Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Sci Total Environ. 2021 Jun 1;771:145401. doi: 10.1016/j.scitotenv.2021.145401. Epub 2021 Jan 27.
Associations of bisphenol A (BPA) levels with renal disease are inconsistent. The present prospective study aims to evaluate the association of serum BPA levels with chronic kidney disease (CKD) in a Chinese middle-aged and elderly population. At baseline 1370 participants (mean age 61.7 years, 58.8% females) free of kidney disease and cancer were followed up nearly 10 years. Baseline serum BPA concentration was measured with high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS). Estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Multivariable logistic regression model was used to investigate relationship between serum BPA levels and incident CKD risk. During a 10-year follow-up, 246 individuals developed CKD. Baseline serum BPA concentration was 2.92 (1.00, 5.27) ng/mL. At baseline, after adjustment for multiple covariates serum BPA levels were negatively correlated with eGFR levels (β = -0.068, P = 0.009). Compared to those with low levels of serum BPA, participants with high levels had a significant negative association with CKD [ORs (95% CI) = 0.35 (0.25, 0.50), P < 0.001], and this association was not modified by conventional risk factors. The negative associations remained in females but not in males (P for interaction = 0.016). Significant interaction between baseline eGFR and serum BPA levels on CKD risk was also found (P for interaction = 0.027), Except subjects with 60-70 mL/min/1.73 m eGFR at baseline, inverse association robustly existed between serum BPA levels and incident CKD risk in the other eGFR subgroups. Further studies are needed to validate our findings.
双酚 A（BPA）水平与肾脏疾病的关联尚不一致。本前瞻性研究旨在评估中国中老年人群血清 BPA 水平与慢性肾脏病（CKD）的关系。在基线时，1370 名无肾脏疾病和癌症的参与者（平均年龄 61.7 岁，58.8%为女性）进行了近 10 年的随访。使用高效液相色谱-串联质谱法（HPLC-MS）测量基线血清 BPA 浓度。使用慢性肾脏病流行病学合作（CKD-EPI）方程计算估计肾小球滤过率（eGFR）。多变量 logistic 回归模型用于研究血清 BPA 水平与 CKD 发病风险之间的关系。在 10 年的随访期间，246 人发生 CKD。基线血清 BPA 浓度为 2.92（1.00，5.27）ng/mL。在基线时，经过多项协变量调整后，血清 BPA 水平与 eGFR 水平呈负相关（β=-0.068，P=0.009）。与低血清 BPA 水平的参与者相比，高血清 BPA 水平的参与者与 CKD 显著负相关[比值比（95%可信区间）=0.35（0.25，0.50），P<0.001]，且这种关联不受传统危险因素的影响。这种负相关仅在女性中存在，而在男性中不存在（P 交互=0.016）。在 CKD 风险方面，还发现了基线 eGFR 和血清 BPA 水平之间的显著交互作用（P 交互=0.027）。除了基线时 eGFR 为 60-70mL/min/1.73m 的受试者外，血清 BPA 水平与其他 eGFR 亚组中 CKD 发病风险之间存在反向关联。需要进一步的研究来验证我们的发现。
