# Phthalates exposure and serum uric acid level in patients with Crohn’s disease: A cross-sectional study

**Authors:** Xinghuang Liu, De Qingzhuoga, Danping Xiong, Liang Wang, Xiaohua Hou, Bai Tao, Liangle Yang, Liangru Zhu, Lei Tu, Saheed Raheem, Saheed Raheem, Saheed Raheem

PMC · DOI: 10.1371/journal.pone.0343097 · PLOS One · 2026-03-03

## TL;DR

This study finds that phthalate exposure is linked to higher uric acid levels in male Crohn’s disease patients, suggesting a potential risk for hyperuricemia.

## Contribution

The study identifies a gender-specific association between phthalate exposure and uric acid metabolism in Crohn’s disease patients.

## Key findings

- Phthalate exposure was positively associated with serum uric acid in male CD patients.
- Oxidative stress partially mediated the association between phthalates and uric acid.
- Higher phthalate exposure increased the odds of hyperuricemia in male CD patients.

## Abstract

Crohn’s disease (CD) is closely associated with disorders of uric acid metabolism. Our previous research found an association between phthalate exposure and oxidative stress in CD, suggesting a potential role for phthalates in metabolic disorders. Therefore, this study aims to examine their influence on uric acid metabolism in patients with CD.

We designed a cross-sectional study involving 117 patients with CD. Ten urinary phthalates metabolites (mPAEs) were detected by gas chromatography-tandem mass spectrometry, and the serum uric acid (SUA) levels were tested. Correlation analysis and Bayesian kernel machine regression (BKMR) models were applied separately to evaluate the associations.

The prevalence of hyperuricemia was 12.8% (15/117) in CD patients. None of them were obese or had abnormal renal function. In males, we identified significant positive associations between SUA and eight mPAEs (MMP, MIBP, MBP, MBzP, MOP, MEOHP, MEHHP, & MECPP). However, no positive associations between mPAEs and SUA were found in females. After BKMR analysis and multivariate adjustments, we found that the average SUA (μmol/L) increased by 1.36-fold, and the odds ratio for hyperuricemia increased by 1.25-fold, when overall phthalates exposure increased from 25% to 75% in male CD patients. This suggests a potential link between phthalates exposure and uric acid metabolism in male patients with CD. Furthermore, oxidative stress mediated approximately 5% of the association, indicating it is a partial, but not primary, mechanism in this process.

Phthalates exposure positively correlated with SUA in male CD patients. Effective PAE exposure control in patients with CD may reduce the risk of hyperuricemia.

## Linked entities

- **Diseases:** Crohn’s disease (MONDO:0005011), hyperuricemia (MONDO:0002144)

## Full-text entities

- **Genes:** OPRM1 (opioid receptor mu 1) [NCBI Gene 4988] {aka LMOR, M-OR-1, MOP, MOR, MOR1, OPRM}, MBP (myelin basic protein) [NCBI Gene 4155], NMRK2 (nicotinamide riboside kinase 2) [NCBI Gene 27231] {aka ITGB1BP3, MIBP, NRK2}
- **Diseases:** intestinal diseases (MESH:D007410), MS (MESH:D009103), HUA (MESH:D033461), infectious diseases (MESH:D003141), Abnormal renal function (MESH:D007674), IBD (MESH:D015212), abdominal mass (MESH:D000007), autoimmune thyroid diseases (MESH:D013967), enteric pathogen infection (MESH:D004751), allergies (MESH:D004342), inflammation of the gastrointestinal tract (MESH:D005770), CD (MESH:D003424), preterm birth (MESH:D047928), toxicity (MESH:D064420), Clostridium difficile (MESH:D003015), death (MESH:D003643), food poisoning (MESH:D005517), metabolic disorders (MESH:D008659), Cytomegalovirus (MESH:D003586), obese (MESH:D009765), ACADEMIC EDITOR (MESH:D007859), renal insufficiency (MESH:D051437), glomerular atrophy (MESH:D001284), chronic kidney disease (MESH:D051436), asthma (MESH:D001249), abdominal pain (MESH:D015746), IUGR (MESH:D005317), Epstein-Barr virus (MESH:D020031), inflammatory (MESH:D007249), renal and hepatic impairment (MESH:D008107), gout (MESH:D006073)
- **Chemicals:** mono-n-octyl phthalate (MESH:C041260), triiodothyronine (MESH:D014284), creatinine (MESH:D003404), MEP (MESH:C581825), lipid (MESH:D008055), 8-iso-PGF2alpha (MESH:C075750), dibutyl phthalate (MESH:D003993), BBP (MESH:C027561), thyroxine (MESH:D013974), PONE-D-25-46092R1 (-), MEHHP (MESH:C479069), PAE (MESH:C032279), mono-iso-butyl phthalate (MESH:C575690), MBzP (MESH:C103325), DEHP (MESH:D004051), MEHP (MESH:C016599), 8-OHdG (MESH:D000080242), MEOHP (MESH:C080276), PAE (MESH:C039557), Uric Acid (MESH:D014527), polymers (MESH:D011108), mono-n-butyl phthalate (MESH:C028577), MMP (MESH:C517284)
- **Species:** Homo sapiens (human, species) [taxon 9606], Mus musculus (house mouse, species) [taxon 10090]

## Full text

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## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12956089/full.md

## References

58 references — full list in the complete paper: https://tomesphere.com/paper/PMC12956089/full.md

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Source: https://tomesphere.com/paper/PMC12956089