Table 2.
Associations of breast cancer risk (invasive and in situ) with phthalate metabolites, ratios of DEHP metabolites, and phthalic acid in all women and by race/ethnicity
| Metabolites (ng/g creatinine) |
All (1032 ca/1030 co) |
Whites (274 ca/273 co) |
Japanese Americans (478ca/478co) |
Native Hawaiians (155 ca/154 co) |
African Americans and Latinos (125 ca/125 co) |
Phet raceb |
|---|---|---|---|---|---|---|
| OR (95% CI)a | OR (95% CI)a | OR (95% CI)a | OR (95% CI)a | OR (95% CI)a | ||
| MMP | ||||||
| ≤ 2.63 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| > 2.63–7.40 | 0.82 (0.65–1.04) | 0.71 (0.44–1.13) | 0.86 (0.61–1.23) | 1.16 (0.68–1.99) | 0.54 (0.26–1.10) | |
| > 7.40 | 0.89 (0.69–1.15) | 0.89 (0.53–1.49) | 0.84 (0.57–1.24) | 1.22 (0.62–2.37) | 0.74 (0.36–1.50) | |
| P trendc | 0.26 | 0.49 | 0.36 | 0.52 | 0.30 | 0.59 |
| MEP | ||||||
| ≤ 30.64 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| > 30.64–84.30 | 1.08 (0.86–1.35) | 0.93 (0.60–1.42) | 1.06 (0.78–1.45) | 1.63 (0.92–2.90) | 0.82 (0.33–2.03) | |
| > 84.30 | 1.07 (0.84–1.35) | 1.13 (0.72–1.78) | 0.97 (0.69–1.38) | 1.50 (0.85–2.66) | 0.75 (0.32–1.80) | |
| P trendc | 0.56 | 0.67 | 0.95 | 0.12 | 0.52 | 0.63 |
| MBP | ||||||
| ≤ 12.92 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| > 12.92–24.60 | 0.83 (0.66–1.04) | 0.99 (0.62–1.58) | 0.84 (0.61–1.15) | 0.89 (0.51–1.55) | 0.53 (0.24–1.16) | |
| > 24.60 | 0.87 (0.69–1.11) | 0.82 (0.52–1.29) | 1.04 (0.73–1.48) | 0.64 (0.34–1.20) | 0.70 (0.35–1.40) | |
| P trendc | 0.21 | 0.41 | 0.93 | 0.20 | 0.41 | 0.80 |
| MiBP | ||||||
| ≤ 3.12 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| > 3.12–6.64 | 0.95 (0.75–1.21) | 0.73 (0.44–1.19) | 0.86 (0.60–1.22) | 1.39 (0.77–2.49) | 1.52 (0.68–3.42) | |
| > 6.64 | 1.15 (0.89–1.49) | 0.74 (0.45–1.23) | 1.21 (0.82–1.79) | 2.07 (1.02–4.21) | 1.33 (0.64–2.75) | |
| P trendc | 0.36 | 0.23 | 0.83 | 0.05 | 0.52 | 0.16 |
| MBzP | ||||||
| ≤ 7.66 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| > 7.66–15.83 | 0.81 (0.65–1.01) | 0.69 (0.45–1.06) | 0.87 (0.63–1.21) | 0.67 (0.37–1.21) | 1.05 (0.56–1.97) | |
| > 15.83 | 0.79 (0.63–0.99) | 0.67 (0.43–1.03) | 0.86 (0.61–1.20) | 0.86 (0.47–1.57) | 0.77 (0.41–1.46) | |
| P trendc | 0.03 | 0.05 | 0.35 | 0.53 | 0.52 | 0.56 |
| MEHP | ||||||
| ≤ 4.72 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| > 4.72–10.88 | 1.00 (0.79–1.26) | 0.91 (0.57–1.43) | 0.86 (0.61–1.22) | 1.74 (0.94–3.22) | 1.23 (0.61–2.44) | |
| > 10.88 | 1.01 (0.77–1.31) | 1.06 (0.46–1.63) | 0.76 (0.52–1.12) | 2.73 (1.25–5.97) | 1.08 (0.52–2.27) | |
| P trendc | 0.97 | 0.94 | 0.17 | 0.01 | 0.81 | 0.07 |
| MEHHP | ||||||
| ≤ 18.44 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| > 18.44–39.67 | 0.96 (0.77–1.20) | 0.73 (0.47–1.14) | 0.98 (0.71–1.34) | 1.37 (0.79–2.35) | 1.03 (0.53–2.02) | |
| > 39.67 | 0.93 (0.74–1.18) | 0.69 (0.44–1.11) | 0.97 (0.69–1.35) | 1.67 (0.90–3.08) | 0.80 (0.39–1.61) | |
| P trendc | 0.56 | 0.11 | 0.83 | 0.09 | 0.56 | 0.23 |
| MEOHP | ||||||
| ≤ 11.54 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| > 11.54–26.28 | 1.03 (0.83–1.28) | 0.66 (0.43–1.02) | 1.21 (0.88–1.67) | 1.21 (0.71–2.05) | 1.09 (0.57–2.12) | |
| > 26.28 | 0.90 (0.72–1.13) | 0.66 (0.42–1.05) | 1.03 (0.74–1.44) | 1.27 (0.71–2.24) | 0.65 (0.33–1.29) | |
| P trendc | 0.46 | 0.06 | 0.67 | 0.39 | 0.28 | 0.24 |
| MECPP | ||||||
| ≤ 23.04 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| > 23.04–45.35 | 0.94 (0.75–1.18) | 0.81 (0.52–1.26) | 0.91 (0.65–1.26) | 1.22 (0.68–2.19) | 1.10 (0.57–2.14) | |
| > 45.35 | 0.99 (0.78–1.25) | 0.77 (0.49–1.22) | 0.98 (0.70–1.38) | 1.94 (1.01–3.70) | 0.80 (0.38–1.66) | |
| P trendc | 0.84 | 0.25 | 0.84 | 0.06 | 0.62 | 0.27 |
| MCHP | ||||||
| ≤ 0.34 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| > 0.34–0.57 | 1.11 (0.88–1.39) | 1.10 (0.71–1.70) | 1.19 (0.85–1.67) | 1.28 (0.73–2.25) | 0.72 (0.36–1.44) | |
| > 0.57 | 1.16 (0.91–1.47) | 1.25 (0.77–2.03) | 1.08 (0.75–1.54) | 1.78 (0.91–3.47) | 0.86 (0.45–1.64) | |
| P trendc | 0.23 | 0.39 | 0.58 | 0.10 | 0.49 | 0.51 |
| MEHP%d | ||||||
| ≤ 5.49% | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| > 5.49–11.08% | 1.27 (1.00–1.61) | 1.46 (0.93–2.30) | 1.09 (0.77–1.56) | 1.63 (0.88–3.03) | 1.22 (0.62–2.38) | |
| > 11.08% | 1.23 (0.94–1.62) | 1.81 (1.06–3.08) | 0.97 (0.65–1.46) | 1.46 (0.73–2.92) | 1.03 (0.46–2.28) | |
| P trendc | 0.09 | 0.03 | 0.94 | 0.22 | 0.84 | 0.44 |
| MEHP/(MEOHP + MEHHP) | ||||||
| ≤ 9.76% | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| > 9.76–21.36% | 1.32 (1.04–1.68) | 1.57 (1.00–2.44) | 1.18 (0.82–1.71) | 1.46 (0.79–2.70) | 1.21 (0.62–2.38) | |
| > 21.36% | 1.26 (0.96–1.66) | 2.10 (1.20–3.65) | 0.98 (0.66–1.47) | 1.14 (0.56–2.34) | 1.38 (0.63–3.03) | |
| P trendc | 0.05 | 0.007 | 0.97 | 0.55 | 0.42 | 0.30 |
| MEHP/(MECCP + MEHHP) | ||||||
| ≤ 7.87% | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| > 7.87–16.86% | 1.28 (1.02–1.63) | 1.35 (0.86–2.08) | 1.20 (0.85–1.77) | 1.38 (0.76–2.49) | 1.36 (0.68–2.70) | |
| > 16.86% | 1.18 (0.90–1.56) | 1.76 (1.04–2.99) | 1.01 (0.67–1.53) | 1.14 (0.58–2.24) | 0.92 (0.41–2.05) | |
| P trendc | 0.13 | 0.04 | 0.82 | 0.56 | 0.93 | 0.64 |
| MEHP/MEHHP | ||||||
| ≤ 0.159 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| > 0.159–0.341 | 1.20 (0.94–1.54) | 1.31 (0.84–2.04) | 1.07 (0.73–1.57) | 1.31 (0.69–2.49) | 1.28 (0.64–2.56) | |
| > 0.341 | 1.24 (0.94–1.63) | 1.84 (1.05–3.21) | 1.08 (0.72–1.63) | 0.90 (0.44–1.84) | 1.31 (0.59–2.94) | |
| P trendc | 0.11 | 0.04 | 0.70 | 0.92 | 0.45 | 0.60 |
| MEHP/MEOHP | ||||||
| ≤ 0.245 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| > 0.245–0.548 | 1.36 (1.08–1.71) | 1.92 (1.23–2.99) | 1.09 (0.78–1.53) | 1.32 (0.73–2.41) | 1.48 (0.75–2.93) | |
| > 0.548 | 1.26 (0.97–1.63) | 2.02 (1.17–3.50) | 0.92 (0.63–1.35) | 1.29 (0.69–2.42) | 1.62 (0.75–3.50) | |
| P trendc | 0.04 | 0.004 | 0.79 | 0.38 | 0.20 | 0.14 |
| MEHP/MECPP | ||||||
| ≤ 0.137 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| > 0.137–0.298 | 1.17 (0.93–1.48) | 1.11 (0.72–1.72) | 1.11 (0.78–1.59) | 1.36 (0.75–2.47) | 1.25 (0.63–2.48) | |
| > 0.298 | 0.96 (0.73–1.25) | 1.14 (0.69–1.88) | 0.80 (0.53–1.21) | 1.12 (0.57–2.34) | 0.97 (0.43–2.20) | |
| P trendc | 0.99 | 0.59 | 0.78 | 0.57 | 0.52 | 0.78 |
| Phthalic acid (PA) | ||||||
| ≤ 36.90 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| > 36.90–79.76 | 1.11 (0.88–1.40) | 0.95 (0.60–1.52) | 1.19 (0.86–1.64) | 1.61 (0.81–3.21) | 0.81 (0.39–1.69) | |
| > 79.76 | 1.21 (0.94–1.56) | 0.98 (0.61–1.58) | 1.17 (0.80–1.69) | 2.22 (1.08–4.57) | 1.04 (0.47–2.30) | |
| P trendc | 0.14 | 0.94 | 0.32 | 0.03 | 0.92 | 0.39 |
aConditional logistic regression with the matched sets as strata and adjusted for education, number of children, age at menarche, menopausal status, BMI at urine collection, neighborhood socioeconomic status at urine collection, smoking, alcohol intake, and Mediterranean energy adjusted total score. Missing categories of covariates were included in the analyses
bP heterogeneity (race) df = 4
cP trend (log phthalate) df = 1
dMEHP% was calculated by converting the DEHP metabolites (MEHP, MEHHP, MEOHP, and MECCP) into nanomoles (nmol) using their respective molecular weights (278, 294, 292, and 308 g/mol) and dividing the molar mass of MEHP by the mass of the sum of these metabolites and then multiplying by 100