Background/Objectives Exposure to environmental chemicals could be one of the contributors to the increasing obesity epidemic. Very little is known about the association of phthalates, ubiquitous chemicals widely used in consumer products, with obesity and lipid metabolism. This study investigated the association of urinary phthalate metabolites and, for the first time, the ratios of the major metabolites of the most common phthalate, di-2-ethylhexyl phthalate (DEHP), with body mass index (BMI), waist circumference, and serum lipid levels in the U.S. female population. Methods This cross-sectional study used the data from the National Health and Nutrition Examination Survey, 1999–2004 and was restricted to women aged ≥18 years, who were not pregnant and had no history of diabetes. Using multivariate ordered logistic regression, we examined associations of seven urinary phthalate metabolites and their metabolic ratios with the BMI, waist circumferences, total cholesterol, triglycerides, and high-density and low-density lipoprotein cholesterol. Results BMI was positively associated with monobutyl phthalate (MBP) and mono-2-ethylhexyl phthalate (MEHP) (OR=1.13, 95% CI, 1.03-1.23 and OR=1.12, 95% CI, 1.03-1.23, respectively). Waist circumference was positively associated with MBP (OR=1.13, 95% CI, 1.03-1.24). A higher ratio of MEHP to mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) was positively associated with both BMI (OR=1.21, 95% CI, 1.09-1.34) and waist circumference (OR=1.20, 95% CI, 1.10-1.31). There were no other significant associations. Conclusions A higher metabolic ratio of MEHP to MEHHP, reflective of slower oxidative conversion of MEHP, is associated with greater BMI and waist circumference.

No abstract

Introduction. The likelihood of having a positive low dose computed tomography (LDCT) lung cancer screening (LCS) examination that requires workup may vary according to patients’ characteristics and risk factors. The purpose of this study is to evaluate patient characteristics associated with positive LCS exams. Methods. We utilized data from 1684 LDCT exams conducted for LCS at five academic and community sites from 2015-2018. During the screening visit, patients were asked to complete a comprehensive questionnaire including socio-demographics, smoking history, occupational and environmental exposures, family history of lung cancer, and comorbid conditions. Information on the LCS examination, including the radiologists’ Lung Reporting and Data System (Lung-RADS) assessment, was obtained from the radiologist report. We dichotomized Lung-RADS into negative (Lung-RADS 1 (negative) or 2 (benign appearance or behavior)) and positive (Lung-RADS 3 (probably benign), 4A (suspicious), or 4B (suspicious)) based on the management recommendation of continuing with annual screening in 12 months or requiring follow-up before 12 months. We compared Lung-RADS results (positive versus negative) by patient characteristics using chi-square tests and examined predictors of positive LCS exams using multivariate logistic regression, reporting adjusted odds ratios (aORs) and 95% confidence intervals (95%CI). Results. Screened patients ranged in age from 50-78 years, with 46.7% less than 65 years and 53.3% ages 65 or older. Approximately 53.3% were male and 46.7% were female; 84.5% were White, 11.8% were African American, and 3.7% were other races. The majority (76.5%) of screened patients were overweight or obese. Two-thirds (68.5%) of patients had more than one LCS exam. Most (85.0%) LCS exams were negative while 15.0% were positive. There were no significant differences in Lung-RADS assessment by race, gender, education, or body mass index. Lung-RADS were significantly more likely to be positive in those ages 65 and older versus those ages less than 65 (aOR=1.47, 95%CI: 1.03-2.10) and in baseline versus subsequent screening exams (aOR=0.43, 95%CI: 0.30-0.62). Conclusion. Predictors of having a positive LCS exam requiring work-up before the next recommended annual screening test include being aged 65 and older and having a baseline LCS examination. Citation Format: Louise M. Henderson, Samantha Sites, Tina Tailor, Sara C. Bearden, Roger Huamani, Allison Throneburg, Max Nagle, M Patricia Rivera. Patient and screening characteristics associated with positive lung cancer screening examinations [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4215.