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Clinical Medicine | Publishing Language: Chinese | Open Access

Association between phthalates and high-density lipoprotein-related inflammatory indicators

Yanzi ZHANGXiuling ZHUKai LIWenqian ZENGBing GUO( )
Faculty of Epidemiology and Health Statistics, West China School of Public Health/West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
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Abstract

Objective

To investigate the association of urinary phthalate metabolites with 4 high-density lipoprotein-cholesterol(HDL-C)-related inflammatory indicators [lymphocyte/HDL-C ratio (LHR), monocyte/HDL-C ratio (MHR), neutrophil/HDL-C ratio (NHR), and platelet/HDL-C ratio (PHR)], and to explain their possible biological mechanisms.

Methods

The 4573 adult participants from the National Health and Nutrition Examination Survey (NHANES) were subjected, and then generalized linear regression (GLM), restricted cubic spline (RCS), and weighted quantile sum (WQS) regressions were performed to explore the potential associations of phthalates mono-exposures and mixed exposures, respectively, with the HDL-C-related inflammation metrics.

Results

Nine urinary phthalate metabolites were significantly positively associated with at least 1 inflammatory marker, while 1 metabolite (MEP) showed a negative association with an inflammatory indicator (LHR). Some exposure metabolites showed a nonlinear association with outcome inflammatory indicators. WQS regression revealed varying weight contributions of individual metabolite to each inflammatory outcome. Subgroup analyses indicated differential association effects of phthalates with HDL-C-related inflammatory metrics across gender, age, and BMI populations.

Conclusion

There are associations between phthalate exposure and HDL-C-related inflammation indicators, but further studies are needed to reveal the underlying mechanisms.

CLC number: R12; R364.5; R446.12 Document code: A

References

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Journal of Army Medical University
Pages 1940-1949

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Cite this article:
ZHANG Y, ZHU X, LI K, et al. Association between phthalates and high-density lipoprotein-related inflammatory indicators. Journal of Army Medical University, 2025, 47(16): 1940-1949. https://doi.org/10.16016/j.2097-0927.202506001

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Received: 03 June 2025
Revised: 22 July 2025
Published: 30 August 2025
© 2025 Journal of Army Medical University

This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).