Lin Yu-Jung, Chang Jung-Wei, Ponnusamy Vinoth Kumar, Huang Han-Bin, Chen Hsin-Chang, Huang Po-Chin
Intelligent Data Mining Laboratory, Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Front Public Health. 2025 May 19;13:1505578. doi: 10.3389/fpubh.2025.1505578. eCollection 2025.
It is uncertain if exposure to BPA and its substitutes has an impact on renal function, including N-acetyl-β-D-glucosaminidase (NAG), which is an early marker for kidney injury. We aimed to (1) Estimate the daily intakes (DIs) of BPA and its substitutes using individual urinary levels and conduct the cumulative risk assessment of bisphenols. (2) Assessed the association between exposure to BPA and its substitutes with various renal function indices using a dose-based and cumulative risk assessment approach.
We recruited 366 participants, and three bisphenols (BPA, bisphenol F, and bisphenol S) were analyzed through ultraperformance liquid chromatography-tandem mass spectrometry. DI levels were calculated for each bisphenol. Hazard index (HI) values were calculated for determining cumulative risk. Using the renal function index, we measured the serum and urinary level (e.g., microalbumin, NAG). The NAG/Creatinine ratio (> 4 IU/g creatinine) and other renal functions indexes based on clinical cut-off points to defined abnormality.
After adjustment for covariates, increased NAG/Creatinine ratios were associated with higher DIs of BPA, showing a dose-response trend (Adjusted Odds Ratio [AOR] : 3.58, 95% CI = 1.52-8.44; AOR : 7.34, 95% CI = 2.26-23.81; < 0.001). Notably, the HI of bisphenols was positively associated with NAG/Creatinine in adults (AOR = 2.18, 95% CI = 1.10-4.34; AOR = 4.27, 95% CI = 2.14-8.51) after adjusted for covariates.
We found a sensitive risk factor for abnormal NAG/creatinine levels after exposure to BPA and its substitute. Further mechanistic studies are needed to clarify these associations.
接触双酚A（BPA）及其替代品是否会对肾功能产生影响尚不确定，包括N-乙酰-β-D-氨基葡萄糖苷酶（NAG），它是肾脏损伤的早期标志物。我们旨在：（1）利用个体尿液水平估算BPA及其替代品的每日摄入量（DIs），并进行双酚类物质的累积风险评估。（2）采用基于剂量和累积风险评估的方法，评估接触BPA及其替代品与各种肾功能指标之间的关联。
我们招募了366名参与者，通过超高效液相色谱-串联质谱法分析了三种双酚（BPA、双酚F和双酚S）。计算了每种双酚的DI水平。计算风险指数（HI）值以确定累积风险。利用肾功能指标，我们测量了血清和尿液水平（如微量白蛋白、NAG）。NAG/肌酐比值（>4 IU/g肌酐）和基于临床切点的其他肾功能指标用于定义异常情况。
在对协变量进行调整后，NAG/肌酐比值升高与BPA的较高DI相关，呈现剂量反应趋势（调整后的优势比[AOR]：3.58，95%置信区间=1.52-8.44；AOR：7.34，95%置信区间=2.26-23.81；P<0.001）。值得注意的是，在对协变量进行调整后，双酚类物质的HI与成年人的NAG/肌酐呈正相关（AOR=2.18，95%置信区间=1.10-4.34；AOR=4.27，95%置信区间=2.14-8.51）。
我们发现接触BPA及其替代品后，NAG/肌酐水平异常存在一个敏感的风险因素。需要进一步的机制研究来阐明这些关联。
