The association between urinary bisphenol A levels and nonalcoholic fatty liver disease in Korean adults: Korean National Environmental Health Survey (KoNEHS) 2015-2017

Environ Health Prev Med. 2021 Sep 14;26(1):91. doi: 10.1186/s12199-021-01010-7.

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) is becoming a global health problem. Bisphenol A (BPA), one of most widely used environmental chemicals, is suspected to be a contributor to the development NAFLD. This study was performed to examine the relationship between human BPA levels and risk of NAFLD.

Methods: The data (n = 3476 adults: 1474 men and 2002 women) used in this study were obtained from the Korean National Environmental Health Survey III (2015-2017). BPA levels were measured in urine samples. NAFLD was defined using hepatic steatosis index after exclusion of other causes of hepatic diseases.

Results: There was a significant linear relationship between the elevated urinary BPA concentrations and risk of NAFLD. In a univariate analysis, odds ratio (OR) of the highest quartile of urinary BPA level was 1.47 [95% confidence interval (CI) 1.11-1.94] compared to the lowest quartile. After adjusted with covariates, the ORs for NAFLD in the third and fourth quartiles were 1.31 [95% CI 1.03-1.67] and 1.32 [95% CI 1.03-1.70], respectively.

Conclusions: Urinary BPA levels are positively associated with the risk of NAFLD in adults. Further experimental studies are needed to understand the molecular mechanisms of BPA on NAFLD prevalence.

Keywords: Bisphenol A; Hepatic steatosis index; Korean adults; Korean national environmental health survey; Nonalcoholic fatty liver disease.

MeSH terms

  • Asian People
  • Benzhydryl Compounds / urine*
  • Environmental Exposure
  • Environmental Health
  • Female
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease / chemically induced
  • Non-alcoholic Fatty Liver Disease / epidemiology*
  • Phenols / urine*
  • Republic of Korea / epidemiology

Substances

  • Benzhydryl Compounds
  • Phenols
  • bisphenol A