Bisphenol A and peripheral arterial disease: results from the NHANES.
BACKGROUND
Bisphenol A (BPA) is a common chemical used in the manufacture of polycarbonate plastics and epoxy resins, and > 93% of U.S. adults have detectable levels of urinary BPA. Recent animal studies have suggested that BPA exposure may have a role in several mechanisms involved in the development of cardiovascular disease (CVD), including weight gain, insulin resistance, thyroid dysfunction, endothelial dysfunction, and oxidative stress. However, few human studies have examined the association between markers of BPA exposure and CVD. Peripheral arterial disease (PAD) is a subclinical measure of atherosclerotic vascular disease and a strong independent risk factor for CVD and mortality.


OBJECTIVE
We examined the association between urinary BPA levels and PAD in a nationally representative sample of U.S. adults.


METHODS
We analyzed data from 745 participants in the National Health and Nutritional Examination Survey 2003-2004. We estimated associations between urinary BPA levels (in tertiles) and PAD (ankle-brachial index < 0.9, n = 63) using logistic regression models adjusted for potential confounders (age, sex, race/ethnicity, education, smoking, body mass index, diabetes mellitus, hypertension, urinary creatinine, estimated glomerular filtration rate, and serum cholesterol levels).


RESULTS
We observed a significant, positive association between increasing levels of urinary BPA and PAD before and after adjusting for confounders. The multivariable-adjusted odds ratio for PAD associated with the highest versus lowest tertile of urinary BPA was 2.69 (95% confidence interval: 1.02, 7.09; p-trend = 0.01).


CONCLUSIONS
Urinary BPA levels were significantly associated with PAD, independent of traditional CVD risk factors.
Department of Epidemiology, West Virginia University School of Public Health, Morgantown, West Virginia, USA. ashankar@hsc.wvu.edu
Anoop
A
Shankar
Srinivas
S
Teppala
Charumathi
C
Sabanayagam
D000328:Adult; D055109:Ankle Brachial Index; D001559:Benzhydryl Compounds / Q000652:urine*; D004781:Environmental Exposure; D004784:Environmental Monitoring; D004785:Environmental Pollutants / Q000652:urine*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000139:chemically induced / Q000453:epidemiology*; D010636:Phenols / Q000652:urine*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D000098826:Bisphenol A Compounds
D001559:Benzhydryl Compounds; D004785:Environmental Pollutants; D010636:Phenols; C006780:bisphenol A; D000098826:Bisphenol A Compounds