General gynaecology: Association of phthalate esters with endometriosis in Indian women

B Snehitha Reddy, B S Reddy, R Rozati, Roya Rozati, B. T. V. B. Reddy, B V R Reddy, N V V S S Raman, NVVSS Raman
BJOG: An International Journal of Obstetrics & Gynaecology · 2006 · vol. 113(5) , pp. 515–520 · doi:10.1111/j.1471-0528.2006.00925.x · PMID:16637895 · W2090374016
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Indian women with endometriosis exhibited significantly higher concentrations of four phthalate esters (DnBP, BBP, DnOP, DEHP) in their blood compared to women without the condition.

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Abstract

OBJECTIVE: To evaluate the possible association between phthalate esters (PEs) and the occurrence of endometriosis. DESIGN: Case-control study. SETTING: Department of Reproductive Medicine, Bhagawan Mahavir Medical Research Centre, Maternal Health and Reproductive Institute and Department of Analytical R&D, Hetero Research Foundation, Hyderabad, Andhra Pradesh, India. SAMPLE: Blood samples were collected from 49 infertile women with endometriosis (study group); 38 age-matched women without endometriosis (control group I) but with infertility related to tubal defects, fibroids, polycystic ovaries, idiopathic infertility and pelvic inflammatory diseases diagnosed by laparoscopy and a further group of 21 age-matched women (control group II) with proven fertility and no evidence of endometriosis and other gynaecological disorders during laparoscopic sterilisation. METHODS: Concentrations of PEs were measured using gas chromatography. MAIN OUTCOME MEASURES: Evaluation of PEs concentrations in women with endometriosis compared with women free from the disease. RESULTS: Women with endometriosis showed significantly higher concentrations of di-n-butyl phthalate (DnBP), butyl benzyl phthalate (BBP), di-n-octyl phthalate (DnOP) and diethyl hexyl phthalate (DEHP) (mean 0.44 [SD 0.41]; 0.66 [SD 0.61]; 3.32 [SD 2.17]; 2.44 [SD 2.17] micrograms/ml) compared with control group I (mean 0.08 [SD 0.14]; 0.12 [SD 0.20]; 0; 0.50 [SD 0.80] micrograms/ml) and control group II (mean 0.15 [SD 0.21]; 0.11 [SD 0.22]; 0; 0.45 [SD 0.68] micrograms/ml). The correlation between the concentrations of PEs and different severity of endometriosis was strong and statistically significant at P < 0.05 for all four compounds (DnBP: r=+0.73, P < 0.0001; BBP: r=+0.78, P < 0.0001; DnOP: r=+0.57, P < 0.0001 and DEHP: r=+0.44, P < 0.0014). CONCLUSIONS: This study suggests that PEs may have an aetiological association with endometriosis.

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Condition tags

endometriosisinfertility

MeSH descriptors

Endometriosis Environmental Exposure Phthalic Acids Adult Age Factors Body Mass Index Case-Control Studies Chromatography, High Pressure Liquid Endometriosis Endometriosis Environmental Exposure Female Humans India Infertility, Female Infertility, Female Infertility, Female Menarche Phthalic Acids Phthalic Acids

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