Department of Nutrition, School of Public Health, Sun Yat-Sen University, 74 Zhong Shan Road 2, Guangzhou 510080, Guangdong, China; Department of Clinical Nutrition, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Department of Nutrition, School of Public Health, Sun Yat-Sen University, 74 Zhong Shan Road 2, Guangzhou 510080, Guangdong, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Ecotoxicol Environ Saf. 2023 Nov 15;267:115629. doi: 10.1016/j.ecoenv.2023.115629. Epub 2023 Oct 25.
Bisphenol A (BPA) is a widespread environmental pollutant linked to detrimental effects on human health and reduced life expectancy following chronic exposure. This prospective cohort study aimed to examine the association between BPA exposure and mortality in American adults and to explore the potential mitigating effects of dietary quality on BPA-related mortality. This study utilized data from 8761 American adults in the 2003-2016 National Health and Nutrition Examination Survey (NHANES). Urinary BPA levels were employed to assess BPA exposure, and dietary quality was evaluated using the Healthy Eating Index-2015 (HEI-2015). All-cause, cardiovascular disease (CVD), and cancer mortality statuses were determined until December 31, 2019, resulting in a cumulative follow-up of 80,564 person-years. The results showed that the highest tertile of urinary BPA levels corresponded to a 36% increase in all-cause mortality and a 62% increase in CVD mortality compared to the lowest tertile. In contrast, the highest tertile of HEI-2015 scores was associated with a 29% reduction in all-cause mortality relative to the lowest tertile. Although no significant interaction was found between HEI-2015 scores and urinary BPA levels concerning mortality, the association between HEI-2015 scores and both all-cause and CVD mortality was statistically significant at low urinary BPA levels. Continuous monitoring of BPA exposure is crucial for evaluating its long-term adverse health effects. Improving dietary quality can lower all-cause mortality and decrease the risk of all-cause and CVD mortality at low BPA exposure levels. However, due to the limited protective effect of dietary quality against BPA exposure, minimizing BPA exposure remains a vital goal.
双酚 A（BPA）是一种广泛存在的环境污染物，与慢性暴露后对人类健康的有害影响和预期寿命降低有关。本前瞻性队列研究旨在检验 BPA 暴露与美国成年人死亡率之间的关系，并探讨膳食质量对 BPA 相关死亡率的潜在缓解作用。本研究利用了来自 2003-2016 年全国健康和营养调查（NHANES）的 8761 名美国成年人的数据。采用尿中 BPA 水平来评估 BPA 暴露情况，并用 2015 年健康饮食指数（HEI-2015）来评估膳食质量。所有原因、心血管疾病（CVD）和癌症死亡率状态直至 2019 年 12 月 31 日确定，累计随访 80564 人年。结果显示，与最低三分位组相比，尿中 BPA 水平最高三分位组的全因死亡率增加了 36%，CVD 死亡率增加了 62%。相反，与最低三分位组相比，HEI-2015 评分最高三分位组的全因死亡率降低了 29%。尽管在死亡率方面，HEI-2015 评分与尿中 BPA 水平之间没有发现显著的交互作用，但在低尿 BPA 水平下，HEI-2015 评分与全因和 CVD 死亡率之间的关联具有统计学意义。持续监测 BPA 暴露对于评估其长期不良健康影响至关重要。改善膳食质量可以降低全因死亡率，并降低低 BPA 暴露水平下全因和 CVD 死亡率的风险。然而，由于膳食质量对 BPA 暴露的保护作用有限，最大限度地减少 BPA 暴露仍然是一个重要目标。
