Table 4.
Associations between DEHP exposure and semen parameters.
| Reference; Study confidence; N | Exposure | Outcome transformation | Effect estimate | Metabolite (ng/mL) [median unless otherwise specified] | Sperm concentration (×106/ml) | Motility (% normal) | Morphology (% normal) |
|---|---|---|---|---|---|---|---|
| ∑DEHP | |||||||
| Huang et al. (2011); Medium; 45 | No transformation, air concentration | No transformation | β (SE; p-value) | 8/56 (n low/n high exposed) [occupational setting] | −0.19 (0.12; p = 0.1) | −0.23 (0.11; p = 0.04) | 0.014 (0.056, p = 0.8) (% abnormal) |
| (Thurston et al., 2016); Medium; 420 | Ln-transformed | Log-transformed | β (CI) | MEOHP mean 13 Range 0.5–1320 | 0.04 (−0.04,0.11) | 0.30 (−0.80,1.41) | 0.21 (−0.32,0.74) |
| Wirth et al. (2008); Medium; 45 | Tertiles | Dichotomous | OR (CI) | 10.1 | T2: 1.97 (0.2, 16.1) T3: 6.65 (0.9, 47.3) |
T2: 0.7 (0.1−4.4) T3: 0.7 (0.1−4.4) |
T2: 1.2 (0.3, 5.4) T3: 1.1 (0.3, 4.7) |
| Herr et al. (2009); Low; 349 | Quartiles | Dichotomous | OR (CI) | 4.4 | Q2: 0.86 (0.37, 1.97) Q3: 1.11 (0.46, 2.70) Q4: 1.57 (0.60, 4.08) |
Q2: 0.61 (0.2, 1.7) Q3: 0.74 (0.3, 2.2) Q4: 0.86 (0.3, 2.9) |
Q2: 1.95 (0.7, 5.2) Q3: 0.91 (0.4, 2.1) Q4: 1.26 (0.57, 2.8) |
| MEOHP | |||||||
| Bloom et al. (2015); Medium; 375 [related to Wang et al., 2015a] | Ln-transformed; 1 IQR difference | Box-Cox transformed | β (CI) | 5.7 | −1.90 (−3.7, −0.2)* | CD | −3.35 (−11.4, 4.7) |
| Wang et al. (2015b); Medium; 1,040 [related to Bloom et al., 2015] | Ln-transformed | Ln-transformed | β (CI) | 5.7 | (see row with % change effect estimates) | 0.80 (−1.0, 2.6) | −0.10 (−0.8, 0.6) |
| Huang et al. (2013); Medium; 62 | Log transformed | No transformation | β (CI) | 18/92 (low/high exposed) | −0.12 (−0.3, 0.06) | −0.02 (−0.3, −0.07) | −0.001 (−0.07, 0.07) |
| Den Hond et al. (2015); Low; 120 | Ln-transformed | No transformation | β (SE) for 1 unit increase | 7.7 (mean in controls) | 0.18 (0.28) | 1.73 (4.15) | −0.12 (0.42) |
| Specht et al. (2014); Medium; 589 | Dichotomous | Ln-transformed | Means (CI) | 0.2 | <LOD: 51.5 ≥LOD: 46.1 (35.3, 60.1) | Not significant (details not reported) | Not significant (details not reported) |
| Wang et al. (2015b); Medium; 1,040 [related to Bloom et al., 2015] | Ln-transformed | Ln-transformed | % change (CI) | 5.7 | 4.08% (−9.4, 17.4) | (see results for β effect estimates) | (see row with β effect estimates) |
| (Pan et al., 2016); Pan et al. (2015); Medium; 1,066 | Ln-transformed | Cubic root for concentration | % change (CI) | 8.4 IQR 4.8–14.3 | −1.3% (−3.6,1.0) | −0.5% (−3.6,2.5) | −2.1% (−5.4,1.2) |
| Axelsson et al. (2015a); Medium; 314 | Quartiles | Cubic root | Mean difference (Q4 vs. Q1) | 9.6 | −0.06 (−0.48, 0.36) | −6.9 (−13, −1.1)* | −0.42 (−2.4, 1.6) |
| Wang et al. (2015b); Medium; 1040 | Quartiles | Dichotomous | OR (CI) | 5.7 7.0 |
Q2: 0.97 (0.53, 1.79) Q3: 0.82 (0.43, 1.55) Q4: 0.86 (0.47, 1.60) |
Q2: 0.86 (0.6, 1.2) Q3: 0.90 (0.6, 1.3) Q4: 0.73 (0.5, 1.1) |
|
| Liu et al. (2012); Medium; 125 | Tertiles | Dichotomous | OR (CI) | 2.7 (mean) | T2: 1.4 (0.3, 7.7) T3: 0.6 (0.1, 4.2) |
T2: 1.0 (0.4, 3.1) T3: 0.6 (0.2, 1.8) |
|
| Hauser et al. (2006); Medium; 463 | Quartiles | Dichotomous | OR (CI) | 32.1 | Q2: 3.1 (0.8, 11.7) Q3: 1.1 (0.3, 4.6) Q4: 1.6 (0.4, 6.3) |
Q2: 0.9 (0.4, 2.0) Q3: 0.6 (0.3, 1.3) Q4: 0.8 (0.3, 1.6) |
Q2: 1.4 (0.5, 3.7) Q3: 0.5 (0.2, 1.5) Q4: 0.7 (0.3, 2.0) |
| MEHP | |||||||
| Jurewicz et al. (2013); Medium; 269 | Log transformed | Log transformed | β (p) | 8.8 | −0.07 (p = 0.3) | −3.85 (p = 0.001)* | 1.29 (p = 0.24) |
| Huang et al. (2013); Medium; 62 (see also means ± SD results) | Log transformed | No transformation | β (CI) | 6.3/23a | −0.07 (−0.6, 0.5) | −0.55 (−1.0, −0.1) | 0.09 (−0.1, 0.3) |
| Huang et al. (2013); Medium; 62 (see also β results) | Categorical | Means ± SD | 6.3/23a | Controls: 46.7 ± 32.0 Low: 19.9 ± 14.6 High: 27.8 ± 25.5 |
Controls: 65.2 ± 10.0 Low: 56.1 ± 18.3 High: 41.4 ± 22.0 |
Controls: 44.8 ± 7.7 Low: 41.4 ± 9.3 High: 41.4 ± 11.6 |
|
| Han et al. (2014); Medium; 232 | Dichotomous | Dichotomous | OR (CI) | 1.1 5th−95th percentile: 0−24 | 1.15 (0.57, 2.33) | 0.48 (0.08, 2.76) | 1.18 (0.58, 2.39) |
*
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.
Q = quartile; T = tertile. Studies are sorted by study confidence level within each metabolite-effect estimate grouping.