Association of Exposure to Endocrine-Disrupting Chemicals During Adolescence With Attention-Deficit/Hyperactivity Disorder–Related Behaviors

Shoaff, Jessica R.; Coull, Brent A.; Weuve, Jennifer; Bellinger, David C.; Calafat, Antònia M.; Schantz, Susan L.; Korrick, Susan A.

doi:10.1001/jamanetworkopen.2020.15041

Cited by 28 publications

(10 citation statements)

References 46 publications

(106 reference statements)

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“…Although we have adjusted all of the critical factors in this study, there may be possibilities of unaccounted or unobserved confounders, such as medical conditions, diet, occupational status, timing of the sample collection, medication use, substance use, and type and frequency of use of phthalate-containing products, in the analysis that may produce biased associations. However, adjustments for some of these factors did not alter associations in other studies . Furthermore, the complex interactions across metabolites may persist and require further evaluation.…”

Section: Discussionmentioning

confidence: 80%

“…However, adjustments for some of these factors did not alter associations in other studies. 3,15,47,48 Furthermore, the complex interactions across metabolites may persist and require further evaluation. The levels of phthalate exposure and their timing of metabolism into different metabolites need to be assessed to establish the relative toxic effects of all phthalates, including their hydrolyzed and conjugated products, in future studies.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

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Association of Exposure to Phthalate Metabolites With Sex Hormones, Obesity, and Metabolic Syndrome in US Women

et al. 2022

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ImportanceObesity and metabolic syndrome are highly prevalent among the US population and are associated with the dysregulation of sex hormones. An increase in obesity and metabolic syndrome may also be associated with exposure to phthalates. The association of exposure to phthalate metabolites with sex hormones and metabolic health has been understudied in the female population.ObjectiveTo evaluate the association between exposure to common phthalate metabolites with total testosterone (TT) levels, sex hormone–binding globulin (SHBG) levels, obesity, and metabolic syndrome among women.Design, Setting, and ParticipantsThis cross-sectional study used data collected from the National Health and Nutrition Examination Survey during 2013 to 2016. Female participants aged 15 years or older with urinary profiles containing common phthalate metabolites were included in this study. Statistical analyses were performed from March 15, 2021, to April 30, 2022.ExposuresUrinary concentrations of phthalate metabolites were classified into tertiles, and the lowest tertile was used as a reference category. The concentrations of phthalate metabolites and their composite scores based on clustering were also used in the analysis.Main Outcomes and MeasuresSerum concentrations of TT and SHBG were dichotomized into high TT levels (&gt;46 ng/dL [to convert to nanomoles per liter, multiply by 0.0347] for age &lt;50 years and &gt;32 ng/dL for age ≥50 years) and low SHBG levels (&lt;2.85 μg/mL [to convert to nanomoles per liter, multiply by 10.53]) as established for the female population. Obesity was defined as a body mass index of 30 or more (calculated as weight in kilograms divided by height in meters squared), and metabolic syndrome was defined using the National Cholesterol Education Program criteria. The serum concentrations of TT and SHBG were also included in the validation analyses. Modified Poisson models were used to estimate the adjusted relative risk (RR) with 95% CIs for the associations.ResultsAmong the 2004 women included in this study, the mean (SD) age was 46.6 (18.5) years (14.7% Hispanic participants, 62.7% non-Hispanic White participants, and 13.2% non-Hispanic Black participants; 17.4% of participants were born outside the US [weighted percentages]; 230 (11.8%) had high TT levels, 210 (10.4%) had low SHBG levels, 825 (39.8%) had obesity, and 965 (45.5%) had metabolic syndrome (weighted percentages). Of the 13 phthalate metabolites, 8 had the highest tertile level greater than 6.2 ng/mL (range, 0.5-75.2 ng/mL). High levels of exposure to mono(2-ethyl-5-carboxypentyl) phthalate (RR, 1.84 [95% CI, 1.33-2.54]), mono(2-ethyl-5-oxohexyl) phthalate (RR, 1.77 [95% CI, 1.21-2.59]), mono(2-ethyl-5-hydroxyhexyl) phthalate (RR, 1.94 [95% CI, 1.34-2.81]), and monobenzyl phthalate (RR, 1.75 [95% CI, 1.21-2.54]) were associated with low SHBG levels but not with high TT levels. High levels of exposure to some of these metabolites were also associated with obesity and metabolic syndrome. Most associations were specific to premenopausal or postmenopausal women.Conclusions and RelevanceIn this cross-sectional study, exposure to certain phthalate metabolites could be associated with low SHBG levels, obesity, and metabolic syndrome depending on menopausal status.

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Section: Discussionmentioning

confidence: 80%

Section: Strengths and Limitationsmentioning

confidence: 99%

Association of Exposure to Phthalate Metabolites With Sex Hormones, Obesity, and Metabolic Syndrome in US Women

et al. 2022

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“…In this view, the endocrine system plays a pivotal role in mediating the effect of the environmental stress on the health of individuals through direct effects [22] and epigenetic modifications [23].…”

Section: A New Psychopathological Modelmentioning

confidence: 99%

Nutrition, Exercise, and Stress Management for Treatment and Prevention of Psychiatric Disorders. A Narrative Review Psychoneuroendocrineimmunology-Based

Bottaccioli

Marzola

et al. 2021

Endocrines

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Psychoneuroendocrineimmunology (PNEI) brings together knowledge acquired since the 1930s from endocrinology, immunology, neuroscience, and psychology. With PNEI, a model of research and interpretation of health and disease is emerging, which sees the human body as a structured and interconnected unit, where the psychological and biological systems are mutually coordinated. In the PNEI view, many factors could influence mental health, with the endocrine system involved in mediating the effects of environmental stress on mental health and inflammation in the onset and course of psychiatric disorders as a result of individual and collective conditions and behaviors. Among these, nutrition is one way by which the environment impacts physiology: indeed, many pieces of research showed that several elements (e.g., probiotics, fish oil, zinc) have a positive effect on mental disorders thus being potentially augmentation agents in treatment. Still, physical activity can moderate depressive symptoms, while prolonged stress increases the risk of psychopathology. Taken together, the PNEI-based approach may inform prevention and treatment strategies, also in the field of mental health care.

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“…Currently, exposure to different environmental pollutants known as EDCs has been associated with different neurological alterations, including attention deficit/hyperactivity disorder and autism spectrum disorder [9,10]. Certain EDCs such as DEHP can dysregulate the hypothalamic-pituitary-gonadal adrenal axis, which is crucial for reproductive and neuronal processes [11].…”

Section: Introductionmentioning

confidence: 99%

Environmental Pollution to Blame for Depressive Disorder?

Segovia-Mendoza

Palacios-Arreola

Pavón

et al. 2022

IJERPH

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Public concern has emerged about the effects of endocrine-disrupting compounds (EDCs) on neuropsychiatric disorders. Preclinical evidence suggests that exposure to EDCs is associated with the development of major depressive disorder (MDD) and could result in neural degeneration. The interaction of EDCs with hormonal receptors is the best-described mechanism of their biological activity. However, the dysregulation of the hypothalamic-pituitary-gonadal adrenal axis has been reported and linked to neurological disorders. At a worldwide level and in Mexico, the incidence of MDD has recently been increasing. Of note, in Mexico, there are no clinical associations on blood levels of EDCs and the incidence of the MDD. Methodology: Thus, we quantified for the first time the serum levels of parent compounds of two bisphenols and four phthalates in patients with MDD. The levels of di-ethyl-hexyl-phthalate (DEHP), butyl-benzyl-phthalate (BBP), di-n-butyl phthalate (DBP), and di-ethyl-phthalate (DEP), bisphenol A (BPA), and bisphenol S (BPS) in men and women with or without MDD were determined with a gas chromatograph-mass spectrometer. Results/conclusion: We found significant differences between concentrations of BBP between controls and patients with MDD. Interestingly, the serum levels of this compound have a dysmorphic behavior, being much higher in women (~500 ng/mL) than in men (≤10 ng/mL). We did not observe significant changes in the serum concentrations of the other phthalates or bisphenols tested, neither when comparing healthy and sick subjects nor when they were compared by gender. The results point out that BBP has a critical impact on the etiology of MDD disorder in Mexican patients, specifically in women.

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Association of Exposure to Endocrine-Disrupting Chemicals During Adolescence With Attention-Deficit/Hyperactivity Disorder–Related Behaviors

Cited by 28 publications

References 46 publications

Association of Exposure to Phthalate Metabolites With Sex Hormones, Obesity, and Metabolic Syndrome in US Women

Association of Exposure to Phthalate Metabolites With Sex Hormones, Obesity, and Metabolic Syndrome in US Women

Nutrition, Exercise, and Stress Management for Treatment and Prevention of Psychiatric Disorders. A Narrative Review Psychoneuroendocrineimmunology-Based

Environmental Pollution to Blame for Depressive Disorder?

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