Urinary bisphenol A concentration and glucose homeostasis in non-diabetic adults: a repeated-measures, longitudinal study
Bisphenol A (BPA) has been shown to be potentially associated with type 2 diabetes; however, there is little evidence associating BPA exposure with glucose metabolic outcomes prior to diabetes onset. We aimed to examine BPA exposure in relation to glucose homeostasis among non-diabetic individuals.
This longitudinal cohort study comprised 2336 Chinese adults aged 40 years or above (62.8% women) and free of diabetes at baseline in 2009, followed for 4 years. Urinary BPA and glucose metabolic traits including fasting plasma glucose (FPG), 2 h post-load plasma glucose, fasting serum insulin, HOMA-IR and HOMA-B were measured at baseline and follow-up. Repeated-measures analysis was performed to evaluate associations of urinary BPA concentration with markers of glucose homeostasis.
After full adjustment for confounders including BMI, each tenfold increase in urinary BPA concentrations was associated with a 3.39% increase in FPG (95% CI 2.24%, 4.55%) and an 11.6% decrease in HOMA-B (95% CI −15.8%, −7.18%) in women. The inverse association between urinary BPA and HOMA-B was more prominent among overweight or obese individuals (change −13.7%; 95% CI −19.3%, −7.61%) compared with those who were of normal weight (change −6.74%; 95% CI −13.2%, 0.20%) (pinteraction = 0.07). Moreover, the ORs of fasting hyperglycaemia and beta cell dysfunction corresponding to a tenfold increase in urinary BPA concentrations were 1.37 (95% CI 1.10, 1.72) and 1.30 (95% CI 1.02, 1.65) in women, respectively. No significant associations existed between urinary BPA and glucose metabolic markers in men.
Our findings suggest that exposure to BPA was independently associated with impaired glucose homeostasis before the development of diabetes in middle-aged and elderly women.
KeywordsBisphenol A Glucose homeostasis HOMA-B Repeated measures Type 2 diabetes
Fasting plasma glucose
Generalised additive mixed models
Post-load plasma glucose
The investigators are grateful to all participants for their cooperation in the study.
BW, ML, TW, YB and GN contributed to the study design and concept. BW and ML analysed the data and drafted the manuscript. ZZ, JL, YC, YX, MX, WW and GN contributed to data interpretation and the editing of the manuscript. TW and YB critically revised the manuscript for important intellectual content. All authors have approved the final version to be published. TW, YB and GN guarantee this work and have full access to all of the data and take responsibility for the integrity of the data.
This work was funded by the Chinese Ministry of Finance, the 973 Foundation (grant 2015CB553601), National Key R&D Program of China (grants 2016YFC1305600, 2017YFC1310700, 2016YFC0901200 and 2016YFC1304904), National Natural Science Foundation of China (grants 81622011 and 81621061), Shanghai Pujiang Program (18PJ1409600) and Shanghai Municipal Education Commission–Gaofeng Clinical Medicine and Doctoral Innovation Grant Support from Shanghai Jiao Tong University School of Medicine (grants 20171901, 20161301, 20152508, 20161307 and BXJ201908).
Duality of interest
The authors declare that there is no duality of interest associated with this manuscript.
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