Bisphenol A exposure and associations with obesity among adults: a critical review

Abstract

Objective: To review the literature on bisphenol A (BPA) exposure and obesity in human populations. Design: Systematic review of the literature via searches of PubMed, EMBASE, Web of Science and reference lists for articles published to 1 August 2014. Setting: China, Italy, Japan, Republic of Korea, Sweden, UK, USA. Subjects: Adults (≥18 years). Results: Eighteen articles were identified and included in the review. Twelve studies included secondary evaluations of BPA exposure and BMI, and six studies evaluated body composition as the primary outcome. All analyses were crosssectional and no study included in the review received a positive quality rating (twelve negative, six neutral). Eight studies observed a statistically significant positive association between urinary or serum BPA levels and BMI, and ten studies observed no association. Studies where BMI was a primary outcome and studies of neutral quality were more likely to observe an association. Conclusions: Study results are conflicting and significant methodological issues limit the ability to draw conclusions from these studies. Prospective studies that measure BPA exposure and changes in body weight and composition are needed to establish temporality, causality and the direction of any observed associations.

Urinary bisphenol A and obesity in adults: results from the Canadian Health Measures Survey

“…11,15,32 Although non-monotonic associations have been commonly observed for BPA and other endocrine disruptors in toxicological studies, 34 ubiquitous low-level exposures to BPA in human populations present a challenge for assessing and interpreting doseresponse relationships. 35 Consistent with previous studies, 11,13,14 our study also provides evidence for positive associations between urinary BPA and continuous BMI and waist circumference measures. However, unlike studies in the USA 11,12 and Asia, 13,14 we did not find an association between urinary BPA and central obesity defined using waist circumference cut-offs.…”

“…This is important as recent systematic reviews have pointed out the lack of adjustment for diet, especially processed food consumption, as a major limitation of studies investigating associations between BPA and health outcomes. 26,35,39 This study has several limitations. First, due to the cross-sectional nature of CHMS data, temporal relationships could not be established.…”

Concentration urinaire de bisphénol A et obésité chez les adultes : résultats de l’Enquête canadienne sur les mesures de la santé

“…Par ailleurs, alors que nos résultats ont plutôt révélé une probabilité croissante d'obésité, certaines études ont fait ressortir un effet seuil ou non monotone d'un quartile de BPA urinaire à l'autre 11,15,32 . Malgré des associations non monotones couramment observées à l'égard du BPA et d'autres perturbateurs endocriniens dans des études toxicologiques 34 , les expositions fréquentes de faible niveau au BPA chez l'humain constituent un défi pour l'évaluation et l'interprétation des relations dose-réponse 35 . À l'instar des études antérieures 11,13,14 , notre étude fournit des données probantes en faveur de l'existence d'associations positives entre la concentration urinaire de BPA et les mesures de l'IMC et du tour de taille.…”

“…Ses points forts sont le fait qu'elle ait été fondée sur la population, la grande taille de son échantillon, l'utilisation de mesures anthropométriques directes, la haute qualité des dosages du BPA dans l'urine et la prise en compte de multiples facteurs potentiels de confusion, dont plusieurs liés à l'alimentation. Ce dernier point est important, car des revues systématiques récentes ont révélé que l'absence d'ajustement en fonction de l'alimentation, et particulièrement de la consommation d'aliments transformés, constituait une limite importante des études sur les associations entre le BPA et divers résultats de santé 26,35,39 .…”

Endocrine Disruptors: a Real Concern for Humans?

“…Moreover, a dramatic increase of metabolic disorders has been observed in the recent years. For example, BPA has been recognized to act as obesogen [40,41] so affecting obesity in animal model and in children [42,43]. Many results evidenced the relationship between EDCs exposure and the onset of type 2 and type 1 diabetes [44,45].…”