Open Access Maced J Med Sci. 2022 May 12; 10(B):1411-1418. 1411 Scientifc Foundation SPIROSKI, Skopje, Republic of Macedonia Open Access Macedonian Journal of Medical Sciences. 2022 May 12; 10(B):1411-1418. https://doi.org/10.3889/oamjms.2022.9721 eISSN: 1857-9655 Category: B - Clinical Sciences Section: Toxicology The Possible Association between Phthalates and Bisphenol A Exposure and Idiopathic Precocious Puberty in Egyptian Girls Rania Mohsen 1 * , Eman El-Zohairy 2 , Mona Mamdouh Hassan 3 , Mokhtar Fathy 2 , Mai Magdi 2 , Shimaa Atef 3 , Marwa Issak 2 , Sarah Hamed N. Taha 2 1 Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Suez University, Suez, Egypt; 2 Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Cairo University, Giza, Egypt; 3 Department of Pediatric, Faculty of Medicine, Cairo University, Giza, Egypt Abstract BACKGROUND: Bisphenol A (BPA) and phthalates are utilized in large spectrum of plastics, as polyvinyl chloride as well as personal products, medical equipment, and epoxy resins. Phthalate and bisphenol A are the most common endocrine disrupting chemicals that interrupt the endocrine system and cause developmental, reproductive, neurological, and immune disturbances in humans. However, the relation between phthalates and bisphenol A and precocious puberty (PP) in human is still controversial. AIM: Consequently, the present study aimed to detect and investigate the association between exposure to bisphenol A and monobutyl phthalate (MBP) and precocious puberty in Egyptian girls. METHODS: Urine samples were collected from 100 young females. The subjects were divided into two major groups, precocious puberty group consisted of 60 young females diagnosed by an endocrine pediatric specialist and controls consisted of 40 normal young females matched in age and demographic characters. In urine, MBP and bisphenol A (BPA) were measured with high-performance liquid chromatography. RESULTS: The mean concentration of MBP level was 22.758 ± 6.216 for the PP group and 15.283 ± 6.262 for controls with statistical diference between the studied groups (p < 0.001). Furthermore, the mean concentration of BPA was 405.02 ± 223.54 for the PP group and 97.95 ± 55 for controls with signifcant diference between groups (p < 0.001). CONCLUSION: The present study found that idiopathic precocious puberty in young females was associated with high phthalate metabolites and bisphenol A levels in urine. Edited by: Ksenija Bogoeva-Kostovska Citation: Mohsen R, El-Zohairy EAF, Hassan MM, Fathy M, Magdi M, Atef S, Issak M, Taha SHN. The Possible Association between Phthalates and Bisphenol A Exposure and Idiopathic Precocious Puberty in Egyptian Girls. Open-Access Maced J Med Sci. 2022 May 12; 10(B):1411-1418. https://doi.org/10.3889/oamjms.2022.9721 Keywords: Endocrine disrupting chemicals; Precocious puberty; Phthalates; Bisphenol A *Correspondence: Rania Mohsen, Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Suez University, Egypt. E-mail: rania. abdelraheem@med.suezuni.edu.eg Received: 09-Apr-2021 Revised: 27-Apr-2021 Accepted: 02-May-2021 Copyright: © 2022 Rania Mohsen, Eman El-Zohairy, Mona Hassan, Mokhtar Fathy, Mai Moustafa Magdi, Shimaa Atef, Marwa Issak, Sarah Hamed N. Taha Funding: This research did not receive any fnancial support Competing Interest: The authors have declared that no competing interest exists Open Access: This is an open-access article distributed under the terms of the Creative Commons Attribution- NonCommercial 4.0 International License (CC BY-NC 4.0) Introduction Precocious puberty (PP) in girls is defned as the appearance of secondary sexual traits before the age of 8 or the commencement of menarche before the age of 9 [1]. PP is estimated to afect one out of 5000 children. Girls are more afected with PP than boys [2]. PP has traditionally been divided into central precocious puberty (also known as gonadotropin- dependent precocious puberty or true precocious puberty) results from premature activation of hypothalamic–pituitary–gonadal (HPG) axis, causing premature secondary sexual growth and peripheral precocious puberty (gonadotropin-independent precocious puberty or pseudo-precocious puberty) occurs when the HPG axis is not activated and can be caused by a variety of other factors [3]. During puberty, the estrogen/androgen balance interacts with growth factors to regulate the growth and maturation of all systems and organs which are an important factor in the puberty process’s sex-specifc tuning. As a result, endocrine disruptors may have a signifcant impact on the puberty process [4]. Endocrine-disrupting chemicals (EDCs) are a class of hormonally active molecules to which we are frequently exposed through direct or indirect route, and which have been widely utilized in industry for over a century. EDCs infuence the hormones (stimulating or suppressing their action) through binding to their receptors and altering the biosynthesis, transport, degradation, and excretion of these hormones [5]. The most common EDCs to which humans are exposed on a daily basis are phthalates and bisphenol A (BPA). These chemicals are found in a wide range of plastics, including polyvinyl chloride (foor carpeting and connectors), as well as epoxy resins, medical devices, tainted food, and personal care goods. As a result, they are everywhere in the environment and our daily lives. Chemicals can be ingested or absorbed through the skin, but they can also be breathed [6].