Association of urinary bisphenol A concentration with medical disorders and laboratory abnormalities in adults

Context Bisphenol A ( BPA) is widely used in epoxy resins lining food and beverage containers. Evidence of effects in animals has generated concern over low- level chronic exposures in humans. Objective To examine associations between urinary BPA concentrations and adult health status. Design, Setting, and Participants Cross- sectional analysis of BPA concentrations and health status in the general adult population of the United States, using data from the National Health and Nutrition Examination Survey 2003- 2004. Participants were 1455 adults aged 18 through 74 years with measured urinary BPA and urine creatinine concentrations. Regression models were adjusted for age, sex, race/ ethnicity, education, income, smoking, body mass index, waist circumference, and urinary creatinine concentration. The sample provided 80% power to detect unadjusted odds ratios ( ORs) of 1.4 for diagnoses of 5% prevalence per 1- SD change in BPA concentration, or standardized regression coefficients of 0.075 for liver enzyme concentrations, at a significance level of P <. 05. Main Outcome Measures Chronic disease diagnoses plus blood markers of liver function, glucose homeostasis, inflammation, and lipid changes. Results Higher urinary BPA concentrations were associated with cardiovascular diagnoses in age-, sex-, and fully adjusted models ( OR per 1- SD increase in BPA concentration, 1.39; 95% confidence interval [ CI], 1.18- 1.63; P=. 001 with full adjustment). Higher BPA concentrations were also associated with diabetes ( OR per 1- SD increase in BPA concentration, 1.39; 95% confidence interval [ CI], 1.21- 1.60; P <. 001) but not with other studied common diseases. In addition, higher BPA concentrations were associated with clinically abnormal concentrations of the liver enzymes gamma- glutamyltransferase ( OR per 1- SD increase in BPA concentration, 1.29; 95% CI, 1.14- 1.46; P <. 001) and alkaline phosphatase ( OR per 1- SD increase in BPA concentration, 1.48; 95% CI, 1.18- 1.85; P=. 002). Conclusion Higher BPA exposure, reflected in higher urinary concentrations of BPA, may be associated with avoidable morbidity in the community- dwelling adult population.