Urinary bisphenol A and obesity: NHANES 2003–2006☆
Highlights
► Association of urinary BPA with BMI and waist circumference in 2003–2006 NHANES. ► Participants in upper BPA quartiles 1.60–1.85 times are likely to be obese. ► Higher BPA concentration also associated with abdominal obesity. ► Prospective studies needed to clarify the direction of the association.
Introduction
The prevention of overweight and obesity is a public health priority in the United States due to its large and increasing prevalence, as well as its strong association with many chronic diseases, including type II diabetes (Hu et al., 2001) and cardiovascular disease (CVD) (Wilson et al., 2002). Approximately two-thirds of Americans are considered overweight or obese and one-third is obese (Wang et al., 2008). If current trends continue, approximately 86% of Americans will be overweight and over half will be obese by 2030 (Wang et al., 2008). Abdominal obesity in particular is thought to be a driving force of insulin resistance and the metabolic syndrome, a constellation of cardiovascular risk factors, which is a strong marker for type II diabetes and CVD (Wilson et al., 2005), as well as for total and cardiovascular mortality (Malik et al., 2004).
Animal and epidemiologic studies support a link between low-dose exposure to endocrine-disrupting chemicals and obesity (Heindel, 2003, Newbold et al., 2007b). Bisphenol A (BPA) is of particular interest because of its widespread human exposure (Calafat et al., 2008). BPA is used in the manufacture of polycarbonate plastic and dental composites and sealants, and is also found in the inner coatings of food and beverage cans. Exposure occurs primarily through the consumption of food and beverages that have been contaminated with BPA during storage (Kang et al., 2006).
Although few studies have been performed in adult animals, studies in rodents suggest that prenatal exposure to low-dose (<50 mg/kg body weight/day) BPA leads to obesity and elevated lipid levels. Pups born to mice exposed to low-dose BPA in drinking water (in combination with a high-fat diet) are heavier in early adulthood compared to pups of untreated mice (Miyawaki et al., 2007); similarly, pups born to perinatally exposed rats are heavier as adults (Rubin et al., 2001). Following a high-fat diet, mice exposed to BPA in utero have also developed elevated total cholesterol and triglycerides (Miyawaki et al., 2007). Although the mechanism by which this occurs is unknown, several pathways have been proposed. Insulin resistance and tissue inflammation may be triggered by the inhibition of adiponectin release, as has been observed in human adipose tissue explants and adipocytes exposed to low-dose BPA (Hugo et al., 2008). Low-dose BPA also stimulates release of IL-6 and TNF-α (Ben-Jonathan et al., 2009), inflammatory cytokines that stimulate lipolysis.
Lang et al. (2008) and Melzer et al. (2010) previously reported positive associations between urinary BPA concentrations and coronary heart disease, myocardial infarction, angina, and diabetes in the National Health and Nutrition Examination Survey (NHANES). However, little attention has been paid to the role of BPA exposure in the development of CVD and type II diabetes precursors, such as obesity and insulin resistance. A closer examination of NHANES data is especially necessary since few other large-scale datasets have information on human BPA exposure. Given the existing evidence from animal and epidemiologic studies, we hypothesized that urinary BPA concentrations would be positively associated with general and central obesity.
Section snippets
Materials and methods
We used data from the 2003–2004 (CDC, 2004a) and 2005–2006 (CDC, 2006a) NHANES to examine the association between urinary BPA, body mass index (BMI), and waist circumference. NHANES, administered by the National Center for Health Statistics, Centers for Disease Control and Prevention, is a cross-sectional study that assesses the health and diet of the civilian, non-institutionalized, United States population using a multistage clustered design. Certain demographic groups, including older
Results
In this population of 2747 adult participants in 2003–2006 NHANES, the geometric mean creatinine-adjusted urinary BPA concentration was 2.05 μg/g creatinine (25th percentile: 1.18, 75th percentile: 3.33). Consistent with 2003–2004 NHANES, higher urinary BPA concentrations were observed for men, younger individuals, smokers, and minorities, including African-Americans, Mexican-Americans, and other Hispanics (Table 1).
Urinary BPA concentration was associated with both general and central obesity.
Discussion
In this cross-sectional analysis of pooled 2003–2006 NHANES, urinary BPA was associated with general and central obesity. This study takes advantage of one of the few large-scale datasets with high-quality data on human exposure to BPA.
Acknowledgments
Ms. Carwile was supported by the Training Program in Environmental Epidemiology under grant T32 ES 007069. We acknowledge the National Center for Health Statistics of the U.S. Centers for Disease Control and Prevention (CDC) for its invaluable work conducting the National Health and Nutrition Examination Survey, and the researchers at the Division of Laboratory Sciences, National Center for Environmental Health of the CDC for conducting the BPA measurements.
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Human subjects review was not required for this analysis of secondary data.