Elevated Urinary Bisphenol A Levels are Associated with Nonalcoholic Fatty Liver Disease among Adults in the United States.
Liver Int. 2019 Mar 29. Epub 2019 Mar 29. PMID: 30924602
BACKGROUND AND AIMS: The relationship between bisphenol A (BPA) and nonalcoholic fatty liver disease (NAFLD) is undefined. We studied the impact of BPA on NAFLD.
METHODS: We performed a cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES) 2005-2014 among adults in the United States (US). NAFLD was diagnosed using the hepatic steatosis index (HSI) and the US fatty liver index (USFLI) in the absence of other causes of chronic liver diseases. The first sample using HSI consisted of 7,605 adults. The second sample using USFLI consisted of 3,631 participants with availability of fasting data.
RESULTS: Of the first 7,605 participants (mean age 47 years, 48.4% male), the prevalence of NAFLD and abnormally elevated alanine aminotransferase (ALT) levels was correlated with urinary BPA levels (p<0.05). Compared to the reference group with lowest quartile of urinary BPA levels, those with 3quartile and 4quartile were 81% and 53% more likely to develop NAFLD defined by HSI. In a multivariate model, the ORs for NAFLD in 3quartile and 4quartile were 1.69 (95% CI 1.39-2.04) and 1.44 (95% CI 1.19-1.76), respectively (P for trend<0.001). In the second sample using USFLI, high BPA levels (4quartile) remained an independent predictor of NAFLD (OR 1.44 95% CI 1.05-1.98, P for trend = 0.012).
CONCLUSIONS: High levels of urinary BPA were associated with NAFLD in a nationally representative sample of adults in the US. The pathophysiology remains unclear and warrants further investigation. This article is protected by copyright. All rights reserved.