Department of Oncology, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huai'an, China.
Front Public Health. 2024 Feb 23;12:1341789. doi: 10.3389/fpubh.2024.1341789. eCollection 2024.
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.
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.
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; = 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.
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.
有证据表明，双酚 A（BPA）与成年人的全因死亡率增加有关。然而，BPA 暴露与癌症死亡率之间的具体关系仍相对未得到充分探索。
本研究使用了国家健康和营养调查（NHANES）数据集来招募参与者。使用液相色谱-质谱（LC-MS）来评估尿液中的 BPA。通过多变量 Cox 比例风险回归和约束三次样条，研究了尿液 BPA 与全因死亡和癌症死亡之间的关系。
本研究共有 8035 名参与者，在 7.5 年的随访后，有 137 人死于癌症。BPA 的中位数水平为 2.0μg/mL。尿液 BPA 水平与全因死亡率无关。对于癌症死亡率，第二四分位数的多变量调整后的危险比为 0.51（95%置信区间：0.30 至 0.86；P=0.011），与最低四分位数相比。受限三次样条显示，这种关联是非线性的（非线性检验 P=0.028），拐点为 1.99ng/mL。
尿液 BPA 暴露与癌症死亡率的风险呈 U 型相关，BPA 水平低于 1.99ng/mL 与癌症死亡率的风险增加相关。
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