Bisphenol A and Diabetes, Insulin Resistance, Cardiovascular Disease and Obesity: Controversy in a (Plastic) Cup?

Extract

One of the more notable public health debates in recent times relates to the purported association between the ubiquitous environmental chemical bisphenol-A (BPA) and a host of chronic diseases. The past 5 years have seen a rapid increase in the evidence linking BPA to obesity, diabetes, and cardiovascular disease in human, population-based epidemiological studies. However, 2 recent reports (1, 2) in the JCEM, while both showing modest associations between BPA (measured in urine) and chronic disease, have achieved little in definitively addressing the controversy. Shankar and Teppala (1), using National Health and Nutritional Examination Survey (NHANES) data, showed a positive association between BPA levels and diabetes, and Wang et al (2) report associations between urinary BPA and obesity and insulin resistance in a cohort of adults aged 40 years or older in China. However, the interpretation of these findings is limited by many caveats that relate to BPA metabolism and its analysis, both in the testing methods currently available and with respect to appropriate adjustment for confounders.