Abstract
BACKGROUND: Limited animal, in vitro, and human studies have reported that exposure to phthalates or bisphenol A (BPA) may affect thyroid signaling. OBJECTIVE: We explored the cross-sectional relationship between urinary concentrations of metabolites of di(2-ethylhexyl) phthalate (DEHP), dibutyl phthalate (DBP), and BPA with a panel of serum thyroid measures among a representative sample of U.S. adults and adolescents. METHODS: We analyzed data on urinary biomarkers of exposure to phthalates and BPA, serum thyroid measures, and important covariates from 1,346 adults (ages ≥ 20 years) and 329 adolescents (ages 12-19 years) from the National Health and Nutrition Examination Survey (NHANES) 2007-2008 using multivariable linear regression. RESULTS: Among adults, we observed significant inverse relationships between urinary DEHP metabolites and total thyroxine (T4), free T4, total triiodothyronine (T3), and thyroglobulin, and positive relationships with thyroid-stimulating hormone (TSH). The strongest and most consistent relationships involved total T4, where adjusted regression coefficients for quintiles of oxidative DEHP metabolites displayed monotonic dose-dependent decreases in total T4 (p-value for trend < 0.0001). Suggestive inverse relationships between urinary BPA and total T4 and TSH were also observed. Conversely, among adolescents, we observed significant positive relationships between DEHP metabolites and total T3. Mono(3-carboxypropyl) phthalate, a secondary metabolite of both DBP and di-n-octyl phthalate, was associated with several thyroid measures in both age groups, whereas other DBP metabolites were not associated with thyroid measures. CONCLUSIONS: These results support previous reports of associations between phthalates-and possibly BPA--and altered thyroid hormones. More detailed studies are needed to determine the temporal relationships and potential clinical and public health implications of these associations.