期刊
CIRCULATION
卷 125, 期 12, 页码 1482-1490出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/CIRCULATIONAHA.111.069153
关键词
bisphenol A; blood lipids; body mass index; coronary artery disease; endocrine disruption
资金
- Medical Research Council UK
- Cancer Research UK
- British Heart Foundation
- Peninsula Medical School, University of Exeter
- European Regional Development Fund
- European Social Fund Convergence Program for Cornwall and the Isles of Scilly
- National Institute for Health Research Collaborations for Leadership in Applied Health Research and Care
- British Heart Foundation [PG/09/097/28118] Funding Source: researchfish
- Medical Research Council [MC_U106179471, G1000143, G0401527] Funding Source: researchfish
Background-The endocrine-disrupting chemical bisphenol A (BPA) is widely used in food and beverage packaging. Higher urinary BPA concentrations were cross-sectionally associated with heart disease in National Health and Nutrition Examination Survey (NHANES) 2003-2004 and NHANES 2005-2006, independent of traditional risk factors. Methods and Results-We included 758 incident coronary artery disease (CAD) cases and 861 controls followed for 10.8 years from the European Prospective Investigation of Cancer-Norfolk UK. Respondents aged 40 to 74 years and free of CAD, stroke, or diabetes mellitus provided baseline spot urine samples. Urinary BPA concentrations (median value, 1.3 ng/mL) were low. Per-SD (4.56 ng/mL) increases in urinary BPA concentration were associated with incident CAD in age-, sex-, and urinary creatinine-adjusted models (n = 1919; odds ratio = 1.13; 95% confidence interval, 1.02-1.24; P = 0.017). With CAD risk factor adjustment (including education, occupational social class, body mass index category, systolic blood pressure, lipid concentrations, and exercise), the estimate was similar but narrowly missed 2-sided significance (n = 1744; odds ratio = 1.11; 95% confidence interval, 1.00-1.23; P = 0.058). Sensitivity analyses with the fully adjusted model, excluding those with early CAD (<3-year follow-up), body mass index >30, or abnormal renal function or with additional adjustment for vitamin C, C-reactive protein, or alcohol consumption, all produced similar estimates, and all showed associations at P <= 0.05. Conclusions-Associations between higher BPA exposure (reflected in higher urinary concentrations) and incident CAD during >10 years of follow-up showed trends similar to previously reported cross-sectional findings in the more highly exposed NHANES respondents. Further work is needed to accurately estimate the prospective exposure-response curve and to establish the underlying mechanisms. (Circulation. 2012;125:1482-1490.)
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