Table 16.
Associations between BBP and DEP exposure and testosterone.
| Reference; Study confidence; N | Transformation | Effect estimate | Metabolite (ng/mL) [median unless otherwise specified] | Exposure IQR (or as specified) | Testosterone effect estimate |
|---|---|---|---|---|---|
| BBP (measured by MBzP) | |||||
| Meeker et al. (2009); Medium; 425 | Ln-transformed exposure and outcome (except testosterone) | β (95% CI) for IQR increase | 8.2 | 4.20−15.9 | 4.58 (−7.91, 17.0) |
| Jurewicz et al. (2013); Medium; 269 | Log-transformed exposure | β (p) | 5.2 | 0.4−205 (range) | −0.09 (p = 0.5) |
| Den Hond et al. (2015); Low; 120 | Ln-transformed exposure | β ± SE | 4.5 | 2.5−9.0 | −0.02 ± 0.02 |
| Chang et al. (2015); Low; 176 | Ln-transformed exposure and outcome | β (95% CI) for IQR increaseŦ | 0.7 (fertile mean) | 0.96 (0.91, 1.02) | |
| Wang et al. (2015c); Medium; 1,040 | Ln-transformed exposure and outcome | % difference (95% CI) 1 unit increase | 2.9 | 1.0−3.4 | −1.2% (−5.3, 2.9) |
| Meeker and Ferguson (2014); Medium; 160 (12–19 yr) | None reported | % change (95% CI) with IQR increase | 5.8 | 3.6−11.3 | −21.1 (−38.6, 1.30) |
| 267 (20–40 yr) | 3.7 | 2.2−6.7 | −4.92 (−12.9, 3.82) | ||
| (Pan et al., 2016); Pan et al. (2015); Medium; 1,066 | Ln-transformed exposure and outcome | % change (CI) | 0.1 | <LOD-0.4 | −2.6% (−5.3,0.1) |
| Axelsson et al. (2015a); Medium; 314 | Ln-transformed exposure and outcome | Mean difference for Q4 vs. Q1 (95% CI) | 13 | 0.5–260 (range) | 2.3 (−2.8, 6.0) |
| DEP (measured by MEP) | |||||
| Meeker et al. (2009); Medium; 425 | Ln-transformed exposure and outcome (except testosterone) | β (95% CI) for IQR increase | 153 | 59.9–518 | 8.87 (−7.18, 24.9) |
| Jurewicz et al. (2013); Medium; 269 | Log-transformed exposure | β (p) | 45 | 3.8–2,483 (range) | 0.08 (p = 0.6) |
| Den Hond et al. (2015); Low; 120 | Ln-transformed exposure | β ± SE | 50 | 20.5–110.5 | 0.01 ± 0.02 |
| Chang et al. (2015); Low; 176 | Ln-transformed exposure and outcome | β (95% CI) for IQR increaseŦ | 13 (fertile mean) | 1.00 (0.97, 1.04) | |
| Wang et al. (2015c); Medium; 1,040 | Ln-transformed exposure and outcome | % difference (95% CI) 1 unit increase | 18 | 7.1−25 | −1.7% (−3.8, 0.30) |
| Meeker and Ferguson (2014); Medium; 160 (12–19 yr) | None reported | % change (95% CI) with IQR increase | 26 | 14.0−46.9 | 9.46 (−17.1, 44.5) |
| 267 (20–40 yr) | 27 | 12.2−74.7 | −3.30 (−9.81, 3.67) | ||
| (Pan et al., 2016); Pan et al. (2015); Medium; 1,066 | Ln-transformed exposure and outcome | % change (CI) | 13 | 6.6–32 | −1.5% (−4.0,1.1) |
| Axelsson et al. (2015a); Medium; 314 | Ln-transformed exposure and outcome | Mean difference for Q4 vs. Q1 (95% CI) | 41 | 2−6,900 (range) | 1.0 (−7.9, 11) |
| Han et al. (2014); Medium; 232 | None reported | Partial correlation coefficient | 3.1 | 0.0−59.7 (5th−95th) | −0.01 |
p < 0.05, results that support an association are shaded. Dark gray represents one or more of the following: p < 0.05, large effect size (e.g., OR ≥ 1.5, β ≥ −0.5, % difference ≥ 1.0%), or exposure-response trend across categories of exposure. Light gray represents other supportive results.
Ŧ Coefficient was calculated by study authors with back-transformation of both hormone and phthalate metabolite concentrations. A coefficient < 1.0 indicates a multiplicative decrease in hormone level for an IQR change in exposure.
Units for testosterone differed across studies: ng/mL (Jurewicz et al., 2013, Meeker and Ferguson, 2014), nmol/L (Han et al., 2014, Axelsson et al., 2015a, 2015b, Chang et al., 2015, Pan et al., 2015), nmol/mL (Specht et al., 2014), pg/mL (Pan et al., 2006), ng/dL (Meeker et al., 2009, Den Hond et al., 2015, Wang et al., 2015a, 2015b, 2015c).