Organochlorine pesticides, phthalate metabolites, and risk of endometriosis

Kristen Upson
2013 · W2599103052
dissertation OA: green CC0
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This study investigated the association between exposure to organochlorine pesticides and phthalate metabolites and the risk of endometriosis in women.

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This study examined whether serum organochlorine pesticides and urinary phthalate metabolites are associated with endometriosis risk, using data from the population-based WREN case-control study of U.S. women aged 18–49. OCPs were measured in serum from 248 cases and 538 controls, while urinary phthalate metabolites were quantified from 92 cases and 195 controls, and odds ratios from unconditional logistic regression were used; linear regression assessed predictors of phthalate exposure. The authors found increased endometriosis risk associated with β-hexachlorocyclohexane (especially among cases with ovarian endometriosis) and mirex, while urinary mono-(2-ethyl-5-hexyl) phthalate (MEHP) showed a strong inverse association with risk; other phthalate metabolites showed inverse or positive patterns, and phthalate exposure varied by time of day, day of week, and season, with some inverse associations for MiBP with body fat measures. The paper acknowledges that prior epidemiologic evidence has been conflicting and that information on phthalate exposure characteristics among premenopausal women was limited, while exposure measures came from the study sample. This paper is centrally about endometriosis — it directly tests associations between organochlorine pesticides, phthalate metabolites, and endometriosis risk.

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Abstract

Thesis (Ph.D.)--University of Washington, 2013
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Organochlorine pesticides, phthalate metabolites, and risk of endometriosis Date relationships.isAuthorOf Upson, Kristen Journal Title Journal ISSN Volume Title Publisher Abstract Background: Endometriosis is an estrogen-driven benign gynecologic condition that may be affected by exposure to environmental chemicals that mimic or alter endogenous hormonal activity, such as organochlorine pesticides (OCPs) and phthalates. However, the impact of these chemicals on endometriosis risk remains unclear, as prior epidemiologic studies have had conflicting results. Additionally, basic information is lacking on characteristics associated with increased phthalate body burden among premenopausal women. Methods: This research investigated the relationships between OCPs, phthalate metabolites, and endometriosis risk and predictors of phthalate exposure using data from a population-based case-control study of endometriosis, Women's Risk of Endometriosis (WREN). WREN was conducted among 18-49 year old female enrollees of a large healthcare system in the U.S. Pacific Northwest. OCP concentrations were measured in the serum of 248 cases and 538 controls and urinary phthalate metabolites were quantified on 92 cases and 195 controls. To investigate the relationship between environmental chemicals and endometriosis risk, odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional logistic regression. To examine predictors of phthalate exposure, ratios of median phthalate metabolite concentrations and 95% CI were estimated using linear regression. Results: Serum concentrations of β-hexachlorocyclohexane, particularly in analyses restricting cases to those with ovarian endometriosis, and mirex were associated with increased endometriosis risk. A strong inverse association was observed between urinary mono-(2-ethyl-5-hexyl) phthalate (MEHP) concentration and endometriosis risk. The data suggested an inverse association with other di-2-ethylhexyl phthalate (DEHP) metabolites and a positive association with mono-benzyl phthalate (MBzP) and mono-ethyl phthalate (MEP). Mono-isobutyl phthalate (MiBP) concentrations were inversely associated with waist circumference and waist-to-hip ratio. Trends across hours of the day (summed metabolites of DEHP), days of the week (MEP), and seasons of the year (MiBP) were observed. Conclusions: This research suggests that environmental exposure to OCPs and phthalates may alter endometriosis risk and that subgroups of premenopausal women may have increased phthalate exposure. Nearly ubiquitous exposure to phthalates as well as extensive past use of environmentally persistent OCPs in the United States or present use in other countries may impact the current health of reproductive-age women. Description Thesis (Ph.D.)--University of Washington, 2013

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