Mitigating the impact of bisphenol A exposure on mortality: Is diet the key? A cohort study based on NHANES

A cross-sectional study exploring relationships between triglyceride glucose index, atherogenic index of plasma, and chronic pain: NHANES 1999-2004

BACKGROUND

Triglyceride glucose (TyG) index and atherogenic index of plasma (AIP) are indicators of insulin resistance. However, inadequate evidence indicates that the TyG index, AIP, and chronic pain are linked.

METHODS

Data from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2004 were used. Directed acyclic graphs were used to identify 11 potential confounders. The TyG index and AIP were treated as continuous variables in the multivariate logistic regression models to assess their association with chronic pain. Furthermore, the nonlinear relationships between these indices and outcomes were investigated using restricted cubic spline plots. Subsequently, subgroup analyses were conducted for the sensitive populations. Receiver operating characteristic curves were used to compare the relationships between indices and outcomes. Ultimately, two sensitivity analyses were performed.

RESULTS

This study identified nonlinear associations between the TyG index, AIP, and chronic pain in 16,996,513 Americans. The odds ratio and 95% confidence interval for the TyG index (per 1 standard deviation increase) was 1.17 (1.02, 1.33), and for AIP (per 1 standard deviation increase) was 1.19 (1.07, 1.34). According to the subgroup analyses, the relationships between exposure and outcome were more pronounced in the non-diabetic population. The TyG index and AIP performed similarly in assessing chronic pain in ROC curves. Additionally, the results of the two sensitivity analyses matched the conclusions of the main study.

CONCLUSIONS

Nonlinear correlations between the TyG index, AIP, and chronic pain were identified among adults in the United States. This demonstrated that the TyG index and AIP displayed similar effectiveness in predicting the risk of chronic pain.

The Adverse Impact of Bisphenol A Exposure on Optimal Cardiovascular Health as Measured by Life's Essential 8 in U.S. Adults: Evidence from NHANES 2005 to 2016

Background/Objectives: Cardiovascular diseases are the primary cause of global morbidity and mortality, with cardiovascular health (CVH) remaining well below the ideal level and showing minimal improvement in the U.S. population over recent years. Bisphenol A (BPA), a pervasive environmental contaminant, has emerged as a potential contributor to adverse cardiovascular outcomes. This cross-sectional study delves into the impact of BPA exposure on achieving optimal CVH, as assessed by the Life's Essential 8 metric, among U.S. adults. Methods: Analyzing data from 6635 participants in the National Health and Nutrition Examination Survey (NHANES) collected between 2005 and 2016, BPA exposure was quantified through urinary BPA levels, while optimal CVH was defined using the American Heart Association's Life's Essential 8 criteria, scoring between 80 and 100. Multivariable logistic regression and propensity score matching were employed to evaluate the association between BPA exposure and CVH. Results: This study reveals that individuals in the highest tertile of urinary BPA levels were 27% less likely to attain optimal CVH compared with those in the lowest tertile (OR, 0.73; 95% CI: 0.59-0.92). This negative association persisted across diverse demographics, including age, sex, and race, mirrored in the link between urinary BPA levels and health factor scores. Conclusions: The findings underscore the potential benefits of reducing BPA exposure in enhancing the prevalence of optimal CVH and mitigating the burden of cardiovascular disease. Given the widespread use of BPA, ongoing monitoring of BPA's impact on CVH is essential. Further studies are necessary to elucidate the long-term and causative connections between BPA and CVH. These insights contribute to understanding the complex interplay between environmental factors and CVH outcomes, informing targeted interventions to mitigate cardiovascular disease risk within the population.

Association of urinary bisphenol A with hyperlipidemia and all-cause mortality: NHANES 2003-2016

BACKGROUND

The connection between urinary bisphenol A (BPA) and hyperlipidemia is still unclear, and few studies have evaluated whether urinary BPA affects mortality among individuals with hyperlipidemia. Therefore, we aimed to investigate the link between urinary BPA and hyperlipidemia and assess the impact of urinary BPA on mortality risk in subjects with hyperlipidemia.

METHODS

We analyzed data of the National Health and Nutrition Examination Survey from 2003 to 2016. Multivariable logistic analysis was performed to examine the relationship between urinary BPA and hyperlipidemia. Cox regression analysis was carried out to investigate the relationship between urinary BPA and all-cause mortality in subjects with hyperlipidemia.

RESULTS

This study included 8,983 participants, of whom 6,317 (70.3%) were diagnosed with hyperlipidemia. The results showed that urinary BPA was higher in participants with hyperlipidemia group than those without hyperlipidemia (3.87 ± 0.32 vs. 2.98 ± 0.14, P = 0.01). Urinary BPA levels were analyzed in tertiles. Compared with tertile 1 of BPA (reference), the odds ratio (95% confidence interval) of hyperlipidemia related to tertile 3 of BPA was 1.28 (1.11-1.48). The hazard ratio for all-cause death associated with the highest versus lowest tertile of urinary BPA was 1.20 (95% confidence interval: 1.01-1.44; P = 0.04) among participants with hyperlipidemia.

CONCLUSIONS

The study indicated a positive relationship between urinary BPA and the risk of hyperlipidemia. Urinary BPA was associated with a significantly higher risk of all-cause mortality in adults with hyperlipidemia.

Endocrine disrupting chemical Bisphenol A and its association with cancer mortality: a prospective cohort study of NHANES

Introduction

There is evidence suggesting that Bisphenol A (BPA) is associated with increased all-cause mortality in adults. However, the specific nature of the relationship between BPA exposure and cancer mortality remains relatively unexplored.

Methods

The National Health and Nutrition Examination Survey (NHANES) dataset was used to recruit participants. Urinary BPA was assessed using liquid chromatography-mass spectrum (LC-MS). Through the use of multivariable Cox proportional hazard regressions and constrained cubic splines, the relationships between urine BPA and death from all causes and cancer were investigated.

Results

This study has a total of 8,035 participants, and 137 died from cancers after a 7.5-year follow-up. The median level of BPA was 2.0 g/mL. Urinary BPA levels were not independently associated with all-cause mortality. For cancer mortality, the second quartile's multivariable-adjusted hazard ratio was 0.51 (95% confidence interval: 0.30 to 0.86; p = 0.011) compared to the lowest quartile. The restricted cubic splines showed that the association was nonlinear (p for nonlinearity = 0.028) and the inflection point was 1.99 ng/mL.

Conclusion

Urinary BPA exposure was U-shaped associated with the risk of cancer mortality, and a lower level of BPA less than 1.99 ng/mL was associated with a higher risk of cancer mortality.