A crossover–crossback prospective study of dibutyl-phthalate exposure from mesalamine medications and semen quality in men with inflammatory bowel disease |
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| Institution: | 1. Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA;2. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA;3. University Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark;4. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA;5. Department of Obstetrics & Gynecology, Center for Molecular Medicine & Genetics, Wayne State University, Detroit, MI, USA;6. Division of Gastroenterology, Children''s Hospital Boston, Harvard Medical School, Boston, MA, USA;7. Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women''s Hospital, Harvard Medical School, Boston, MA, USA;8. Center for Inflammatory Bowel Disease, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA;9. Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA;1. Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States;2. Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, United States;3. Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States;4. Division of Maternal and Fetal Medicine, Brigham and Women''s Hospital, Harvard Medical School, Boston, MA, United States |
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| Abstract: | BackgroundPhthalates are widely used chemicals with ubiquitous exposure. Dibutyl-phthalate (DBP), a male reproductive toxicant in animals, is understudied in humans. Some mesalamine medications used to treat inflammatory bowel disease (IBD) have DBP in their coating, whereas other mesalamine formulations do not.ObjectivesTaking advantage of differences in mesalamine formulations, we investigated whether high-DBP exposure from mesalamine medications was associated with decreased semen parameters.Methods73 men with IBD taking mesalamine participated in a crossover-crossback prospective study. Men taking non-DBP containing mesalamine at baseline i.e., background exposure, crossed-over for four months to high-DBP mesalamine and then crossed-back for four months to their non-DBP mesalamine (B1HB2-arm;Background1-High-Background2) and vice versa for men taking high-DBP mesalamine at baseline (H1BH2-arm;High1-Background-High2). Men provided up to six semen samples (2: baseline, 2: crossover and 2: crossback).ResultsWe estimated crossover, crossback and carryover effects using linear mixed models adjusted for abstinence time, age, season and duration on high-DBP mesalamine at baseline. Semen parameters in B1HB2-arm (26 men, 133 samples) decreased after high-DBP mesalamine exposure (crossover versus baseline), especially motility parameters, and continued to decrease further even after crossback to non-DBP mesalamine (crossback versus crossover). The cumulative carryover effect of high-DBP (crossback versus baseline) was a decrease of % total sperm motility by 7.61(CI:− 13.1, − 2.15), % progressive sperm motility by 4.23(CI:− 8.05, − 0.4) and motile sperm count by 26.0% (CI:− 46.2%, 1.7%). However, H1BH2-arm (47 men, 199 samples) had no significant change during crossover or crossback.ConclusionsMen newly exposed to high-DBP mesalamine for four months had a cumulative reduction in several semen parameters, primarily sperm motility, that was more pronounced and statistically significant even after exposure ended for four months. |
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