Association of Multiple Urinary Phthalates Metabolites with Diabetes Risk in Elderly Population

As a common environmental endocrine disruptor, phthalate exposure could affect the diabetes risk. However, it remains unclear whether phthalate exposure in the elderly population alters diabetes risk. We conducted a cross-sectional survey to explore the effect of urinary phthalate metabolites on diabetes in the elderly. We conducted a health survey of 200 elderly in northeastern China and measured urinary concentrations of 64 phthalate metabolites. We next evaluated the association between major phthalates and phthalate mixtures and diabetes in the elderly. The least absolute shrinkage and selection operator (LASSO) regression screened for mono (3-carboxypropyl) phthalate (MCPP), monoethyl phthalate (MEP), and mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) as important predictors for diabetes. Weighted quantile sum (WQS) regression and Bayesian Kernel Machine regression (BKMR) models consistently found MEHHP (Weights = 51.9%, PIP = 0.97) to have the greatest effect on diabetes risk in the elderly. Furthermore, MEHHP was associated with an increased risk of diabetes in the multipollutant logistic regression model (OR = 2.148, 95% CI: 1.255 to 3.677). The overall effect of coexposure to MCPP, MEHHP, and MEP on the risk of diabetes in elderly population was significant and positive. In summary, we found that increased urinary MEHHP levels could increase the risk of diabetes in the elderly population. Co-exposure to MCPP, MEHHP and MEP may increase the risk of diabetes.