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Everyday chemicals linked to chronic disease in men

Chemicals found in everyday plastics materials are linked to cardiovascular disease, type-2 diabetes and high blood pressure in men, according to Australian researchers.

Researchers from the University of Adelaide and the South Australian Health and Medical Research Institute (SAHMRI) investigated the independent association between chronic diseases among men and concentrations of potentially harmful chemicals known as phthalates.

Phthalates are a group of chemicals widely used in common consumer products, such as food packaging and wrappings, toys, medications, and even medical devices.

Researchers found that of the 1,500 Australian men tested, phthalates were detected in urine samples of 99.6% of those aged 35 and over.

"We found that the prevalence of cardiovascular disease, type-2 diabetes and high blood pressure increased among those men with higher total phthalate levels," says senior author Associate Professor Zumin Shi, from the University of Adelaide's Adelaide Medical School and the Freemasons Foundation Centre for Men's Health, and a member of SAHMRI's Nutrition & Metabolism theme.

"While we still don't understand the exact reasons why phthalates are independently linked to disease, we do know the chemicals impact on the human endocrine system, which controls hormone release that regulate the body's growth, metabolism, and sexual development and function.

"In addition to chronic diseases, higher phthalate levels were associated with increased levels of a range of inflammatory biomarkers in the body," he says.

Age and western diets are directly associated with higher concentrations of phthalates. Previous studies have shown that men who ate less fresh fruit and vegetables and more processed and packaged foods, and drank carbonated soft drinks, have higher levels of phthalates in their urine.

"Importantly, while 82% of the men we tested were overweight or obese – conditions known to be associated with chronic diseases – when we adjusted for this in our study, the significant association between high levels of phthalates and disease was not substantially altered," Shi says.

"In addition, when we adjusted for socio-economic and lifestyle factors such as smoking and alcohol, the association between high levels of phthalates and disease was unchanged."

Shi says that although the studies were conducted in men, the findings are also likely to be relevant to women. "While further research is required, reducing environmental phthalates exposure where possible, along with the adoption of healthier lifestyles, may help to reduce the risk of chronic disease," he says.

Abstract
Objective: To investigate associations between urinary total phthalate concentration, chronic low-grade inflammation and non-communicable diseases in a cohort of South Australian men.
Methods: 1504 men aged 39–84 years who provided a urinary sample at the follow-up visit of the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study, a randomly-selected group of urban-dwelling, community-based men from Adelaide, Australia (n = 2038; study participation rate: 78.1%). Total phthalate concentration was quantified in fasting morning urine samples. Chronic diseases were assessed through self-report questionnaire or directly measured using standardised clinical and laboratory procedures. Inflammatory biomarkers were assayed by ELISA or spectroscopy. Multivariable linear and logistic regression models were applied to determine associations of log-transformed urinary phthalate concentration with inflammation and chronic disease.
Results: Total phthalates were detected in 99.6% of urinary samples; geometric mean (95% CI) was 114.1 (109.5–118.9) µg/g creatinine. Higher total phthalate levels were associated with higher levels of hs-CRP, IL-6 (all p < 0.05) and TNF-α but not MPO. Urinary total phthalate concentrations were positively associated with cardiovascular disease, type-2-diabetes and hypertension. Comparing extreme quartiles of total phthalate, prevalence ratios were 1.78 (95% CI 1.17 – 2.71, p-trend = 0.001) for cardiovascular disease and 1.84 (95%CI 1.34 – 2.51, p-trend = 0.001) for type-2-diabetes and 1.14 (95%CI 1.01 – 1.29, p-trend = 0.013) for hypertension. Total phthalates and asthma and depression were not significantly associated.
Conclusion: A positive association between total phthalates and cardiovascular disease, type-2-diabetes, hypertension and increased levels of chronic low-grade inflammatory biomarkers was observed in urban-dwelling Australian men.

Authors
Peter Y Bai, Gary Wittert, Anne W Taylor, Sean A Martin, Robert W Milne, Alicia J Jenkins, Andrzej S Januszewski, Zumin Shi

[link url="http://www.adelaide.edu.au/news/news93422.html"]University of Adelaide material[/link]
[link url="http://www.sciencedirect.com/science/article/pii/S0013935117301330?via%3Dihub"]Environmental Research abstract[/link]

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