Association between bisphenol A exposure and cardiometabolic outcomes: a longitudinal approach

Abstract Background Increased cardiometabolic risk is associated with abnormalities in blood biomarkers profile and adiposity measurements. Some substances found in the food matrix or the environment, called endocrine-disrupting chemicals, may impair cardiometabolic health in the yearly and later stages of life. Bisphenol A (BPA) is a food contaminant that migrates from food contact materials and may act as an endocrine disruptor, negatively affecting human health. The present work aims to assess the longitudinal association between BPA exposure and cardiometabolic outcomes. Methods Data from the four waves of the Portuguese population-based birth cohort Generation XXI were used (n = 3138). Dietary data were collected by 3-d food diaries, using the FoodEx2 classification system to describe the reported foods. BPA daily exposure was estimated using a random forest model, combining dietary information with urinary BPA measured in 24-h urine from a subsample, used to predict the remaining sample’s BPA exposure. The generalised least squares model was used to test the associations between BPA and cardiometabolic outcomes. Results Blood insulin and HOMA-IR presented a significant longitudinal association with BPA daily exposure after adjustment for important variables and energy (0.06 SD(0.03, 0.09); 0.05 SD(0.02, 0.08) respectively). The same findings were observed for fat mass and waist circumference (0.03 SD(0.01, 0.06); 0.06 SD(0.04, 0.08), respectively). For z-BMI, a significant cross-sectional and longitudinal association was found (0.03 SD(0.01, 0.04); 0.02 SD(0.00, 0.04), respectively). Conclusions This was the first study assessing the association between BPA exposure and health outcomes from childhood to adolescence. We found an association between BPA exposure and an increased blood insulin level, insulin resistance, fat mass percentage, waist circumference and z-score of body mass index. Our results point to the need to reduce exposure to BPA in the early stages of life. Key messages • BPA exposure was estimated using direct and indirect methods. • BPA can impair cardiometabolic outcomes from the early stages of life, such as higher blood insulin level, insulin resistance, fat mass, waist circumference, and body mass index.