Introduction: The impairment of liver function and enhancement for NAFLD development may be attributed to the ubiquitous exposure to endocrine disrupting chemicals such as phthalates. In this study the urinary levels of monoethyl phthalate (MEP) and mono-(2-ethylhexyl) phthalate (MEHP) were compared with the parameters of hepatic function and lipids in overweight, diabetic patients and normal weight population.

Methods and patients: In 305 volunteers of both genders who were divided into three groups based on the body mass index, waist circumference and glucose levels: I -obese with central obesity, II -patients with diagnosed type 2 diabetes mellitus (T2DM) treated only with medical nutrition therapy and III-control, normal weight healthy volunteers, phthalate metabolites concentration was determined in the morning spot urine.

Results: The urine samples from 66 volunteers were positive on MEP while 72 were positive on MEHP. Aspartate Aminotrasferase (AST) and Alanine Aminotransferase (ALT) concentrations differed significantly between MEP+ and MEP- normal weight healthy volunteers (P=0.02 and P=0.01, respectively) while significantly higher Gamma-Glutamyl transferase GGT levels were observed in MEHP+ control subgroup (P=0.017). The positive correlation was observed between AST, ALT and log 10 MEP levels in obese patients (P=0.02 and P=0.05). GGT positively correlated with MEP concentration in T2DM patients (P=0.048). Negative correlation was found between log 10 MEP values in the control group and both total cholesterol and LDL levels (P=0.0051 and P=0.0015, respectively) while in obese group MEP was positively associated with serum triglycerides (P=0.024). The log 10 MEHP in the control group was correlated negatively with serum HDL (P=0.0035). BMI was significantly increased (P=0.044) in BMI in MEHP+ control subgroup compared to MEHP-.

Conclusions: The ubiquitous exposure to phthalates may be related to the impairment of normal liver function according to the results obtained in this study.