Aekplakorn Wichai, Chailurkit La-Or, Ongphiphadhanakul Boonsong
Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Diabetes. 2015 Mar;7(2):240-9. doi: 10.1111/1753-0407.12159. Epub 2014 May 8.
Epidemiological studies of the association between bisphenol A (BPA) exposure and diabetes have been inconsistent. The present study determined serum BPA concentrations in the Thai population and their association with hyperglycemia and diabetes.
In all, 2581 serum samples from the Thai National Health Examination Survey (2009) were used to determine BPA levels. Impaired fasting glucose (IFG) was defined as fasting plasma glucose ≥100 and <126 mg/dL. Diabetes was defined as a history of a physician's diagnosis or fasting plasma glucose ≥126 mg/dL. Multinomial logistic regression was used to examine the association of serum BPA with IFG and diabetes.
Of 2581 samples tested, BPA was detected in 2135 samples (weighted percentage 78.1%), with a geometric mean concentration of 0.34 ng/mL BPA. Serum BPA levels were significantly higher among those with diabetes or IFG compared with normoglycemic individuals (0.52 and 0.38 vs 0.33 ng/mL, respectively; P < 0.001). After adjusting for potential confounders, compared with the first quartile (≤0.071 ng/mL), the overall adjusted odds ratios (OR) of serum BPA concentration in the third and fourth quartiles (0.319-0.745 and ≥0.746 ng/mL, respectively) for IFG were 1.72 (95% confidence interval [CI] 1.19, 2.49) and 1.23 (95% CI 0.80, 1.89), respectively; for diabetes, the adjusted OR were 1.88 (95% CI 1.18, 2.99) and 1.83 (95% CI 1.12, 2.95), respectively, with a slightly stronger association among men than in women.
Serum BPA concentrations were not associated with IFG, but were positively associated with diabetes in the Thai population. Further prospective studies are needed to confirm the relationship.
关于双酚A（BPA）暴露与糖尿病之间关联的流行病学研究结果并不一致。本研究测定了泰国人群的血清BPA浓度及其与高血糖和糖尿病的关联。
总共使用了来自泰国国家健康检查调查（2009年）的2581份血清样本测定BPA水平。空腹血糖受损（IFG）定义为空腹血糖≥100且<126mg/dL。糖尿病定义为有医生诊断史或空腹血糖≥126mg/dL。采用多项逻辑回归分析血清BPA与IFG和糖尿病的关联。
在检测的2581份样本中，2135份样本检测到BPA（加权百分比78.1%），BPA几何平均浓度为0.34ng/mL。糖尿病或IFG患者的血清BPA水平显著高于血糖正常个体（分别为0.52和0.38 vs 0.33ng/mL；P<0.001）。在调整潜在混杂因素后，与第一四分位数（≤0.071ng/mL）相比，IFG患者血清BPA浓度处于第三和第四四分位数（分别为0.319 - 0.745和≥0.746ng/mL）时的总体调整比值比（OR）分别为1.72（95%置信区间[CI]1.19，2.49）和1.23（95%CI 0.80，1.89）；糖尿病患者的调整OR分别为1.88（95%CI 1.18，2.99）和1.83（95%CI 1.12，2.95），男性的关联略强于女性。
在泰国人群中，血清BPA浓度与IFG无关，但与糖尿病呈正相关。需要进一步的前瞻性研究来证实这种关系。
