title: Association of urinary bisphenol A concentration with medical disorders and laboratory abnormalities in adults.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  Higher BPA exposure, reflected in higher urinary concentrations of BPA, may be associated with avoidable morbidity in the community-dwelling adult population.
authors.affiliation: Epidemiology and Public Health Group, Peninsula Medical School, Barrack Rd, Exeter EX2 5DW, UK.
authors.forename: Iain A
authors.initials: IA
authors.lastname: Lang
authors.forename: Tamara S
authors.initials: TS
authors.lastname: Galloway
authors.forename: Alan
authors.initials: A
authors.lastname: Scarlett
authors.forename: William E
authors.initials: WE
authors.lastname: Henley
authors.forename: Michael
authors.initials: M
authors.lastname: Depledge
authors.forename: Robert B
authors.initials: RB
authors.lastname: Wallace
authors.forename: David
authors.initials: D
authors.lastname: Melzer
mesh_terms: D000328:Adult; D000368:Aged; D001559:Benzhydryl Compounds; D015415:Biomarkers / Q000097:blood / Q000652:urine*; D001786:Blood Glucose; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000652:urine; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology* / Q000652:urine; D004784:Environmental Monitoring; D004785:Environmental Pollutants / Q000633:toxicity* / Q000652:urine*; D062665:Epidemiological Monitoring; D005260:Female; D006304:Health Status; D006801:Humans; D007249:Inflammation; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008107:Liver Diseases / Q000097:blood / Q000453:epidemiology* / Q000652:urine; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000097:blood / Q000453:epidemiology / Q000652:urine; D010636:Phenols / Q000633:toxicity* / Q000652:urine*; D012044:Regression Analysis; D012140:Respiratory Tract Diseases / Q000097:blood / Q000453:epidemiology / Q000652:urine; D014481:United States; D000098826:Bisphenol A Compounds
chemical_list: D001559:Benzhydryl Compounds; D015415:Biomarkers; D001786:Blood Glucose; D004785:Environmental Pollutants; D008055:Lipids; D010636:Phenols; C006780:bisphenol A; D000098826:Bisphenol A Compounds