Bisphenol A in polycystic ovary syndrome and its association with liver-spleen axis.
BACKGROUND
Bisphenol A, one of the highest-volume chemicals currently available, is known to act as endocrine disruptor and alters several metabolic functions, including inflammatory pathways. Elevated serum levels of bisphenol A have been found in women with polycystic ovary syndrome (PCOS) and a role of low-grade chronic inflammation has been recently reported in the pathogenesis of this syndrome. Increased spleen volume, a reliable and stable index of chronic inflammation, was strictly associated with the severity of hepatic steatosis (HS) in obese subjects, determining the so-called liver-spleen axis.


OBJECTIVE
To evaluate the contribution of increased serum bisphenol A levels to low-grade chronic inflammation, HS and hyperandrogenism in women with PCOS.


METHODS
Forty lean and overweight/obese premenopausal women with PCOS and 20 healthy age-matched women were consecutively enrolled in a cross-sectional study from 2009 to 2011 at the Federico II University Hospital in Naples.


METHODS
Bisphenol A, homoeostasis model assessment of insulin resistance (HoMA-IR), laboratory liver tests, testosterone, sex hormone-binding globulin, free androgen index (FAI), C-reactive protein, interleukin-6, and the ultrasound quantification of HS and spleen longitudinal diameter.


RESULTS
Independently of body weight, higher bisphenol A levels in PCOS women were associated with higher grades of insulin resistance, HS, FAI and inflammation, spleen size showing the best correlation. At multivariate analysis, spleen size and FAI were the best predictors of bisphenol A (β coefficients 0.379, P = 0.007 and 0.343, P = 0.014, respectively).


CONCLUSIONS
In premenopausal women with PCOS, we evidenced an association of serum bisphenol A levels with HS and markers of low-grade inflammation, in particular with spleen size, unravelling the presence of the liver-spleen axis in this syndrome.
Department of Clinical and Experimental Medicine, University Federico II of Naples, Naples, Italy.
Giovanni
G
Tarantino
Rossella
R
Valentino
Carolina
C
Di Somma
Vittoria
V
D'Esposito
Federica
F
Passaretti
Genoveffa
G
Pizza
Valentina
V
Brancato
Francesco
F
Orio
Pietro
P
Formisano
Annamaria
A
Colao
Silvia
S
Savastano
D000328:Adult; D001559:Benzhydryl Compounds / Q000097:blood*; D005260:Female; D006801:Humans; D008099:Liver / Q000378:metabolism* / Q000473:pathology; D010636:Phenols / Q000097:blood*; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000378:metabolism / Q000473:pathology; D013154:Spleen / Q000378:metabolism* / Q000473:pathology; D055815:Young Adult; D000098826:Bisphenol A Compounds
D001559:Benzhydryl Compounds; D010636:Phenols; C006780:bisphenol A; D000098826:Bisphenol A Compounds