title: Relationship of urinary bisphenol A concentration to risk for prevalent type 2 diabetes in Chinese adults: a cross-sectional analysis.
abstract: BACKGROUND
  Greater bisphenol A exposure has been shown to be associated with a higher risk for self-reported adverse health outcomes, including diabetes.
  
  
  OBJECTIVE
  To examine the association between bisphenol A exposure and type 2 diabetes in adults.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Songnan, Baoshan District, Shanghai, China.
  
  
  METHODS
  3423 local residents aged 40 years or older who were enrolled from 27 June 2008 to 10 August 2009.
  
  
  METHODS
  Urinary concentrations of bisphenol A from morning spot urine samples (exposure) and fasting plasma glucose concentration, plasma glucose concentration 2 hours after an oral glucose tolerance test, and serum insulin concentration (outcomes).
  
  
  RESULTS
  Median age of the participants was 59.0 years (interquartile range, 53.0 to 68.7 years), 40% were men, and 1087 had type 2 diabetes. The median urinary bisphenol A level was 0.81 ng/mL (interquartile range, 0.47 to 1.43 ng/mL). Clinical characteristics differed between participants with normal glucose regulation and those with impaired glucose regulation and by bisphenol A quartile, but in multivariable analyses, there was no clear association between bisphenol A levels and type 2 diabetes. The adjusted odds ratio (OR) of type 2 diabetes was slightly increased for participants in the second bisphenol A quartile (0.48 to 0.81 ng/mL) (adjusted OR, 1.30 [95% CI, 1.03 to 1.64]) and the fourth quartile (>1.43 ng/mL) (adjusted OR, 1.37 [CI, 1.08 to 1.74]) but not the third quartile (0.82 to 1.43 ng/mL) (adjusted OR, 1.09 [CI, 0.86 to 1.39]), and a test of the trend of the association was not statistically significant.
  
  
  CONCLUSIONS
  The cross-sectional study design and nonrandom sample of participants limit the conclusions that can be drawn. Many patients in the study already had diabetes, successful treatment of which could have obscured apparent associations. Dietary variables were not measured; however, this is necessary in observational studies of bisphenol A and diabetes because the presence of the chemical in the body may reflect consumption of sugared drinks in plastic bottles.
  
  
  CONCLUSIONS
  These findings do not confirm a previously reported association between urinary bisphenol A levels and self-reported type 2 diabetes.
authors.affiliation: Shanghai Jiao-Tong University School of Medicine, Shanghai, China. gning@sibs.ac.cn
authors.forename: Guang
authors.initials: G
authors.lastname: Ning
authors.forename: Yufang
authors.initials: Y
authors.lastname: Bi
authors.forename: Tiange
authors.initials: T
authors.lastname: Wang
authors.forename: Min
authors.initials: M
authors.lastname: Xu
authors.forename: Yu
authors.initials: Y
authors.lastname: Xu
authors.forename: Yun
authors.initials: Y
authors.lastname: Huang
authors.forename: Mian
authors.initials: M
authors.lastname: Li
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Li
authors.forename: Weiqing
authors.initials: W
authors.lastname: Wang
authors.forename: Yuhong
authors.initials: Y
authors.lastname: Chen
authors.forename: Yaohua
authors.initials: Y
authors.lastname: Wu
authors.forename: Jianing
authors.initials: J
authors.lastname: Hou
authors.forename: Aiyun
authors.initials: A
authors.lastname: Song
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.forename: Shenghan
authors.initials: S
authors.lastname: Lai
mesh_terms: D000328:Adult; D001559:Benzhydryl Compounds; D001786:Blood Glucose / Q000378:metabolism; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism; D004781:Environmental Exposure / Q000009:adverse effects*; D004785:Environmental Pollutants / Q000009:adverse effects* / Q000652:urine*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D010636:Phenols / Q000009:adverse effects* / Q000652:urine*; D010969:Plastics; D000098826:Bisphenol A Compounds
chemical_list: D001559:Benzhydryl Compounds; D001786:Blood Glucose; D004785:Environmental Pollutants; D007328:Insulin; D010636:Phenols; D010969:Plastics; C006780:bisphenol A; D000098826:Bisphenol A Compounds