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The Association between Urinary Bisphenol-A, Phthalate Metabolites and Body Fat Composition in US Adults Using NHANES

Due to the widespread use of the endocrine disruptors Bisphenol-A (BPA) and phthalates in many plastic consumer goods, medical equipment, and personal care products, more than 95% of the US population show detectable levels of urinary BPA and phthalate metabolites. Both have been linked to increased body mass index (BMI in kg/m2), an inexpensive diagnostic tool for obesity, which may however not reflect body fatness. Since excess body fat is associated with cardiovascular diseases, cancer and type II diabetes, it is important to understand the relationship between body fat composition and exposure to BPA and phthalates, a relationship that is still unknown. Using NHANES 1999-2006 data on adults aged >20 years, we investigated the relationship between urinary BPA (N=2,534), monoethyl-phthalate (mEP, N=5,431), monobutyl-phthalate (mBP), monoethylhexyl-phthalate (mEHP) and monobenzyl-phthalate (mBzP, each N=5,436) measured by high-performance liquid chromatography tandem mass spectrometry, and body fat composition measured as lean mass (LM, grams), fat mass (FM, grams) and percent body fat (%BF) using Dual Energy X-ray Absorptiometry. A multivariable linear regression analysis yielded that independently of BMI, BPA, mBP, and mBzP were inversely associated with LM (quartile 4 b=-862.16 (354.65), -731.76 (248.89), -909.13 (252.32), respectively; all p<0.02, p-trend<0.02); mEHP and FM were inversely associated (quartile 4 b=-297.98 (144.87), p=0.04, p-trend<0.02); BPA, mBP, and mBzP were positively associated with %BF but not clinically significant. These results provide novel insights in the relationship between urinary BPA, phthalates and LM independent of BMI, and it highlights the need for prospective studies establishing temporality of this relationship.
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