title: Association between urinary bisphenol A concentration and obesity prevalence in children and adolescents.
abstract: BACKGROUND
  Bisphenol A (BPA), a manufactured chemical, is found in canned food, polycarbonate-bottled liquids, and other consumer products. In adults, elevated urinary BPA concentrations are associated with obesity and incident coronary artery disease. BPA exposure is plausibly linked to childhood obesity, but evidence is lacking to date.
  
  
  OBJECTIVE
  To examine associations between urinary BPA concentration and body mass outcomes in children.
  
  
  METHODS
  Cross-sectional analysis of a nationally representative subsample of 2838 participants aged 6 through 19 years randomly selected for measurement of urinary BPA concentration in the 2003-2008 National Health and Nutrition Examination Surveys.
  
  
  METHODS
  Body mass index (BMI), converted to sex- and age-standardized z scores and used to classify participants as overweight (BMI ≥85th percentile for age/sex) or obese (BMI ≥95th percentile).
  
  
  RESULTS
  Median urinary BPA concentration was 2.8 ng/mL (interquartile range, 1.5-5.6). Of the participants, 1047 (34.1% [SE, 1.5%]) were overweight and 590 (17.8% [SE, 1.3%]) were obese. Controlling for race/ethnicity, age, caregiver education, poverty to income ratio, sex, serum cotinine level, caloric intake, television watching, and urinary creatinine level, children in the lowest urinary BPA quartile had a lower estimated prevalence of obesity (10.3% [95% CI, 7.5%-13.1%]) than those in quartiles 2 (20.1% [95% CI, 14.5%-25.6%]), 3 (19.0% [95% CI, 13.7%-24.2%]), and 4 (22.3% [95% CI, 16.6%-27.9%]). Similar patterns of association were found in multivariable analyses examining the association between quartiled urinary BPA concentration and BMI z score and in analyses that examined the logarithm of urinary BPA concentration and the prevalence of obesity. Obesity was not associated with exposure to other environmental phenols commonly used in other consumer products, such as sunscreens and soaps. In stratified analysis, significant associations between urinary BPA concentrations and obesity were found among whites (P < .001) but not among blacks or Hispanics.
  
  
  CONCLUSIONS
  Urinary BPA concentration was significantly associated with obesity in this cross-sectional study of children and adolescents. Explanations of the association cannot rule out the possibility that obese children ingest food with higher BPA content or have greater adipose stores of BPA.
authors.affiliation: Department of Pediatrics, New York University School of Medicine, New York, NY 10016, USA. leonardo.trasande@nyumc.org
authors.forename: Leonardo
authors.initials: L
authors.lastname: Trasande
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Attina
authors.forename: Jan
authors.initials: J
authors.lastname: Blustein
mesh_terms: D050154:Adiposity; D000293:Adolescent; D001559:Benzhydryl Compounds; D044383:Black People / Q000706:statistics & numerical data; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology* / Q000208:ethnology / Q000652:urine*; D010636:Phenols / Q000652:urine*; D015995:Prevalence; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult; D000098826:Bisphenol A Compounds
chemical_list: D001559:Benzhydryl Compounds; D010636:Phenols; C006780:bisphenol A; D000098826:Bisphenol A Compounds