Table 5.
Percent Change (95% CI) in Serum Hormone Concentrations Associated With a Doubling in Urinary Phthalate Group Concentrations Stratified by Age, NHANES 2013–2016
| Measured Hormonal Outcomes | Calculated Hormonal Outcomes | ||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Total Testosterone | Estradiol | SHBG | Free Testosteronea | Bioavailable Testosteronea | Testosterone/estradiol ratio | Free androgen indexa | |||||||||||||||||||||
| % | 95% CI | % | 95% CI | % | 95% CI | % | 95% CI | % | 95% CI | % | 95% CI | % | 95% CI | ||||||||||||||
| 20-39 years | |||||||||||||||||||||||||||
| Σ LMW | -3.64 | -7.21 | 0.07 | -3.04 | -6.66 | 0.72 | 0.93 | -2.92 | 4.94 | -4.76 | -8.62 | -0.75 | * | -4.60 | -8.55 | -0.47 | * | -0.61 | -4.40 | 3.33 | -4.53 | -8.88 | 0.02 | ||||
| Σ HMW | 0.85 | -2.31 | 4.11 | -1.71 | -5.05 | 1.74 | -0.09 | -5.17 | 5.26 | 0.55 | -2.56 | 3.76 | 0.38 | -2.83 | 3.69 | 2.60 | -1.05 | 6.40 | 0.94 | -3.35 | 5.41 | ||||||
| Σ DEHP | -0.73 | -3.94 | 2.59 | 0.39 | -3.39 | 4.33 | -1.90 | -5.69 | 2.03 | 0.35 | -2.88 | 3.68 | -0.50 | -3.72 | 2.83 | -1.12 | -4.65 | 2.54 | 1.20 | -2.30 | 4.82 | ||||||
| Σ DINP | -1.56 | -4.63 | 1.62 | -0.47 | -3.80 | 2.99 | -3.15 | -7.58 | 1.50 | -0.21 | -2.81 | 2.46 | -0.83 | -3.38 | 1.80 | -1.10 | -3.62 | 1.49 | 1.65 | -1.65 | 5.06 | ||||||
| Σ DINCH | 3.73 | -0.23 | 7.85 | -2.08 | -6.67 | 2.74 | 2.13 | -4.48 | 9.19 | 2.28 | -1.70 | 6.43 | 2.17 | -1.93 | 6.45 | 5.93 | -0.01 | 12.23 | * | 1.57 | -3.61 | 7.02 | |||||
| Σ DEHTP | 1.78 | 0.19 | 3.39 | * | -1.25 | -3.46 | 1.00 | 1.27 | -2.20 | 4.86 | 1.07 | -0.62 | 2.79 | 1.19 | -0.56 | 2.97 | 3.07 | 0.70 | 5.50 | * | 0.51 | -2.39 | 3.49 | ||||
| 40-59 years | |||||||||||||||||||||||||||
| Σ LMW | 3.91 | -0.62 | 8.64 | -0.08 | -4.22 | 4.24 | 3.52 | -3.18 | 10.67 | 2.19 | 0.36 | 4.06 | * | 2.13 | 0.27 | 4.02 | * | 3.99 | 0.53 | 7.56 | * | 0.38 | -2.27 | 3.10 | |||
| Σ HMW | 0.12 | -6.11 | 6.77 | -0.56 | -3.44 | 3.45 | 0.41 | -8.23 | 9.87 | -0.21 | -3.86 | 3.58 | -0.46 | -4.50 | 3.76 | 0.18 | -3.87 | 4.40 | -0.29 | -5.37 | 5.07 | ||||||
| Σ DEHP | 0.89 | -3.13 | 5.07 | -1.20 | -5.27 | 3.04 | -0.50 | -5.36 | 4.60 | 1.35 | -2.51 | 5.37 | 0.98 | -2.93 | 5.06 | 2.11 | -1.29 | 5.64 | 1.40 | -3.03 | 6.03 | ||||||
| Σ DINP | 1.85 | -4.17 | 8.24 | -0.56 | -3.48 | 0.24 | 4.35 | -3.72 | 13.10 | -0.85 | -3.57 | 1.94 | -0.77 | -3.64 | 2.18 | 2.42 | -1.78 | 6.80 | -2.40 | -5.69 | 1.00 | ||||||
| Σ DINCH | -3.45 | -5.70 | -1.14 | # | 0.05 | -2.91 | 2.86 | -5.76 | -11.69 | 0.57 | -0.42 | -3.50 | 2.77 | -0.38 | -3.48 | 2.82 | -3.50 | -6.94 | 0.07 | 2.45 | -3.35 | 8.60 | |||||
| Σ DEHTP | -1.51 | -3.72 | 0.74 | 0.60 | -1.58 | 2.82 | -3.26 | -6.85 | 0.48 | 0.48 | -1.20 | 2.20 | 0.27 | -1.53 | 2.12 | -2.10 | -3.75 | -0.42 | * | 1.80 | -0.78 | 4.45 | |||||
| ≥60 years | |||||||||||||||||||||||||||
| Σ LMW | -1.08 | -9.00 | 7.53 | -2.93 | -7.57 | 1.94 | 3.05 | -3.96 | 10.58 | -3.68 | -9.18 | 2.16 | -3.97 | -9.87 | 2.32 | 1.91 | -3.86 | 8.01 | -4.01 | -8.93 | 1.17 | ||||||
| Σ HMW | -4.92 | -9.79 | 0.21 | -3.74 | -7.65 | 0.34 | -0.88 | -6.28 | 4.83 | -4.68 | -8.40 | -0.81 | * | -5.02 | -8.57 | -1.32 | * | -1.23 | -7.27 | 5.21 | -4.08 | -7.68 | -0.33 | ||||
| Σ DEHP | -7.72 | -12.76 | -2.39 | # | -5.55 | -9.81 | -1.09 | * | -4.35 | -8.61 | 0.11 | -5.17 | -9.81 | -0.30 | * | -5.73 | -10.53 | -0.68 | * | -2.30 | -6.19 | 1.76 | -3.53 | -8.10 | 1.28 | ||
| Σ DINP | -3.61 | -8.91 | 2.00 | -3.84 | -7.46 | -0.07 | * | -4.49 | -11.29 | 2.82 | -0.25 | -4.92 | 4.65 | -0.50 | -5.16 | 4.38 | 0.23 | -5.33 | 6.13 | 0.93 | -4.48 | 6.64 | |||||
| Σ DINCH | -7.87 | -12.43 | -3.06 | # | -1.76 | -5.29 | 1.89 | -8.92 | -14.38 | -3.11 | # | -1.52 | -7.81 | 5.21 | -2.01 | -7.91 | 4.27 | -6.21 | -10.38 | -1.86 | * | 1.15 | -5.33 | 8.09 | |||
| Σ DEHTP | -1.97 | -5.81 | 2.04 | -2.61 | -5.49 | 0.37 | 0.41 | -3.05 | 4.00 | -2.42 | -5.08 | 0.32 | -2.54 | -5.12 | 0.10 | 0.66 | -3.48 | 4.97 | -2.37 | -4.48 | -0.21 |
Abbreviations: CI, confidence interval; DEHP, di-2-ethylhexyl phthalate; DEHTP, dioctyl terephthalate; DINCH, cyclohexane-1,2-dicarboxylic acid diisononyl ester; DINP, diisononyl phthalate; HMW, high molecular weight; LMW, low molecular weight.
* P ≤ 0.05.
# P ≤ 0.0083.
aCalculated based on Vermeulen et al. formula from measured sex hormone binding globulin, testosterone, and albumin.