Bisphenol A and the risk of cardiometabolic disorders

A systematic review with meta-analysis of the epidemiological evidence

Fanny Rancière, Jasmine G. Lyons, Venurs H. Y. Loh, Jérémie Botton, Tamara Galloway, Tiange Wang, Jonathan E. Shaw, Dianna J. Magliano

Research output: Contribution to journalReview ArticleResearchpeer-review

78 Citations (Scopus)

Abstract

Bisphenol A (BPA) is suspected to be associated with several chronic metabolic diseases. The aim of the present study was to review the epidemiological literature on the relation between BPA exposure and the risk of cardiometabolic disorders. PubMed and Embase databases were searched up to August 2014 by two independent investigators using standardized subject terms. We included observational studies (cohort, case-control and cross-sectional studies) carried out in children or adults, measuring urinary BPA (uBPA), including at least 100 participants and published in English. The health outcomes of interest were diabetes, hyperglycemia, measures of anthropometry, cardiovascular disease (CVD) and hypertension. Data were extracted and meta-analyzed when feasible, using a random-effects model. Thirty-three studies with sample size ranging from 239 to 4811 met the inclusion criteria, including five with a prospective design. Twelve studies reported on diabetes or hyperglycemia, 16 on anthropometry, 6 on CVD and 3 on hypertension. Evidence for a positive association between uBPA concentrations and diabetes, overweight, obesity, elevated waist circumference (WC), CVD and hypertension was found in 7/8, 2/7, 6/7, 5/5, 4/5 and 2/3 of the cross-sectional studies, respectively. We were able to conduct outcome-specific meta-analyses including 12 studies. When comparing the highest vs. the lowest uBPA concentrations, the pooled ORs were 1.47 (95 % CI: 1.21-1.80) for diabetes, 1.21 (95 % CI: 0.98-1.50) for overweight, 1.67 (95 % CI: 1.41-1.98) for obesity, 1.48 (95 % CI: 1.25-1.76) for elevated WC, and 1.41 (95 % CI: 1.12-1.79) for hypertension. Moreover, among the five prospective studies, 3 reported significant findings, relating BPA exposure to incident diabetes, incident coronary artery disease, and weight gain. To conclude, there is evidence from the large body of cross-sectional studies that individuals with higher uBPA concentrations are more likely to suffer from diabetes, general/abdominal obesity and hypertension than those with lower uBPA concentrations. Given the potential importance for public health, prospective cohort studies with proper adjustment for dietary characteristics and identification of critical windows of exposure are urgently needed to further improve knowledge about potential causal links between BPA exposure and the development of chronic disease.

Original languageEnglish
Article number46
Number of pages23
JournalEnvironmental Health: A Global Access Science Source
Volume14
Issue number1
DOIs
Publication statusPublished - 31 May 2015
Externally publishedYes

Keywords

  • Bisphenol A
  • Cardiovascular disease
  • Diabetes
  • Epidemiology
  • Hyperglycemia
  • Hypertension
  • Meta-analysis
  • Obesity
  • Overweight
  • Systematic review

Cite this

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title = "Bisphenol A and the risk of cardiometabolic disorders: A systematic review with meta-analysis of the epidemiological evidence",
abstract = "Bisphenol A (BPA) is suspected to be associated with several chronic metabolic diseases. The aim of the present study was to review the epidemiological literature on the relation between BPA exposure and the risk of cardiometabolic disorders. PubMed and Embase databases were searched up to August 2014 by two independent investigators using standardized subject terms. We included observational studies (cohort, case-control and cross-sectional studies) carried out in children or adults, measuring urinary BPA (uBPA), including at least 100 participants and published in English. The health outcomes of interest were diabetes, hyperglycemia, measures of anthropometry, cardiovascular disease (CVD) and hypertension. Data were extracted and meta-analyzed when feasible, using a random-effects model. Thirty-three studies with sample size ranging from 239 to 4811 met the inclusion criteria, including five with a prospective design. Twelve studies reported on diabetes or hyperglycemia, 16 on anthropometry, 6 on CVD and 3 on hypertension. Evidence for a positive association between uBPA concentrations and diabetes, overweight, obesity, elevated waist circumference (WC), CVD and hypertension was found in 7/8, 2/7, 6/7, 5/5, 4/5 and 2/3 of the cross-sectional studies, respectively. We were able to conduct outcome-specific meta-analyses including 12 studies. When comparing the highest vs. the lowest uBPA concentrations, the pooled ORs were 1.47 (95 {\%} CI: 1.21-1.80) for diabetes, 1.21 (95 {\%} CI: 0.98-1.50) for overweight, 1.67 (95 {\%} CI: 1.41-1.98) for obesity, 1.48 (95 {\%} CI: 1.25-1.76) for elevated WC, and 1.41 (95 {\%} CI: 1.12-1.79) for hypertension. Moreover, among the five prospective studies, 3 reported significant findings, relating BPA exposure to incident diabetes, incident coronary artery disease, and weight gain. To conclude, there is evidence from the large body of cross-sectional studies that individuals with higher uBPA concentrations are more likely to suffer from diabetes, general/abdominal obesity and hypertension than those with lower uBPA concentrations. Given the potential importance for public health, prospective cohort studies with proper adjustment for dietary characteristics and identification of critical windows of exposure are urgently needed to further improve knowledge about potential causal links between BPA exposure and the development of chronic disease.",
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Bisphenol A and the risk of cardiometabolic disorders : A systematic review with meta-analysis of the epidemiological evidence. / Rancière, Fanny; Lyons, Jasmine G.; Loh, Venurs H. Y.; Botton, Jérémie; Galloway, Tamara; Wang, Tiange; Shaw, Jonathan E.; Magliano, Dianna J.

In: Environmental Health: A Global Access Science Source, Vol. 14, No. 1, 46, 31.05.2015.

Research output: Contribution to journalReview ArticleResearchpeer-review

TY - JOUR

T1 - Bisphenol A and the risk of cardiometabolic disorders

T2 - A systematic review with meta-analysis of the epidemiological evidence

AU - Rancière, Fanny

AU - Lyons, Jasmine G.

AU - Loh, Venurs H. Y.

AU - Botton, Jérémie

AU - Galloway, Tamara

AU - Wang, Tiange

AU - Shaw, Jonathan E.

AU - Magliano, Dianna J.

PY - 2015/5/31

Y1 - 2015/5/31

N2 - Bisphenol A (BPA) is suspected to be associated with several chronic metabolic diseases. The aim of the present study was to review the epidemiological literature on the relation between BPA exposure and the risk of cardiometabolic disorders. PubMed and Embase databases were searched up to August 2014 by two independent investigators using standardized subject terms. We included observational studies (cohort, case-control and cross-sectional studies) carried out in children or adults, measuring urinary BPA (uBPA), including at least 100 participants and published in English. The health outcomes of interest were diabetes, hyperglycemia, measures of anthropometry, cardiovascular disease (CVD) and hypertension. Data were extracted and meta-analyzed when feasible, using a random-effects model. Thirty-three studies with sample size ranging from 239 to 4811 met the inclusion criteria, including five with a prospective design. Twelve studies reported on diabetes or hyperglycemia, 16 on anthropometry, 6 on CVD and 3 on hypertension. Evidence for a positive association between uBPA concentrations and diabetes, overweight, obesity, elevated waist circumference (WC), CVD and hypertension was found in 7/8, 2/7, 6/7, 5/5, 4/5 and 2/3 of the cross-sectional studies, respectively. We were able to conduct outcome-specific meta-analyses including 12 studies. When comparing the highest vs. the lowest uBPA concentrations, the pooled ORs were 1.47 (95 % CI: 1.21-1.80) for diabetes, 1.21 (95 % CI: 0.98-1.50) for overweight, 1.67 (95 % CI: 1.41-1.98) for obesity, 1.48 (95 % CI: 1.25-1.76) for elevated WC, and 1.41 (95 % CI: 1.12-1.79) for hypertension. Moreover, among the five prospective studies, 3 reported significant findings, relating BPA exposure to incident diabetes, incident coronary artery disease, and weight gain. To conclude, there is evidence from the large body of cross-sectional studies that individuals with higher uBPA concentrations are more likely to suffer from diabetes, general/abdominal obesity and hypertension than those with lower uBPA concentrations. Given the potential importance for public health, prospective cohort studies with proper adjustment for dietary characteristics and identification of critical windows of exposure are urgently needed to further improve knowledge about potential causal links between BPA exposure and the development of chronic disease.

AB - Bisphenol A (BPA) is suspected to be associated with several chronic metabolic diseases. The aim of the present study was to review the epidemiological literature on the relation between BPA exposure and the risk of cardiometabolic disorders. PubMed and Embase databases were searched up to August 2014 by two independent investigators using standardized subject terms. We included observational studies (cohort, case-control and cross-sectional studies) carried out in children or adults, measuring urinary BPA (uBPA), including at least 100 participants and published in English. The health outcomes of interest were diabetes, hyperglycemia, measures of anthropometry, cardiovascular disease (CVD) and hypertension. Data were extracted and meta-analyzed when feasible, using a random-effects model. Thirty-three studies with sample size ranging from 239 to 4811 met the inclusion criteria, including five with a prospective design. Twelve studies reported on diabetes or hyperglycemia, 16 on anthropometry, 6 on CVD and 3 on hypertension. Evidence for a positive association between uBPA concentrations and diabetes, overweight, obesity, elevated waist circumference (WC), CVD and hypertension was found in 7/8, 2/7, 6/7, 5/5, 4/5 and 2/3 of the cross-sectional studies, respectively. We were able to conduct outcome-specific meta-analyses including 12 studies. When comparing the highest vs. the lowest uBPA concentrations, the pooled ORs were 1.47 (95 % CI: 1.21-1.80) for diabetes, 1.21 (95 % CI: 0.98-1.50) for overweight, 1.67 (95 % CI: 1.41-1.98) for obesity, 1.48 (95 % CI: 1.25-1.76) for elevated WC, and 1.41 (95 % CI: 1.12-1.79) for hypertension. Moreover, among the five prospective studies, 3 reported significant findings, relating BPA exposure to incident diabetes, incident coronary artery disease, and weight gain. To conclude, there is evidence from the large body of cross-sectional studies that individuals with higher uBPA concentrations are more likely to suffer from diabetes, general/abdominal obesity and hypertension than those with lower uBPA concentrations. Given the potential importance for public health, prospective cohort studies with proper adjustment for dietary characteristics and identification of critical windows of exposure are urgently needed to further improve knowledge about potential causal links between BPA exposure and the development of chronic disease.

KW - Bisphenol A

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KW - Diabetes

KW - Epidemiology

KW - Hyperglycemia

KW - Hypertension

KW - Meta-analysis

KW - Obesity

KW - Overweight

KW - Systematic review

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U2 - 10.1186/s12940-015-0036-5

DO - 10.1186/s12940-015-0036-5

M3 - Review Article

VL - 14

JO - Environmental Health: A Global Access Science Source

JF - Environmental Health: A Global Access Science Source

SN - 1476-069X

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