Association of urinary bisphenol A with chronic obstructive pulmonary disease-related diseases: evidence from the National Health and Nutrition Examination Survey database (2005-2016)

Abstract

In vivo and in vitro studies have found that exposure to bisphenol A (BPA) can lead to pulmonary diseases, but there exists little evidence regarding the association between urinary BPA level and chronic obstructive pulmonary disease (COPD)-related diseases in the population. National Health and Nutrition Examination Survey data, from 2005 to 2016, were utilized in this study. Participants who self-reported having emphysema, chronic bronchitis, or COPD were defined as having COPD-related diseases. A multivariate logistic regression analysis was used to analyze the association of urinary BPA with COPD-related diseases in the overall population and according to sex. Three separate models including different covariates were used in our analyses. The association of urinary BPA with COPD-related diseases in different subgroups (age, smoking status, participants belonging to "ever had asthma" and "ever had cardiovascular disease") other than sex was also analyzed. Based on the different models, 9189, 7006, and 6946 participants were used in our study. BPA was found to be significantly associated with COPD-related diseases in all models. The concentration of BPA in urine was significantly associated with COPD-related diseases regardless of whether BPA concentration was treated as a continuous variable (odds ratio (OR): 1.24, 95% confidence interval (CI): 1.11-1.38, in model 3) or as tertiles (OR: 2.01, 95% CI: 1.49-2.72, between the lowest group and highest group, in model 3). This association was significant among male but not female participants. BPA also demonstrated a significant association with emphysema and chronic bronchitis in adults, particularly in males. No significant interaction was found for all the other subgroup analyses. Urinary BPA was associated with COPD-related diseases in adult participants, especially males.

Keywords: Bisphenol A; Chronic bronchitis; Chronic obstructive pulmonary bronchitis; Emphysema; National Health and Nutrition Examination Survey.