{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T10:24:19Z","timestamp":1772965459662,"version":"3.50.1"},"reference-count":63,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2017,6,5]],"date-time":"2017-06-05T00:00:00Z","timestamp":1496620800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Phthalate exposure was reported to be associated with diabetes mellitus (DM) and cardiovascular disease (CVD). Yet, reported associations and the potential sex differences are inconsistent. We conducted a cross-sectional study involving 2330 participants in the Fall of 2012. Urinary metabolites of 10 phthalates were measured. The status of having DM and CVD-related outcomes were self-reported. In the overall study population, the logistic regression analyses showed that the urinary levels of mono-2-ethyl-5-oxohexyphthalate (MEOHP), mono-2-ethyl-5-hydroxyhexylphthalate(MEHHP) and mono-2-ethyl-5-carboxypentylphthalate (MECPP) were positively associated with DM. Higher urinary levels of monomethyl phthalate (MMP) and mono-2-carboxymethyl-hexyl phthalate (MCMHP) were associated with increased odds of hyperlipidemia, while mono-2-ethylhexylphthalate (MEHP) was significantly inverse-associated with hyperlipidemia. We did not observe significant associations for other CVD-related outcomes with phthalate metabolites. When stratifying by sex, MEHHP, MEOHP, MECPP, MCMHP and the micromolar sums of the oxidative metabolites of DEHP (\u03a3DEHPox) were all significantly related to DM in males, but not in females. No significant sex differences were found in CVD-related outcomes, except the sporadic associations between phthalates and hyperlipidemia. These findings highlight the importance of investigating the sex-specific relationship between phthalates exposure and DM.<\/jats:p>","DOI":"10.3390\/ijerph14060598","type":"journal-article","created":{"date-parts":[[2017,6,6]],"date-time":"2017-06-06T10:53:09Z","timestamp":1496746389000},"page":"598","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Sex Differences in the Association of Urinary Concentrations of Phthalates Metabolites with Self-Reported Diabetes and Cardiovascular Diseases in Shanghai Adults"],"prefix":"10.3390","volume":"14","author":[{"given":"Ruihua","family":"Dong","sequence":"first","affiliation":[{"name":"Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai 200000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shanzhen","family":"Zhao","sequence":"additional","affiliation":[{"name":"Shanghai Entry-Exit Inspection and Quarantine Bureau, Shanghai 200000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han","family":"Zhang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai 200000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingsi","family":"Chen","sequence":"additional","affiliation":[{"name":"Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai 200000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meiru","family":"Zhang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai 200000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Wang","sequence":"additional","affiliation":[{"name":"Shanghai Entry-Exit Inspection and Quarantine Bureau, Shanghai 200000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Wu","sequence":"additional","affiliation":[{"name":"Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai 200000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9646-1474","authenticated-orcid":false,"given":"Shuguang","family":"Li","sequence":"additional","affiliation":[{"name":"Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai 200000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Chen","sequence":"additional","affiliation":[{"name":"Key Laboratory of Public Health Safety of Ministry of Education, Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai 200000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2017,6,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/1476-069X-13-43","article-title":"Phthalates and diet: A review of the food monitoring and epidemiology data","volume":"13","author":"Serrano","year":"2014","journal-title":"Environ. Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1111\/j.1539-6924.2006.00770.x","article-title":"What are the sources of exposure to eight frequently used phthalic acid esters in Europeans?","volume":"26","author":"Wormuth","year":"2006","journal-title":"Risk Anal."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1111\/j.1365-2605.2005.00567.x","article-title":"Human exposure to phthalates via consumer products","volume":"29","author":"Schettler","year":"2006","journal-title":"Int. J. Androl."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1007\/BF03161027","article-title":"Phthalates in food and medical devices","volume":"2","author":"Chou","year":"2006","journal-title":"J. Med. Toxicol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.1080\/15287390490513300","article-title":"Estimated exposure to phthalates in cosmetics and risk assessment","volume":"67","author":"Koo","year":"2004","journal-title":"J. Toxicol. Environ. Health Part A"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1007\/s00204-005-0674-4","article-title":"Detection of phthalate metabolites in human saliva","volume":"79","author":"Silva","year":"2005","journal-title":"Arch. Toxicol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.atherosclerosis.2011.05.001","article-title":"Circulating levels of bisphenol A and phthalates are related to carotid atherosclerosis in the elderly","volume":"218","author":"Lind","year":"2011","journal-title":"Atherosclerosis"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1002\/mnfr.200800312","article-title":"Reproductive toxicity of phthalate esters","volume":"54","author":"Chahoud","year":"2010","journal-title":"Mol. Nutr. Food Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.mce.2009.02.017","article-title":"Par-mediated activity of phthalates: A link to the obesity epidemic?","volume":"304","author":"Desvergne","year":"2009","journal-title":"Mol. Cell. Endocrinol."},{"key":"ref_10","first-page":"415","article-title":"Plasma phospholipid fatty acid composition as a biomarker of habitual dietary fat intake in an ethnically diverse cohort","volume":"17","author":"Hodge","year":"2007","journal-title":"NMCD"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"359267","DOI":"10.1155\/2008\/359267","article-title":"Peroxisome proliferator-activated receptors as mediators of phthalate-induced effects in the male and female reproductive tract: Epidemiological and experimental evidence","volume":"2008","author":"Latini","year":"2008","journal-title":"PPAR"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1042\/BSR20120042","article-title":"The endocrine disruptor mono-(2-ethylhexyl) phthalate promotes adipocyte differentiation and induces obesity in mice","volume":"32","author":"Hao","year":"2012","journal-title":"Biosci. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Hectors, T.L., Vanparys, C., Pereira-Fernandes, A., Martens, G.A., and Blust, R. (2013). Evaluation of the ins-1 832\/13 cell line as a beta-cell based screening system to assess pollutant effects on beta-cell function. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0060030"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"S53","DOI":"10.1038\/ijo.2008.207","article-title":"Interference of pollutants with PPARS: Endocrine disruption meets metabolism","volume":"32","author":"Feige","year":"2008","journal-title":"Int. J. Obes."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4172","DOI":"10.1210\/jc.2015-2765","article-title":"Adiponectin levels differentiate metabolically healthy vs. unhealthy among obese and nonobese white individuals","volume":"100","author":"Ahl","year":"2015","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Kim, J.H., Park, H.Y., Bae, S., Lim, Y.H., and Hong, Y.C. (2013). Diethylhexyl phthalates is associated with insulin resistance via oxidative stress in the elderly: A panel study. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0071392"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.2337\/dc11-2396","article-title":"Circulating levels of phthalate metabolites are associated with prevalent diabetes in the elderly","volume":"35","author":"Lind","year":"2012","journal-title":"Diabetes Care"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1289\/ehp.1104717","article-title":"Urinary phthalate metabolite concentrations and diabetes among women in the national health and nutrition examination survey (NHANES) 2001\u20132008","volume":"120","author":"Stahlhut","year":"2012","journal-title":"Environ. Health Perspect."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1016\/j.envres.2011.05.015","article-title":"Phthalate exposure associated with self-reported diabetes among Mexican women","volume":"111","author":"Svensson","year":"2011","journal-title":"Environ. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"7018","DOI":"10.1021\/es502076j","article-title":"Urinary phthalate metabolite associations with biomarkers of inflammation and oxidative stress across pregnancy in Puerto Rico","volume":"48","author":"Ferguson","year":"2014","journal-title":"Environ. Sci. Technol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2792","DOI":"10.1097\/01.ASN.0000141966.69934.21","article-title":"The inflammatory syndrome: The role of adipose tissue cytokines in metabolic disorders linked to obesity","volume":"15","author":"Wisse","year":"2004","journal-title":"JASN"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e1428","DOI":"10.4088\/JCP.14m09009","article-title":"Inflammation, obesity, and metabolic syndrome in depression: Analysis of the 2009\u20132010 national health and nutrition examination survey (NHANES)","volume":"75","author":"Rethorst","year":"2014","journal-title":"J. Clin. Psychiatry"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2640","DOI":"10.1210\/jc.2015-1686","article-title":"Association of exposure to di-2-ethylhexylphthalate replacements with increased insulin resistance in adolescents from NHANES 2009\u20132012","volume":"100","author":"Attina","year":"2015","journal-title":"J. Clin. Endocrinol. Metabol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/1476-069X-11-21","article-title":"Serum concentrations of phthalate metabolites are related to abdominal fat distribution two years later in elderly women","volume":"11","author":"Lind","year":"2012","journal-title":"Environ. Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1289\/ehp.9882","article-title":"Concentrations of urinary phthalate metabolites are associated with increased waist circumference and insulin resistance in adult U.S. Males","volume":"115","author":"Stahlhut","year":"2007","journal-title":"Environ. Health Perspect."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/1476-069X-13-6","article-title":"Gender and racial\/ethnic differences in the associations of urinary phthalate metabolites with markers of diabetes risk: National health and nutrition examination survey 2001\u20132008","volume":"13","author":"Huang","year":"2014","journal-title":"Environ. Health"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s12940-016-0136-x","article-title":"The association between phthalates and metabolic syndrome: The national health and nutrition examination survey 2001\u20132010","volume":"15","author":"Huang","year":"2016","journal-title":"Environ. Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.envres.2008.08.007","article-title":"Environmental phthalate exposure in relation to reproductive outcomes and other health endpoints in humans","volume":"108","author":"Swan","year":"2008","journal-title":"Environ. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.1289\/ehp.9016","article-title":"Decreased serum free testosterone in workers exposed to high levels of di-n-butyl phthalate (DBP) and di-2-ethylhexyl phthalate (DEHP): A cross-sectional study in china","volume":"114","author":"Pan","year":"2006","journal-title":"Environ. Health Perspect."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1289\/ehp.8075","article-title":"Human breast milk contamination with phthalates and alterations of endogenous reproductive hormones in infants three months of age","volume":"114","author":"Main","year":"2006","journal-title":"Environ. Health Perspect."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1161\/HYPERTENSIONAHA.115.05603","article-title":"Association of exposure to di-2-ethylhexylphthalate replacements with increased blood pressure in children and adolescents","volume":"66","author":"Trasande","year":"2015","journal-title":"Hypertension"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.jpeds.2013.03.072","article-title":"Urinary phthalates are associated with higher blood pressure in childhood","volume":"163","author":"Trasande","year":"2013","journal-title":"J. Pediatr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1038\/ijo.2015.8","article-title":"Associations of urinary phthalates with body mass index, waist circumference and serum lipids among females: National health and nutrition examination survey 1999\u20132004","volume":"39","author":"Yaghjyan","year":"2015","journal-title":"Int. J. Obes."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.envint.2017.01.008","article-title":"Food consumption survey of shanghai adults in 2012 and its associations with phthalate metabolites in urine","volume":"101","author":"Dong","year":"2017","journal-title":"Environ. Int."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1289\/ehp.7337","article-title":"Urinary creatinine concentrations in the U.S. Population: Implications for urinary biologic monitoring measurements","volume":"113","author":"Barr","year":"2005","journal-title":"Environ. Health Perspect."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"3138","DOI":"10.1021\/es103879m","article-title":"Occurrence of phthalate metabolites in human urine from several Asian countries","volume":"45","author":"Guo","year":"2011","journal-title":"Environ. Sci. Technol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1289\/ehp.0901712","article-title":"Dietary intake is associated with phthalate body burden in a nationally representative sample","volume":"118","author":"Colacino","year":"2010","journal-title":"Environ. Health Perspect."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/j.envint.2011.03.005","article-title":"Phthalate metabolites in urine from China, and implications for human exposures","volume":"37","author":"Guo","year":"2011","journal-title":"Environ. Int."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.scitotenv.2015.11.005","article-title":"Phthalate metabolites in urine of Chinese young adults: Concentration, profile, exposure and cumulative risk assessment","volume":"543","author":"Gao","year":"2016","journal-title":"Sci. Total Environ."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1007\/s00204-004-0642-4","article-title":"New metabolites of di(2-ethylhexyl)phthalate (DEHP) in human urine and serum after single oral doses of deuterium-labelled DEHP","volume":"79","author":"Koch","year":"2005","journal-title":"Arch. Toxicol."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Wang, H., Zhou, Y., Tang, C., He, Y., Wu, J., Chen, Y., and Jiang, Q. (2013). Urinary phthalate metabolites are associated with body mass index and waist circumference in Chinese school children. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0056800"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.ijheh.2013.06.006","article-title":"Urinary phthalate metabolites and male reproductive function parameters in Chongqing general population, China","volume":"217","author":"Han","year":"2013","journal-title":"Int. J. Hyg. Environ. Health"},{"key":"ref_43","first-page":"101","article-title":"The CDC fourth national report on human exposure to environmental chemicals: What it tells us about our toxic burden and how it assist environmental medicine physicians","volume":"15","author":"Crinnion","year":"2010","journal-title":"Alternat. Med. Rev. A J. Clin. Therap."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.ijheh.2006.09.005","article-title":"Occurrence and daily variation of phthalate metabolites in the urine of an adult population","volume":"210","author":"Fromme","year":"2007","journal-title":"Int. J. Hyg. Environ. Health"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.ijheh.2015.04.002","article-title":"Human biomonitoring of phthalate exposure in Austrian children and adults and cumulative risk assessment","volume":"218","author":"Hartmann","year":"2015","journal-title":"Int. J. Hyg. Environ. Health"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.tox.2004.11.013","article-title":"Evaluation of anti-androgenic activity of di-(2-ethylhexyl)phthalate","volume":"208","author":"Stroheker","year":"2005","journal-title":"Toxicology"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1289\/ehp.6663","article-title":"Mono(2-ethyl-5-hydroxyhexyl) phthalate and mono-(2-ethyl-5-oxohexyl) phthalate as biomarkers for human exposure assessment to di-(2-ethylhexyl) phthalate","volume":"112","author":"Kato","year":"2004","journal-title":"Environ. Health Perspect."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.ejim.2007.09.023","article-title":"Shbg levels correlate with insulin resistance in postmenopausal women","volume":"20","author":"Akin","year":"2009","journal-title":"Eur. J. Int. Med."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Liu, S., and Sun, Q. (2016). Sex differences, endogenous sex-hormone hormones, sex-hormone binding globulin (SHBG), and exogenous disruptors in diabetes and related metabolic outcomes. J. Diabetes.","DOI":"10.1111\/1753-0407.12517"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1001\/jama.295.11.1288","article-title":"Sex differences of endogenous sex hormones and risk of type 2 diabetes: A systematic review and meta-analysis","volume":"295","author":"Ding","year":"2006","journal-title":"JAMA"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1056\/NEJMoa0804381","article-title":"Sex hormone-binding globulin and risk of type 2 diabetes in women and men","volume":"361","author":"Ding","year":"2009","journal-title":"N. Eng. J. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2658","DOI":"10.1093\/humrep\/dev225","article-title":"Phthalates might interfere with testicular function by reducing testosterone and insulin-like factor 3 levels","volume":"30","author":"Chang","year":"2015","journal-title":"Hum. Reprod."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.envint.2014.02.002","article-title":"Associations between serum phthalates and biomarkers of reproductive function in 589 adult men","volume":"66","author":"Specht","year":"2014","journal-title":"Environ. Int."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"4346","DOI":"10.1210\/jc.2014-2555","article-title":"Urinary phthalate metabolites are associated with decreased serum testosterone in men, women, and children from NHANES 2011\u20132012","volume":"99","author":"Meeker","year":"2014","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"287","DOI":"10.2164\/jandrol.108.006403","article-title":"Urinary metabolites of di(2-ethylhexyl) phthalate are associated with decreased steroid hormone levels in adult men","volume":"30","author":"Meeker","year":"2009","journal-title":"J. Androl."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Sheikh, I.A., Yasir, M., Abu-Elmagd, M., Dar, T.A., Abuzenadah, A.M., Damanhouri, G.A., Al-Qahtani, M., and Beg, M.A. (2016). Human sex hormone-binding globulin as a potential target of alternate plasticizers: An in silico study. BMC Structur. Biol., 16.","DOI":"10.1186\/s12900-016-0067-3"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Sheikh, I.A., Turki, R.F., Abuzenadah, A.M., Damanhouri, G.A., and Beg, M.A. (2016). Endocrine disruption: Computational perspectives on human sex hormone-binding globulin and phthalate plasticizers. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0151444"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1093\/humrep\/dev260","article-title":"Exposure of pregnant women to persistent organic pollutants and cord sex hormone levels","volume":"31","author":"Warembourg","year":"2016","journal-title":"Hum. Reprod."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"488","DOI":"10.2164\/jandrol.111.013557","article-title":"Urinary concentrations of di(2-ethylhexyl) phthalate metabolites and serum reproductive hormones: Pooled analysis of fertile and infertile men","volume":"33","author":"Mendiola","year":"2012","journal-title":"J. Androl."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"861","DOI":"10.2337\/diacare.27.4.861","article-title":"Association of bioavailable, free, and total testosterone with insulin resistance: Influence of sex hormone-binding globulin and body fat","volume":"27","author":"Tsai","year":"2004","journal-title":"Diabetes Care"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1111\/1753-0407.12325","article-title":"Endocrine-disrupting chemicals, risk of type 2 diabetes, and diabetes-related metabolic traits: A systematic review and meta-analysis","volume":"8","author":"Song","year":"2016","journal-title":"J. Diabetes"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1111\/j.1468-1331.2012.03862.x","article-title":"Urine phthalate concentrations are higher in people with stroke: United States national health and nutrition examination surveys (NHANES), 2001\u20132004","volume":"20","author":"Shiue","year":"2013","journal-title":"Eur. J. Neurol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1289\/ehp.02110515","article-title":"Reproducibility of urinary phthalate metabolites in first morning urine samples","volume":"110","author":"Hoppin","year":"2002","journal-title":"Environ. Health Perspect."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/14\/6\/598\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:38:00Z","timestamp":1760207880000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/14\/6\/598"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6,5]]},"references-count":63,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2017,6]]}},"alternative-id":["ijerph14060598"],"URL":"https:\/\/doi.org\/10.3390\/ijerph14060598","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,6,5]]}}}