Association between mixed exposure of phthalates and migraine: Evidence from NHANES 2003-2004

Abstract

Abstract Background Estrogen fluctuations influence the incidence of migraine, and phthalates are representative chemicals for isoestrogens. However, the combined effects of phthalate exposure on migraine have not been explored. It’s also unknown whether the effects of phthalates on migraine are gender-specific. Methods We used the multiple logistic regression, weighted quantile sum (WQS), and bayesian kernel machine regression (BKMR) models to evaluate the associations between migraine and mixed phthalates in participants from NHANES 2003–2004. Results A total of 1310 participants were included in the study. In logistic regression, MEP was significantly associated with migraine in the second quartile (OR = 1.78, 95% CI = 1.17–2.70, P = 0.0067). The results stratified by sex showed no increase in the odds of current migraines after exposure to phthalate metabolites in either man or woman. The results in the positive mode showed that WQS index was significantly associated with migraine in crude model (OR = 1.33, 95% CI = 1.06–1.67, P = 0.014), but not in fully adjusted models (OR = 1.05, 95% CI = 0.83–1.34, P = 0.693). In the negative WQS model, the difference was not statistically significant. MHH and MC1 were the most weighted chemicals in the positive and negative modes, respectively. In BKMR analysis, when the chemical concentrations were in 50 percent digits or higher, the potential continuous outcome trend for migraine increased relative to their 45 percent digits, but the upward trend is not significant. MHH and MC1 showed positive trends. The effects of phthalates on migraine were not influenced by gender in both the BKMR model and the WQS model. Conclusion The joint effect of phthalates exposure on migraine was not significant, and there was still no significant association either in the male or the female subgroups.