Association between Phthalate Metabolites and Risk of Endometriosis: A Meta-Analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies
PubMed 31574938 · doi:10.3390/ijerph16193678
What was done
The authors searched PubMed, Web of Science, and EMBASE through March 3, 2019, to conduct a meta-analysis evaluating the association between exposure to five phthalate metabolites and endometriosis risk. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated across included studies.
What was found
Eight studies were included. MEHHP exposure was statistically associated with endometriosis (OR = 1.246, 95% CI = 1.003-1.549). Regional subgroup analysis showed a significant association in Asia (OR = 1.786, 95% CI = 1.005-3.172, I² = 0%), but not in the USA (OR = 1.170, 95% CI = 0.949-1.442, I² = 45.6%). No significant associations were observed for the other four metabolites: MEHP (OR = 1.089, 95% CI = 0.858-1.383), MEP (OR = 1.073, 95% CI = 0.899-1.282), MBzP (OR = 0.976, 95% CI = 0.810-1.176), or MEOHP (OR = 1.282, 95% CI = 0.874-1.881).
Why it matters
The findings synthesize evidence linking environmental plasticizer exposure to endometriosis, identifying MEHHP as a potential exposure of concern in specific populations.
Limits
The meta-analysis included only eight observational studies, total participant sample size was not reported in the abstract, the association for MEHHP was borderline statistically significant, and four of the five examined metabolites showed null results.
Cited by
- supports In women, higher phthalate exposure is associated with irregular menstrual cycles and an increased risk of endometriosis.