Insulin Resistance in Adolescents and Urinary Phthalates

Leonardo Trasande, MD, MPP  Departments of Pediatrics, Environmental Medicine,  Population Health, and  Medicine, School of Medicine, and  Wagner School of Public Service, and  Steinhardt School of Culture, Education, and Human Development, Department of Nutrition MedicalResearch.com: Interview with
Leonardo Trasande, MD, MPP

Departments of Pediatrics, Environmental Medicine,  Population Health, and  Medicine, School of Medicine, and  Wagner School of Public Service, and  Steinhardt School of Culture, Education, and Human Development, Department of Nutrition

MedicalResearch.com: What are the main findings of the study?

Answer: We detect associations of urinary phthalate metabolites in a cross-sectional study of US adolescents.  The association is highly robust to multiple sensitivity analyses, and specific to phthalates commonly found in food.  Further, longitudinal study of dietary phthalate exposures is needed.

MedicalResearch.com: 

Were any of the findings unexpected?

Answer: Associations persisted despite controlling for bisphenol A, another endocrine disrupting chemical commonly found in foods, and HOMA-IR and insulin resistance were not significantly associated with metabolites of lower-molecular weight phthalates commonly found in cosmetics and other personal care products.

MedicalResearch.com: What should clinicians and patients take away from your report?

Answer: While further studies are needed, it should be noted that alternatives to DEHP include wax paper and aluminum wrap; indeed, a dietary intervention which introduced fresh foods that were not canned or packaged in plastic reduced DEHP metabolites by 53-56%. Fresh fruit consumption may also reduce DEHP exposure, given reduced contact of plastic prior to consumption.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Answer: Additional, longitudinal studies are needed, both to confirm the association and elaborate the different potential mechanisms involved.

Citation:

Urinary Phthalates and Increased Insulin Resistance in Adolescents

Leonardo Trasande, Adam J. Spanier, Sheela Sathyanarayana, Teresa M. Attina, and Jan Blustein

Pediatrics peds.2012-4022; published ahead of print August 19, 2013, doi:10.1542/peds.2012-4022

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