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Phthalate exposure enhances incidence of urinary incontinence: US NHANES, 2003–2004 and 2005–2006

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Abstract

The aim of this study is to investigate the associations between phthalate exposure and UI in a nationally representative sample of US adults. Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) database was used for analysis. In total, 2,818 participants with measurements for phthalate metabolites and complete UI questionnaire data were enrolled in our study. Furthermore, seven phthalate metabolites were measured, which were obtained from urine samples and creatinine-standardized in the subsequent analyses. After dividing these phthalate metabolites into three groups, multivariable regression models were performed to evaluate the association between phthalate metabolites and UI rates. Moreover, interaction analyses and subgroup analyses stratified by gender were performed. In these seven phthalate metabolites, high level of mono-carboxynonyl phthalate (MCNP), mono-carboxyoctyl phthalate (MCOP), mono-isobutyl phthalate (MiBP), mono-n-butyl phthalate (MBP), and mono-3-carboxypropyl phthalate (MCPP) showed increased risk of UI (odds ratio (OR) = 1.52, 1.42, 1.43, 1.50, 1.51, respectively, all p value < 0.05). Trend test showed that incidence of UI increased significantly with concentration. A higher incidence of UI among participants was observed in the maximal tertile of phthalate when comparing with the lowest tertile. Subgroup analysis found that different phthalates have varying influence for different types of UI. Moreover, the analyses stratified for sex indicated that the high concentrations of MCNP and median concentrations of MCCP were associated with increase of the odds of UI in women and in men, respectively. Overall, the exposure to phthalates was positively associated with UI among US adults. Notably, different phthalates have varying influence for different types of UI, and male and female exposure to phthalate could result in the different prevalence of UI.

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 Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This study was supported by grants from National Natural Science Foundation of China (82070784, 81702536), a grant from Science & Technology Department of Sichuan Province, China (2022JDRC0040) to J. A., and a grant from 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (ZYGD18011) to H.L.

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    Authors and Affiliations

    1. Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 88 South Keyuan Road, Chengdu, 610041, People’s Republic of China

      Xianyanling Yi, Kun Jin, Shi Qiu, Xingyu Xiong, Tianyi Zhang, Dazhou Liao, Xiaonan Zheng, Hang Xu, Hong Li, Lu Yang, Qiang Wei & Jianzhong Ai

    2. Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, 610041, China

      Ge Peng

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    1. Xianyanling Yi
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    2. Kun Jin
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    Contributions

    J. Ai, Q. Wei, and X. Yi conceived the project and drafted the manuscript, K. Jin, X. Xiong, T. Zhang, and G. Peng searched the databases, S. Qiu, X. Zheng, D. Liao, and H. Xu analyzed data, and H. Li and L. Yang revised the manuscript. All authors read and approved the final version of the manuscript.

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    Correspondence to Jianzhong Ai.

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    Responsible Editor: Lotfi Aleya

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    Xianyanling Yi, Kun Jin, and Shi Qiu contributed to this work equally.

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    Yi, X., Jin, K., Qiu, S. et al. Phthalate exposure enhances incidence of urinary incontinence: US NHANES, 2003–2004 and 2005–2006. Environ Sci Pollut Res 29, 64692–64703 (2022). https://doi.org/10.1007/s11356-022-20307-w

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    • DOI: https://doi.org/10.1007/s11356-022-20307-w

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