Department of Food Science and Human Nutrition, Institute for Integrative Toxicology, Michigan State University, East Lansing, MI 48824, USA.
Department of Pharmacology and Toxicology, Institute for Integrative Toxicology, College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824, USA.
Int J Environ Res Public Health. 2022 Feb 26;19(5):2741. doi: 10.3390/ijerph19052741.
Fibroid etiology is poorly understood but is likely hormonally mediated. Therefore, we evaluated associations between midlife phthalates (hormone-altering chemicals) and prior fibroid diagnosis, and considered differences by weight gain status. Women (ages: 45−54; n = 754) self-reported past fibroid diagnosis. We pooled 1−4 urines collected after fibroid diagnosis over the consecutive weeks to analyze nine phthalate metabolites and calculate relevant molar sums (e.g., di(2-ethylhexyl) phthalate, ΣDEHP; anti-androgenic phthalates, ΣAA; all metabolites, ΣPhthalates). Using Poisson regression, we evaluated associations between phthalate biomarkers and the risk of having fibroid diagnosis. We explored if associations differed by weight gain from age 18 to 45−54 or in women diagnosed with fibroids within 5 years of phthalate assessment. Our major finding was that women had a 13% (RR: 1.13; 95%CI: 1.02, 1.26) and 16% (RR: 1.16; 95% CI: 1.03, 1.31) greater risk of prior fibroid diagnosis for each two-fold increase in ΣDEHP or ΣAA, respectively. These associations were strongest in women who became overweight/obese from age 18 to 45−54 and in those diagnosed <5 years before phthalate assessment. Based on these results, prospective studies should corroborate our findings related to associations between phthalates and fibroids, and may consider evaluating the role that weight gain may play in these associations.
纤维瘤的病因尚不清楚，但可能与激素有关。因此，我们评估了中年时期邻苯二甲酸酯（改变激素的化学物质）与之前纤维瘤诊断之间的关联，并考虑了体重增加状况的差异。女性（年龄：45-54 岁；n=754）自我报告了过去的纤维瘤诊断。我们收集了纤维瘤诊断后连续数周内的 1-4 次尿液，以分析 9 种邻苯二甲酸酯代谢物并计算相关的摩尔总和（例如，邻苯二甲酸二（2-乙基己基）酯，ΣDEHP；抗雄激素邻苯二甲酸酯，ΣAA；所有代谢物，ΣPhthalates）。我们使用泊松回归评估了邻苯二甲酸酯生物标志物与纤维瘤诊断风险之间的关联。我们探讨了这些关联是否因从 18 岁到 45-54 岁的体重增加而有所不同，或者在评估邻苯二甲酸酯后 5 年内被诊断出患有纤维瘤的女性中是否有所不同。我们的主要发现是，对于ΣDEHP 或ΣAA 每增加两倍，女性先前患有纤维瘤的风险分别增加 13%（RR：1.13；95%CI：1.02，1.26）和 16%（RR：1.16；95%CI：1.03，1.31）。这些关联在从 18 岁到 45-54 岁期间体重超重/肥胖的女性和在评估邻苯二甲酸酯前 5 年内被诊断出患有纤维瘤的女性中最强。基于这些结果，前瞻性研究应该证实我们关于邻苯二甲酸酯与纤维瘤之间关联的发现，并可能考虑评估体重增加在这些关联中的作用。
