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Longitudinal Associations of Phthalate Exposures During Childhood and Body Size Measurements in Young Girls

Deierlein, Andrea L.; Wolff, Mary S.; Pajak, Ashley; Pinney, Susan M.; Windham, Gayle C.; Galvez, Maida P.; Silva, Manori J.; Calafat, Antonia M.; Kushi, Lawrence H.; Biro, Frank M.; Teitelbaum, Susan L.the Breast Cancer and Environment Research Program

doi: 10.1097/EDE.0000000000000489
Environmental Epidemiology

Background: Phthalates are environmental chemicals that may play a role in the development of obesity. Few studies have investigated longitudinal associations between postnatal phthalate exposures and subsequent anthropometric measurements in children.

Methods: We collected data as part of The Breast Cancer and Environment Research Program at three US sites. A total of 1,239 girls, aged 6–8 years, were enrolled in 2004–2007. We categorized baseline phthalate exposures, assessed from creatinine-corrected urinary concentrations of low-molecular weight phthalate metabolites, as low, <78; medium, 78 to <194; and high, ≥194 μg/g creatinine and of high-molecular weight phthalates as low, <111; medium, 111–278; and high, ≥278 μg/g creatinine. Anthropometric measurements were collected through 2012 (n = 1,017). Linear mixed effects regression estimated how baseline low and high-molecular weight phthalate concentrations related to changes in girls’ body mass index (BMI), height, and waist circumference at ages 7–13 years.

Results: Low-molecular weight phthalates were positively associated with gains in BMI and waist circumference. Predicted differences in BMI and waist circumference between girls with high versus low concentrations of low-molecular weight phthalates increased from 0.56 (95% confidence interval [CI]: −0.02, 1.1) to 1.2 kg/m2 (95% CI: 0.28, 2.1) and from 1.5 (95% CI: −0.38, 3.3) to 3.9 cm (95% CI: 1.3, 6.5), respectively. High-molecular weight phthalates were negatively associated with height but only among girls who were normal weight at baseline (BMI ≤ 85th percentile).

Conclusion: Phthalates, specifically low-molecular weight phthalates, have small but detectable associations with girls’ anthropometric outcomes. Low-molecular weight phthalates showed stronger associations than other types of phthalates.

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From the aDepartment of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; bDepartment of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH; cDivision of Environmental and Occupational Disease Control, California Department of Public Health, Richmond, CA; dCenters for Disease Control and Prevention, Atlanta, GA; eDivision of Research, Kaiser Permanente, Oakland, CA; and fDivision of Adolescent Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH.

Submitted 21 May 2015; accepted 24 March 2016.

Supported by the Breast Cancer and the Environment Research Program (BCERP) Award Numbers U01ES012770, U01ES012771, U01ES012800, U01ES012801, U01ES019435, U01ES019453, U01ES019454, U01ES019457, R827039 and P01ES009584, P30ES006096, and P30ES023515 from the National Institute of Environmental Health Sciences, the National Cancer Institute, EPA, NIH, DHHS, CSTA-UL1RR029887, NYS Empire Clinical Research Investigator Program, Pediatric Environmental Health Fellowship HD049311, and the Avon Foundation.

The authors report no conflicts of interest.

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Correspondence: Andrea L. Deierlein, 17 East 102nd Street D3-125, New York, NY 10029. E-mail:

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