160 (27.6%) | 1 | 41 (7.1%) | 1 | 30 (5.2%) | 1 | 5 (0.9%) | 1 | 35 (6.1%) | 1 |
Q2 | 576 | 37 (6.4%) | 0.95 (0.58, 1.57) | 137 (23.8%) | 0.92 (0.67, 1.28) | 28 (4.9%) | 0.68 (0.39, 1.20) | 14 (2.4%) | 0.47 (0.23, 0.95) | 4 (0.7%) | 0.86 (0.23, 3.29) | 18 (3.1%) | 0.51 (0.27, 0.96) | |
Q3 | 591 | 44 (7.4%) | 0.97 (0.59, 1.59) | 136 (23.0%) | 0.73 (0.53, 1.02) | 26 (4.4%) | 0.49 (0.27, 0.92) * | 28 (4.8%) | 0.85 (0.46, 1.55) | 3 (0.5%) | 0.64 (0.15, 2.81) | 31 (5.3%) | 0.78 (0.45, 1.37) | |
Q4 | 577 | 55 (9.5%) | 1.10 (0.69, 1.77) | 198 (34.3%) | 1.16 (0.85, 1.59) | 53 (9.3%) | 1.15 (0.70, 1.88) | 42 (7.3%) | 0.99 (0.56, 1.72) | 4 (0.7%) | 0.66 (0.15, 2.92) | 46 (8.0%) | 0.90 (0.53, 1.53) | |
p | 0.682 | 0.609 | 0.656 | 0.606 | 0.385 | 0.997 | ||||||||
MEOHP | Q1 | 587 | 35 (6.0%) | 1 | 159 (27.1%) | 1 | 30 (5.1%) | 1 | 28 (4.8%) | 1 | 4 (0.7%) | 1 | 32 (5.5%) | 1 |
Q2 | 607 | 30 (4.9%) | 0.96 (0.55, 1.68) | 148 (24.4%) | 0.88 (0.64, 1.22) | 27 (4.5%) | 0.74 (0.40, 1.38) | 30 (5.0%) | 1.16 (0.63, 2.11) | 4 (0.7%) | 1.06 (0.25, 4.40) | 34 (5.6%) | 1.10 (0.63, 1.93) | |
Q3 | 596 | 61 (10.2%) | 1.76 (1.07, 2.91) * | 150 (25.2%) | 0.73 (0.52, 1.01) | 47 (8.0%) | 1.16 (0.66, 2.03) | 25 (4.2%) | 0.66 (0.34, 1.26) | 3 (0.5%) | 0.59 (0.10, 3.35) | 28 (4.7%) | 0.62 (0.33, 1.14) | |
Q4 | 533 | 54 (10.1%) | 1.62 (0.97, 2.70) | 174 (32.6%) | 1.09 (0.78, 1.50) | 44 (8.3%) | 1.52 (0.88, 2.62) | 31 (5.9%) | 1.03 (0.56, 1.90) | 5 (0.9%) | 1.47 (0.37, 5.82) | 36 (6.8%) | 1.01 (0.57, 1.79) | |
p | 0.013 | 0.881 | 0.046 | 0.737 | 0.865 | 0.611 | ||||||||
MEHHP | Q1 | 563 | 29 (5.2%) | 1 | 145 (25.8%) | 1 | 29 (5.2%) | 1 | 29 (5.2%) | 1 | 2 (0.4%) | 1 | 31 (5.5%) | 1 |
Q2 | 605 | 47 (7.8%) | 1.72 (1.01, 2.92) * | 145 (24.0%) | 0.76 (0.54, 1.06) | 33 (5.5%) | 0.90 (0.50, 1.60) | 26 (4.3%) | 0.61 (0.33, 1.13) | 4 (0.7%) | 2.20 (0.38, 12.64) | 30 (5.0%) | 0.68 (0.39, 1.23) | |
Q3 | 609 | 50 (8.2%) | 1.41 (0.82, 2.44) | 163 (26.8%) | 0.79 (0.57, 1.10) | 53 (8.8%) | 1.26 (0.73, 2.19) | 30 (5.0%) | 0.65 (0.35, 1.19) | 6 (1.0%) | 2.79 (0.52, 15.10) | 36 (6.0%) | 0.74 (0.42, 1.31) | |
Q4 | 549 | 54 (9.9%) | 1.92 (1.14, 3.25) * | 178 (32.6%) | 1.22 (0.88, 1.69) | 33 (6.1%) | 1.02 (0.57, 1.81) | 29 (5.3%) | 0.77 (0.42, 1.40) | 4 (0.7%) | 2.26 (0.40, 12.85) | 33 (6.1%) | 0.81 (0.46, 1.44) | |
p | 0.044 | 0.169 | 0.635 | 0.531 | 0.438 | 0.557 | ||||||||
MECPP | Q1 | 600 | 28 (4.7%) | 1 | 149 (24.8%) | 1 | 30 (5.0%) | 1 | 26 (4.3%) | 1 | 4 (0.7%) | 1 | 30 (5.0%) | 1 |
Q2 | 613 | 40 (6.5%) | 1.29 (0.75, 2.23) | 152 (24.8%) | 0.90 (0.65, 1.24) | 29 (4.8%) | 1.04 (0.57, 1.89) | 23 (3.8%) | 0.79 (0.42, 1.50) | 4 (0.7%) | 0.86 (0.20, 3.69) | 27 (4.4%) | 0.79 (0.44, 1.42) | |
Q3 | 595 | 57 (9.6%) | 1.74 (1.04, 2.91) * | 160 (26.9%) | 0.91 (0.66, 1.25) | 48 (8.1%) | 1.48 (0.85, 2.59) | 33 (5.6%) | 1.02 (0.56, 1.85) | 4 (0.7%) | 0.76 (0.16, 3.52) | 37 (6.3%) | 0.93 (0.53, 1.63) | |
Q4 | 515 | 55 (10.7%) | 1.86 (1.11, 3.14) * | 170 (33.0%) | 1.26 (0.91, 1.75) | 41 (8.0%) | 1.53 (0.87, 2.71) | 32 (6.3%) | 1.04 (0.56, 1.92) | 4 (0.8%) | 1.12 (0.26, 4.84) | 36 (7.0%) | 0.98 (0.55, 1.73) | |
p | 0.010 | 0.190 | 0.071 | 0.650 | 0.926 | 0.910 | ||||||||
MCMHP | Q1 | 604 | 38 (6.3%) | 1 | 159 (26.3%) | 1 | 26 (4.3%) | 1 | 31 (5.2%) | 1 | 4 (0.7%) | 1 | 35 (5.8%) | 1 |
Q2 | 602 | 41 (6.8%) | 1.14 (0.68, 1.90) | 155 (25.7%) | 1.02 (0.74, 1.40) | 35 (5.9%) | 1.39 (0.76.2.54) | 30 (5.0%) | 1.01 (0.56, 1.81) | 5 (0.8%) | 1.34 (0.35, 5.13) | 35 (5.8%) | 1.06 (0.62, 1.83) | |
Q3 | 599 | 56 (9.3%) | 1.42 (0.87, 2.32) | 149 (24.9%) | 0.81 (0.58, 1.12) | 50 (8.4%) | 1.86 (1.05, 3.30) * | 22 (3.7%) | 0.63 (0.33, 1.18) | 3 (0.5%) | 0.55 (0.10, 3.07) | 25 (4.2%) | 0.60 (0.33, 1.09) | |
Q4 | 518 | 45 (8.7%) | 1.26 (0.76, 2.08) | 169 (32.4%) | 1.22 (0.88, 1.69) | 37 (7.2%) | 1.78 (0.98, 3.20) | 31 (6.0%) | 0.98 (0.54, 1.76) | 4 (0.8%) | 1.12 (0.26, 4.72) | 35 (6.8%) | 0.98 (0.56, 1.69) | |
p | 0.266 | 0.514 | 0.032 | 0.657 | 0.676 | 0.490 | ||||||||
ƩDEHP | Q1 | 556 | 34 (5.8%) | 1 | 149 (25.3%) | 1 | 31 (5.3%) | 1 | 28 (4.8%) | 1 | 5 (0.8%) | 1 | 33 (5.6%) | 1 |
Q2 | 550 | 37 (6.3%) | 1.08 (0.63, 1.84) | 133 (22.7%) | 0.90 (0.64, 1.25) | 32 (5.5%) | 1.13 (0.63, 2.04) | 23 (4.0%) | 0.09 (0.48, 1.69) | 5 (0.9%) | 1.03 (0.28, 3.78) | 28 (4.8%) | 0.91 (0.52, 1.62) | |
Q3 | 532 | 50 (8.6%) | 1.06 (0.63, 1.77) | 158 (27.1%) | 0.81 (0.58, 1.13) | 37 (6.4%) | 0.87 (0.48, 1.59) | 24 (4.1%) | 0.59 (0.31, 1.12) | 2 (0.3%) | 0.19 (0.02, 1.71) | 26 (4.5%) | 0.51 (0.28, 0.95) | |
Q4 | 505 | 59 (10.5%) | 1.40 (0.85, 2.31) | 191 (33.9%) | 1.22 (0.88, 1.68) | 48 (8.6%) | 1.44 (0.83, 2.51) | 39 (7.0%) | 0.96 (0.53, 1.73) | 4 (0.7%) | 0.77 (0.19, 3.12) | 43 (7.7%) | 0.92 (0.53, 1.60) | |
p | 0.195 | 0.308 | 0.287 | 0.669 | 0.414 | 0.465 |
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Dong, R.; Zhao, S.; Zhang, H.; Chen, J.; Zhang, M.; Wang, M.; Wu, M.; Li, S.; Chen, B. Sex Differences in the Association of Urinary Concentrations of Phthalates Metabolites with Self-Reported Diabetes and Cardiovascular Diseases in Shanghai Adults. Int. J. Environ. Res. Public Health 2017, 14, 598. https://doi.org/10.3390/ijerph14060598
Dong R, Zhao S, Zhang H, Chen J, Zhang M, Wang M, Wu M, Li S, Chen B. Sex Differences in the Association of Urinary Concentrations of Phthalates Metabolites with Self-Reported Diabetes and Cardiovascular Diseases in Shanghai Adults. International Journal of Environmental Research and Public Health. 2017; 14(6):598. https://doi.org/10.3390/ijerph14060598
Chicago/Turabian StyleDong, Ruihua, Shanzhen Zhao, Han Zhang, Jingsi Chen, Meiru Zhang, Min Wang, Min Wu, Shuguang Li, and Bo Chen. 2017. "Sex Differences in the Association of Urinary Concentrations of Phthalates Metabolites with Self-Reported Diabetes and Cardiovascular Diseases in Shanghai Adults" International Journal of Environmental Research and Public Health 14, no. 6: 598. https://doi.org/10.3390/ijerph14060598