Association between urinary concentrations of bisphenol A substitutes and diabetes in adults

doi:10.4239/wjd.v13.i7.521

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Jul 15, 2022 (publication date) through Feb 27, 2025

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

World J Diabetes. Jul 15, 2022; 13(7): 521-531
Published online Jul 15, 2022. doi: 10.4239/wjd.v13.i7.521

Table 1 Descriptive statistics of main variables analyzed in individuals of group 1 (diabetes)

	Non-diabetic	Diabetic
n	3017	641
Age	41.11 (40.48-41.75)	58.33 (57.15-59.53)^d
Gender, % of men	46.6	51
BMI, kg/m²	27.82 (27.6-28.04)	31.4 (30.86-31.94)^d
Fasting glucose, mg/dL	98.08 (97.56-98.6)	149.6 (144.4-154.9)^d
HbA1c, %	5.41 (5.40-5.43)	7.26 (7.14-7.39)^d
Cotinine, serum, ng/mL	0.28 (0.24-0.31)	0.18 (0.13-0.24)^a
Smoker, %	42.5	50.2
Systolic blood pressure, mmHg	121 (120.4-121.6)	130.2 (128.7-131.7)^d
Diastolic blood pressure, mmHg	68.86 (68.42-69.31)	68.21 (67.17-69.26)
Hypertension, %	36.1	71.9
Dyslipidemia, %	35	66.6
Total cholesterol, mg/dL	187.4 (186-188.9)	180.7 (177.2-184.2)^c
Bisphenol F, µg/g creatinine	0.41 (0.39-0.43)	0.43 (0.38-0.48)
Bisphenol S, µg/g creatinine	0.5 (0.48-0.52)	0.59 (0.53-0.64)^b

^aP < 0.05.

^bP < 0.01.

^cP < 0.001.

^dP < 0.0001.

The results are expressed as percentages (%) or as geometric mean (95%CI). BMI: Body mass index; HbA1c: Hemoglobin A1c.

Table 2 Descriptive statistics of main variables analyzed in individuals of group 2 (bisphenol S)

BPS quartile	Q1	Q2	Q3	Q4
n	915	911	894	938
Age	42.88 (41.65-44.14)	42.42 (41.22-43.65)	44.5 (43.32-45.72)	45.8 (43.89-46.3)^d
Gender, % of men	56.3	49.7	42.8	40.6
BMI, kg/m²	27.76 (27.36-28.17)	28.41 (27.99-28.83)	28.94 (28.51-29.38)^c	28.57 (28.15-29)^a
Diabetes mellitus, %	15.3	16.6	18.1	20
Fasting glucose, mg/dL	103.7 (101.8-105.8)	104.5 (102.4-106.6)	108.2 (105.5-111)	108.8 (106.3-111.5)^a
HbA1c, %	5.62 (5.57-5.68)	5.66 (5.61-5.72)	5.75 (5.69-5.81)	5.78 (5.71-5.85)
Smoker, %	43.6	44.8	42.4	44.5
Cotinine, serum, ng/mL	0.24 (0.19-0.32)	0.27 (0.21-0.35)	0.24 (0.18-0.31)	0.27 (0.21-0.35)
Hypertension, %	39	40.6	43.4	46.3
Systolic blood pressure, mmHg	120.6 (119.5-121.7)	123.1 (122-124.2)	122.5 (121.4-123.7)	123.9 (122.7-125.1)
Diastolic blood pressure, mmHg	68.31 (67.5-69.13)	69.36 (68.52-70.21)	69.18 (68.37-69.99)	68.18 (67.37-69)
Dyslipidemia, %	39.3	40.6	40.8	41.5
Total cholesterol, mg/dL	184.3 (131.6-187)	184.7 (182-187.3)	187.7 (184.9-190.5)	188.3 (185.7-190. 9)
Bisphenol F, µg/g creatinine	0.37 (0.34-0.41)	0.43 (0.39-0.47)^a	0.41 (0.38-0.45)	0.45 (0.41-0.49)^b

^aP < 0.05, significant differences with respect to group Q1.

^bP < 0.01, significant differences with respect to group Q1.

^cP < 0.001, significant differences with respect to group Q1.

^dP < 0.05, significant differences between Q2 and Q4.

The results are expressed as percentages (%) or as geometric mean (95%CI). BMI: Body mass index; HbA1c: Hemoglobin A1c; BPS: Bisphenol S; BPF: Bisphenol F.

Table 3 Descriptive statistics of main variables analyzed in individuals of group 3 (bisphenol F)

BPF quartile	Q1	Q2	Q3	Q4
n	912	912	922	912
Age	41.22 (40.04-42.42)	44.81 (43.59-46.06)^c	45.22 (44.02-46.46)^d	43.69 (42.5-44.92)^a
Gender, % of men	58.2	44.5	43.7	43
BMI, kg/m²	29.04 (28.61-29.48)	28.01 (27.6-28.43)^b	28.04 (27.63-28.45)^b	28.59 (28.16-29.02)
Diabetes mellitus, %	17.1	19.7	16.4	16.9
Fasting glucose, mg/dL	108.3 (105.9-110.7)	106.2 (103.9-108.6)	104.7 (102.6-106.9)	105.6 (5.63-5.75)
HbA1c, %	5.7 (5.64-5.75)	5.74 (5.68-5.81)	5.69 (5.63-5.75)	5.69 (5.63-5.75)
Smoker, %	38.6	40.9	46.4	49.3
Cotinine, serum, ng/mL	0.18 (0.14-0.23)	0.19 (0.15-0.25)	0.29 (0.22-0.38)	0.43 (0.33-0.57)^c^,^e^,^f
Hypertension, %	39.7	42	43.3	44.4
Systolic blood pressure, mmHg	121.9 (120.9-123.1)	122.9 (121.8-124.1)	123 (121.8-124.1)	122.3 (121.1-123.5)
Diastolic blood pressure, mmHg	68.73 (67.93-69.53)	68.53 (67.76-69.31)	68.79 (67.94-69.64)	68.95 (68.1-69.82)
Dyslipidemia, %	37.6	41	43.4	40.2
Total cholesterol, mg/dL	185.3 (182.2-187.9)	186.9 (184.1-189.8)	186.7 (184.1-189.4)	185-9 (183.3-188.6)
BPS, µg/g creatinine	0.48 (0.44-0.51)	0.5 (0.46-0.54)	0.55 (0.51-0.59)	0.54 (0.50-0.58)

^aP < 0.05, significant differences with respect to group Q1.

^bP < 0.01, significant differences with respect to group Q1.

^cP < 0.001, significant differences with respect to group Q1.

^dP < 0.0001, significant differences with respect to group Q1.

^eP < 0.05, significant differences between Q2 and Q4.

^fP < 0.05, significant differences between Q3 and Q4.

The results are expressed as percentages (%) or as geometric mean (95%CI). BMI: Body mass index; HbA1c: Hemoglobin A1c; BPS: Bisphenol S; BPF: Bisphenol F.

Table 4 Simple linear regression with hemoglobin A1c and fasting glucose

	HbA1c			Fasting glucose
Variable	Adjusted R²	β₀	β	Adjusted R²	β₀	β
¹BPS	0.005^d	5.835^d	0.069^d	0.006^c	111.69^d	2.48^d
¹BPF	0.000	5.795	0.006	0.000	109.65	-0.39

^cP < 0.001.

^dP < 0.0001.

¹Log transformed.

HbA1c: Hemoglobin A1c; BPS: Bisphenol S; BPF: Bisphenol F.

Table 5 Association between phenols and diabetes

	Diabetes
Variable	OR (95%CI)	P value
¹BPS (1)	1.115 (1.038-1.196)	0.003
¹BPS (2)	1.109 (1.026-1.198)	0.009
¹BPS (3)	1.099 (1.016-1.188)	0.018
¹BPF (1)	1.020 (0.961-1.083)	0.513
¹BPF (2)	1.005 (0.941-1.072)	0.890
¹BPF (3)	0.991 (0.928-1.059)	0.795

¹Log-transformed.

(1) Individual; (2) Corrected for age, sex, and body mass index; and (3) Corrected for the above parameters and smoking, hypertension, and dyslipidemia. OR: Odds ratio; BPS: Bisphenol S; BPF: Bisphenol F.

Table 6 Association between diabetes and bisphenol S or F quartile

	Q1	Q2	Q3	Q4
Variable	Ref.	OR (95% CI)	OR (95%CI)	OR (95%CI)
¹Diabetes (1)	Ref.	1.1 (0.86-1.41)	1.23 (0.96-1.57)	1.39 (1.09-1.77)^c
¹Diabetes (2)	Ref.	1.11 (0.85-1.46)	1.14 (0.87-1.48)	1.32 (1.01-1.71)^a
¹Diabetes (3)	Ref.	1.09 (0.83-1.43)	1.12 (0.86-1.47)	1.28 (0.99-1.67)
²Diabetes (1)	Ref.	1.19 (0.94-1.51)	0.95 (0.74-1.21)	0.98 (0.77-1.26)
²Diabetes (2)	Ref.	1.16 (0.90-1.51)	0.88 (0.68-1.15)	0.94 (0.72-1.23)
²Diabetes (3)	Ref.	1.17 (0.90-1.52)	0.86 (0.66-1.13)	0.92 (0.70-1.20)

^aP < 0.05.

^cP < 0.001.

¹Bisphenol S (group 2).

²Bisphenol F (group 3).

(1) Individual; (2) Corrected for age, sex, and body mass index; and (3) Corrected for the above parameters and smoking, hypertension, and dyslipidemia. OR: Odds ratio.

Table 7 Association between hypertension or dyslipidemia and bisphenol S or F

	Hypertension		Dyslipidemia
Variable	OR (95%CI)	P value	OR (95%CI)	P value
¹BPS (1)	1.12 (1.06-1.18)	0.000	0.99 (0.99-1.11)	0.099
¹BPS (2)	1.09 (1.02-1.17)	0.007	1.02 (0.95-1.08)	0.607
¹BPS (3)	1.08 (1.01-1.16)	0.017	0.99 (0.937-1.065)	0.980
¹BPF (1)	1.07 (1.02-1.12)	0.005	1.05 (1.005-1.1)	0.03
¹BPF (2)	1.06 (1.001-1.12)	0.044	1.04 (0.98-1.1)	0.168
¹BPF (3)	1.04 (0.99-1.11)	0.136	1.03 (0.98-1.09)	0.274

¹Log-transformed.

(1) Individual; (2) Corrected for age, sex, and body mass index; and (3) Corrected for the above parameters and smoking, hypertension, and dyslipidemia. OR: Odds ratio.

Citation: Moreno-Gómez-Toledano R, Vélez-Vélez E, Arenas MI, Saura M, Bosch RJ. Association between urinary concentrations of bisphenol A substitutes and diabetes in adults. World J Diabetes 2022; 13(7): 521-531
URL: https://www.wjgnet.com/1948-9358/full/v13/i7/521.htm
DOI: https://dx.doi.org/10.4239/wjd.v13.i7.521