---
title: "Phthalate Metabolites and Risk of Metabolic Syndrome and Type 2 Diabetes: Prospective Taiwan Bioba"
id: "pubmed-42480829"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42480829"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42480829/"
doi: "10.1016/j.envres.2026.125294"
published_at: "2026-09-15T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Phthalate Metabolites and Risk of Metabolic Syndrome and Type 2 Diabetes: Prospective Taiwan Bioba
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42480829
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42480829/)
- **DOI:** [10.1016/j.envres.2026.125294](https://doi.org/10.1016%2Fj.envres.2026.125294)
- **Published At:** 2026-09-15T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This prospective cohort study used Taiwan Biobank data to evaluate associations between urinary **phthalate** metabolite concentrations and subsequent metabolic outcomes. - Eligible participants had baseline measurements of 10 urinary phthalate metabolites quantified by liquid chromatography–tandem mass spectrometry (LC-MS/MS) and no pre-existing metabolic syndrome (MetS). - Primary metabolic outcomes included changes in waist circumference, blood pressure, blood glucose (including **HbA1c**), and lipid profiles; incident MetS and incident type 2 diabetes mellitus (**T2DM**) were also assessed. - Statistical analyses included multivariable linear regression for continuous changes, logistic regression for MetS incidence, and Cox proportional hazards regression for incident **T2DM**. - The analytic sample for MetS analyses was 790 participants with mean follow-up of 4.25 years; 102 participants (12.9%) developed MetS during follow-up. - Among 556 participants without pre-existing **T2DM**, 22 (3.96%) developed incident **T2DM**. - Each natural-log unit increase in baseline MiBP (a **DBP** metabolite) was associated with a small increase in **HbA1c** (+0.04%). - A ln-unit increase in baseline MnBP (another DBP metabolite) was associated with a 1.82-fold higher adjusted risk of incident **T2DM**, but this association lost statistical significance after false-discovery-rate (FDR) correction. - Associations observed between MiBP and increases in triglycerides and total cholesterol, and between DEHP metabolites and increased **HbA1c** and decreased HDL-c, did not remain significant after FDR correction. - No significant association was observed between baseline phthalate metabolite concentrations and MetS prevalence. - Sex and age did not significantly modify the reported associations. - Authors note that **DBP** exposures were linked to deterioration in **HbA1c** and lipid profiles, while the potential link between DBP and elevated T2DM risk requires further confirmation. - Conflict of interest: one author reports financial support from the National Science and Technology Council in Taiwan; other authors declared no known competing interests.
## Clinical Analysis & Structured Key Points
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Epub 2026 Jul 21. # The association between phthalate metabolite concentrations and the risk of metabolic syndrome and type 2 diabetes- a population-based cohort study [Yuan-Jung Chou](https://pubmed.ncbi.nlm.nih.gov/?term=Chou+YJ&cauthor_id=42480829)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42480829/#full-view-affiliation-1 "Graduate Institute of Food Safety, College of Agriculture and Natural Resources, National Chung Hsing University, Taichung, Taiwan."), [Pei-Tzu Shan](https://pubmed.ncbi.nlm.nih.gov/?term=Shan+PT&cauthor_id=42480829)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42480829/#full-view-affiliation-1 "Graduate Institute of Food Safety, College of Agriculture and Natural Resources, National Chung Hsing University, Taichung, Taiwan."), [Chin-Li Lu](https://pubmed.ncbi.nlm.nih.gov/?term=Lu+CL&cauthor_id=42480829)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42480829/#full-view-affiliation-2 "Graduate Institute of Food Safety, College of Agriculture and Natural Resources, National Chung Hsing University, Taichung, Taiwan; Department of Food Science and Biotechnology, College of Agriculture and Natural Resources, National Chung Hsing University, Taichung, Taiwan; Graduate Institute of Clinical Nursing, College of Medicine, National Chung Hsing University, Taichung, Taiwan. Electronic address: chinlilu@nchu.edu.tw.") Affiliations Expand ### Affiliations * 1 Graduate Institute of Food Safety, College of Agriculture and Natural Resources, National Chung Hsing University, Taichung, Taiwan. * 2 Graduate Institute of Food Safety, College of Agriculture and Natural Resources, National Chung Hsing University, Taichung, Taiwan; Department of Food Science and Biotechnology, College of Agriculture and Natural Resources, National Chung Hsing University, Taichung, Taiwan; Graduate Institute of Clinical Nursing, College of Medicine, National Chung Hsing University, Taichung, Taiwan. Electronic address: chinlilu@nchu.edu.tw. * PMID: **42480829** * DOI: [ 10.1016/j.envres.2026.125294 ](https://doi.org/10.1016/j.envres.2026.125294) Item in Clipboard # The association between phthalate metabolite concentrations and the risk of metabolic syndrome and type 2 diabetes- a population-based cohort study Yuan-Jung Chou et al. Environ Res. 2026. Show details Display options Display options Format Abstract PubMed PMID Environ Res Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Environ+Res%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Environ+Res%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42480829/) . 2026 Sep 15;306(Pt 3):125294. doi: 10.1016/j.envres.2026.125294. Epub 2026 Jul 21. ### Authors [Yuan-Jung Chou](https://pubmed.ncbi.nlm.nih.gov/?term=Chou+YJ&cauthor_id=42480829)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42480829/#short-view-affiliation-1 "Graduate Institute of Food Safety, College of Agriculture and Natural Resources, National Chung Hsing University, Taichung, Taiwan."), [Pei-Tzu Shan](https://pubmed.ncbi.nlm.nih.gov/?term=Shan+PT&cauthor_id=42480829)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42480829/#short-view-affiliation-1 "Graduate Institute of Food Safety, College of Agriculture and Natural Resources, National Chung Hsing University, Taichung, Taiwan."), [Chin-Li Lu](https://pubmed.ncbi.nlm.nih.gov/?term=Lu+CL&cauthor_id=42480829)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42480829/#short-view-affiliation-2 "Graduate Institute of Food Safety, College of Agriculture and Natural Resources, National Chung Hsing University, Taichung, Taiwan; Department of Food Science and Biotechnology, College of Agriculture and Natural Resources, National Chung Hsing University, Taichung, Taiwan; Graduate Institute of Clinical Nursing, College of Medicine, National Chung Hsing University, Taichung, Taiwan. Electronic address: chinlilu@nchu.edu.tw.") ### Affiliations * 1 Graduate Institute of Food Safety, College of Agriculture and Natural Resources, National Chung Hsing University, Taichung, Taiwan. * 2 Graduate Institute of Food Safety, College of Agriculture and Natural Resources, National Chung Hsing University, Taichung, Taiwan; Department of Food Science and Biotechnology, College of Agriculture and Natural Resources, National Chung Hsing University, Taichung, Taiwan; Graduate Institute of Clinical Nursing, College of Medicine, National Chung Hsing University, Taichung, Taiwan. Electronic address: chinlilu@nchu.edu.tw. * PMID: **42480829** * DOI: [ 10.1016/j.envres.2026.125294 ](https://doi.org/10.1016/j.envres.2026.125294) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract Previous studies have suggested an association between phthalate exposure and metabolic syndrome (MetS); however, prospective evidence remains limited. This cohort study investigated the association between phthalate exposure and MetS, its components, and incident type 2 diabetes mellitus (T2DM). Data were drawn from the Taiwan Biobank. Eligible participants had baseline urinary phthalate metabolite measurements and no pre-existing MetS. Urinary concentrations of 10 phthalate metabolites were quantified using liquid chromatography-tandem mass spectrometry. Changes in waist circumference, blood pressure, blood glucose, and lipid profiles between baseline and follow-up were calculated. Incident T2DM was identified by linking participants' medical records. Multivariable linear regression, logistic regression and Cox proportional hazard regression models were performed. Over a mean follow-up of 4.25 years, 102 of 790 participants (12.9%) developed MetS. Each ln-unit increase in baseline MiBP was associated with greater increases in HbA1c (0.04%). The association between MiBP and increase in triglycerides and total cholesterol, and between DEHP metabolites and increased HbA1c and decreased HDL-c did not remain statistically significant after false-discovery-rate (FDR) correction. No association was observed with the MetS prevalence. Among 556 participants without pre-existing T2DM, 22 (3.96%) developed T2DM. Each ln-unit increase in baseline MnBP was associated with 1.82-fold higher risks of incident T2DM after adjustment although this association did not remain significant after FDR correction. Neither sex nor age significantly modify these associations. This prospective study suggested that DBP was associated with deterioration of HbA1c and lipid profiles, whereas a potential association between DBP and increased risk of T2DM requires further confirmation. **Keywords:** Cohort study; DBP; DEHP; Metabolic syndrome; Phthalates; Type 2 diabetes. Copyright © 2026 Elsevier Inc. All rights reserved. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Chin-Li Lu reports financial support was provided by National Science and Technology Council in Taiwan. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. ## Similar articles * [ Gender differences in the impact of 3-year status changes of metabolic syndrome and its components on incident type 2 diabetes mellitus: a decade of follow-up in the Tehran Lipid and Glucose Study. ](https://pubmed.ncbi.nlm.nih.gov/37305040/) Hadaegh F, Abdi A, Kohansal K, Hadaegh P, Azizi F, Tohidi M.Hadaegh F, et al.Front Endocrinol (Lausanne). 2023 May 25;14:1164771. doi: 10.3389/fendo.2023.1164771. eCollection 2023.Front Endocrinol (Lausanne). 2023.PMID: 37305040Free PMC article. * [ Sex Differences between Urinary Phthalate Metabolites and Metabolic Syndrome in Adults: A Cross-Sectional Taiwan Biobank Study. ](https://pubmed.ncbi.nlm.nih.gov/36012094/) Shih YL, Hsieh CJ, Lee TY, Liao PH, Wu HT, Liu CY.Shih YL, et al.Int J Environ Res Public Health. 2022 Aug 22;19(16):10458. doi: 10.3390/ijerph191610458.Int J Environ Res Public Health. 2022.PMID: 36012094Free PMC article. * [ Associations between exposure to environmental pollutants, metabolic syndrome risk, and obesity-related anthropometric indices. ](https://pubmed.ncbi.nlm.nih.gov/41353993/) Al-Saleh I, Elkhatib R, Alswayeh R, Al-Rouqi R, Baali M, Aljerayed Y, De Padua SS, Alnuwaysir H, Hussein G, Sultana H, Yousaf N, Waqar A, Alhusayn K, Khan S, Shammama A, Aldowaish A, Alkattabi F, Almansour G, Mohamed G, Devol E.Al-Saleh I, et al.Int J Hyg Environ Health. 2026 Mar;272:114720. doi: 10.1016/j.ijheh.2025.114720. Epub 2025 Dec 6.Int J Hyg Environ Health. 2026.PMID: 41353993 * [ Development of type 2 diabetes mellitus in people with intermediate hyperglycaemia. ](https://pubmed.ncbi.nlm.nih.gov/30371961/) Richter B, Hemmingsen B, Metzendorf MI, Takwoingi Y.Richter B, et al.Cochrane Database Syst Rev. 2018 Oct 29;10(10):CD012661. doi: 10.1002/14651858.CD012661.pub2.Cochrane Database Syst Rev. 2018.PMID: 30371961Free PMC article. * [ Metabolic Syndrome and Incidence of Parkinson Disease: A Community-Based Longitudinal Study and Meta-Analysis. ](https://pubmed.ncbi.nlm.nih.gov/40834329/) Zhang X, Wang J, Dove A, Yu T, Li Q, Gottesman RF, Xu W.Zhang X, et al.Neurology. 2025 Sep 23;105(6):e214033. doi: 10.1212/WNL.0000000000214033. Epub 2025 Aug 20.Neurology. 2025.PMID: 40834329Free PMC article. 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