Associations between urinary phthalate metabolite concentrations and markers of liver injury in the US adult population

•Research on the joint toxic effect of various phthalates exposure on the liver is lacking.•Several phthalate metabolites were significantly related to indicators of liver function tests.•The combined effect of the phthalate mixture on the markers of liver injury was statistically significant. Phthalates have been largely used for years in varieties of products worldwide. However, research on the joint toxic effect of various phthalates exposure on the liver is lacking. We aimed to assess exposure to phthalates on liver function tests (LFTs). This analysis included data on 6046 adults (≥20 years old) who participated in a National Health and Nutrition Examination Survey (NHANES) in 2007–2016. We employed linear regression and Bayesian kernel machine regression (BKMR), to explore the associations of urinary phthalate metabolites with 8 indicators of LFTs. Di(2-ethylhexyl) phthalate (ΣDEHP) was found to be positively associated with serum alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP) (all P FDR