ArticleJournal of exposure science & environmental epidemiology2024
Phthalate mixtures and insulin resistance: an item response theory approach to quantify exposure burden to phthalate mixtures.
Article in Journal of exposure science & environmental epidemiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 11 citations in OpenAlex.
- Quantifying PFAS-Omics Burden Scores for Nontargeted Analysis Using Multidimensional Item Response Theory: An Exploratory Analysis of Novel and Legacy PFAS in Cord Blood.Environmental science & technology · 2026Article
- Nanomedicine-Driven Modulation of the Gut-Brain Axis: Innovative Approaches to Managing Chronic Inflammation in Alzheimer's and Parkinson's Disease.International journal of molecular sciences · 2025Review
- Impact of prenatal Di(2-ethylhexyl) phthalate exposure on pubertal development in female offspring rats: A focus on ERα-Mediated IGF-1/NKB crosstalk in the hypothalamus.Scientific reports · 2025Article
- Exposome Burden Scores to Summarize Environmental Chemical Mixtures: Creating a Fair and Common Scale for Cross-study Harmonization, Report-back and Precision Environmental Health.Current environmental health reports · 2025Review
- Review
- Exposure to per- and polyfluoroalkyl substances and alterations in plasma microRNA profiles in children.Environmental research · 2024Article
- Pre-natal and early life lead exposure and childhood inhibitory control: an item response theory approach to improve measurement precision of inhibitory control.Environmental health : a global access science source · 2024Article
- Applying Latent Variable Models to Estimate Cumulative Exposure Burden to Chemical Mixtures and Identify Latent Exposure Subgroups: A Critical Review and Future Directions.Statistics in biosciences · 2024Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundMolar sums are often used to quantify total phthalate exposure, but they do not capture patterns of exposure to multiple phthalates.
objectiveTo introduce an exposure burden score method for quantifying exposure to phthalate metabolites and examine the association between phthalate burden scores and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR).
methodsWe applied item response theory (IRT) to data from 3474 adults aged 20-60 years in the 2013-2018 National Health and Examination Survey (NHANES) to quantify latent phthalate exposure burden from 12 phthalate metabolites. We compared model fits of three IRT models that used different a priori groupings (general phthalate burden; low molecular weight (LMW) and high molecular weight (HMW) burdens; and LMW, HMW and DEHP burden), and used the best fitting model to estimate phthalate exposure burden scores. Regression models assessed the covariate-adjusted association between phthalate burden scores and HOMA-IR. We compared findings to those using molar sums. In secondary analyses, we examined how the IRT model could be used for data harmonization when a subset of participants are missing some phthalate metabolites, and accounted for measurement error of the phthalate burden scores in estimating associations with HOMA-IR through a resampling approach using plausible value imputation.
resultsA three correlated factors model (LMW, HMW and DEHP burdens) provided the best fit. One interquartile range (IQR) increase in DEHP burden score was associated with 0.094 (95% CI: 0.022, 0.164, p = 0.010) increase in log HOMA-IR, co-adjusted for LMW and HMW burden scores. Findings were consistent when using log molar sums. Associations of phthalate burden and insulin resistance were also consistent when participants were simulated to be missing some phthalate metabolites, and when we accounted for measurement error in estimating burden scores.
conclusionBoth phthalate molar sums and burden scores are sensitive to associations with insulin resistance. Phthalate burden scores may be useful for data harmonization.
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