Urine phthalate levels and liver function in US adolescents: Analyses of NHANES 2007-2016

Abstract Phthalates are non-persistent chemicals with endocrine-disrupting abilities widely used in a variety of consumer products. Evidence for the effects of phthalate exposure on liver function in adolescents is lacking. The aim of this study was to investigate the association between urine phthalate levels and changes in liver function indicators. Methods: Data were analyzed from the combined 2007-2016 National Health and Nutrition Examination Survey (NHANES). Weighted linear regressions were used to explore the association between urinary phthalate metabolites and indicators of liver function. Bayesian kernel machine regressions (BKMR) were used to evaluate the joint effects of phthalate metabolite mixtures on indicators of liver function. Results: Weighted Linear regression models showed that MCOP and MiBP were negatively associated with TBIL (all P FDR < 0.05), MCPP was positively correlated with TBIL (P FDR < 0.05), ΣDEHP, MCOP, and MEP (all P FDR < 0.05) were negatively correlated with ALB, while MCPP was positively correlated with ALB (P FDR < 0.05), and MCOP was negatively correlated with TP (P FDR < 0.05). BKMR analysis showed phthalate metabolite mixtures had significant positive dose response relationships with ALT, AST, GGT, ALP and TBIL, and significant negative dose response relationships with ALB and TP. Conclusions: Phathalate metabolites were associated with changes in liver function indicators among U.S. adolescents.