Association of urinary phthalate metabolites concentrations with body mass index and waist circumference

Environ Sci Pollut Res Int. 2018 Apr;25(11):11143-11151. doi: 10.1007/s11356-018-1413-8. Epub 2018 Feb 7.


This study aims to investigate the association of urinary concentration of phthalate metabolites with body mass index (BMI) and waist circumference (WC) in 2016 on 242 children and adolescents, aged 6-18 years living in Isfahan, Iran. Urinary concentration of mono-butyl phthalate (MBP), mono-benzyl phthalate (MBzP), mono-2-ethylhexyl phthalate (MEHP), mono-methyl phthalate (MMP), mono (2-ethyl-5-exohexyl) phthalate (MEOHP), and mono (2-ethyl-5hydroxyhexyl) phthalate (MEHHP) metabolites were determined. For comparison of means, t test and to evaluate the association of analytes in different groups according to weight ANOVA was used. The correlation was applied to determine the association between phthalate metabolites with age, sex, WC, BMI, and BMI z-score. The univariate and multivariate regression models were used to determine the association of metabolites concentration with BMI z-score and WC. Mean (SD) BMI, BMI z-score and WC were 23.89 (4.41) kg/m2, 1.37 (1.3), and 82.37 (12.71) cm, respectively. There was a significant correlation between boys' age with BMI z-score (p value = 0.03) and WC (p value = 0.01), while the corresponding figures were not statistically significant in girls (p value = 0.48, and 0.4, respectively). Of the total population, 37 participants (15.3%) were obese. MMP, MBP, and MBzP metabolites were observed in all samples while MEHP, MEOHP, and MEHHP in 99.6, 95.86, and 96.28% of the studied population. Mean concentration of MMP (64.38 μg/L) and MBzP (268 μg/L) had the lowest and highest concentrations of metabolites, respectively. A significant relationship was observed among all studied metabolites and weight groups (p value ≤ 0.02). After adjustment for potential confounders, all metabolites (except MMP) showed a low-to-moderate positive and significant relationship with BMI z-score (β = 0.17-0.3). A weak to moderate positive and significant relationship was observed between all phthalate metabolites and WC (β = 0.14-0.39). The concentration of phthalate metabolites was much higher in the population living in Isfahan-Iran than in some other populations, indicating a high exposure to contaminants. Therefore, further studies and preventive measures are required for improving the environmental health.

Keywords: Adolescent; Children; Obesity; Phthalate; Urinary metabolites.

MeSH terms

  • Adolescent
  • Body Mass Index
  • Child
  • Cross-Sectional Studies
  • Environmental Exposure*
  • Environmental Monitoring
  • Environmental Pollutants / urine*
  • Female
  • Humans
  • Iran / epidemiology
  • Male
  • Obesity / epidemiology
  • Obesity / etiology
  • Phthalic Acids / urine*
  • Waist Circumference*


  • Environmental Pollutants
  • Phthalic Acids