Serum Bisphenol A is an independent risk factor of hyperuricemia: A 6-year prospective study
Introduction
Abnormalities in purine metabolism lead to hyperuricemia [1]. Hyperuricemia is not only a cause of gout but is also independently associated with cardiovascular diseases, chronic kidney diseases, and mortality [2], [3], [4], [5]. In China, the prevalence of hyperuricemia has rapidly increased from 1.4% to 13.3% over the past 3 decades [6], [7], and a similar trend has been seen in the United States [8], [9]. Determining the etiology of hyperuricemia is important for halting the increasing burden of this disease.
The etiology of hyperuricemia depends upon genetics and environment [1], [10], [11], [12]. Genetics alone do not explain the rapid increase in the prevalence of hyperuricemia over the past decades, and modifiable environmental risk factors need to be identified [10]. The National Health and Nutrition Examination Survey (NHANES) has suggested that environmental pollutants such as arsenic and organochlorine are closely associated with the risk of hyperuricemia [11], [12]. Bisphenol A (BPA) is an environmental endocrine disruptor that is typically used in food containers, so human exposure to BPA is widespread [13]. Epidemiologic studies have shown that elevated BPA exposure is correlated with metabolic disorders (i.e., hypertension and type 2 diabetes) as well as cardiorenal dysfunction [14], [15], [16], [17]. Furthermore, our recent study in animals and cells indicated that BPA may promote hyperuricemia via activating xanthine oxidase [18]. Nevertheless, whether BPA is a risk factor for hyperuricemia remains uncertain and needs to be explored in prospective study [10].
We established a prospective, population-based study to investigate the relationship between BPA exposure and serum uric acid concentrations; furthermore, we analyzed whether serum BPA level is an independent risk factor for hyperuricemia.
Section snippets
Study population and sampling approach
This study is a part of the Environment, Inflammation and Metabolic Diseases Study (EIMDS), which is a prospective study that aimed at identifying the environmental and inflammatory risk factors of metabolic disorders such as diabetes, hypertension, chronic kidney diseases, and hyperuricemia [16], [17], [19], [20]. In the current study, the effect of BPA on the risk of hyperuricemia was evaluated.
Hyperuricemia was defined as a blood uric acid concentration greater than 7 mg/dL in men and 6 mg/dL
Characteristics of participants at baseline
The baseline characteristics of participants are shown in Table 1 and Supplementary Table 1. The 288 men and 194 women without hyperuricemia enrolled in the study were 61.6 ± 11.16 years old. Subjects were stratified into those with low, median, and high tertiles of baseline serum BPA level [0.17 (0.12–0.24), 0.51 (0.39–0.81), 3.39 (2.35–4.92) ng/mL, respectively]. Compared to the participants with lower levels of BPA exposure, subjects with higher BPA exposure exhibited higher levels of
Discussion
In this prospective study, we reported that baseline serum BPA levels had a positive correlation with the annual change in serum uric acid concentration and that baseline serum BPA predicted the 6-year risk of developing hyperuricemia. These findings remained the same when potential confounders were included in statistical models. Our findings suggest that BPA is a risk factor for hyperuricemia.
As an environmental endocrine disruptor, BPA has been shown to be involved in hypertension, type 2
Author’s contributions
Jinbo Hu, Chuan Peng, and Qifu Lidesigned the study, oversaw the data collection, and wrote the manuscript. Jiayu Li and Aipin Zhang conducted the data analysis and contributed to the writing of the manuscript. Linqiang Ma, Yi Yang, and Linkun Zhang contributed to the study design, provided statistical expertise. Qingfeng Cheng contributed to the writing of the manuscript. Rufei Gao assisted with the data collection, and contributed to the writing and editing of the manuscript. Yue Wang and
Financial support information
National Key Research & Development Plan, major project of precision medicine research (2017YFC0909600, sub-project: 2017YFC0909602, 2017YFC0909603). National Key Clinical Specialties Construction Program of China to the Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University; and the National Natural Science Foundation of China (81370954 and 81670785) to Qifu Li; and the Fundamental Science & Advanced Technology Research of Chongqing (Major Project,
Acknowledgments
The authors thank Laboratory of Endocrine and the Laboratory of Lipid & Glucose Metabolism, the First Affiliated Hospital of Chongqing Medical University.
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2023, Nutrition, Metabolism and Cardiovascular DiseasesCitation Excerpt :The change in the microbiota has been related to insulin resistance [54] and increased levels of UA in animals [52]. Moreover, serum levels of bisphenol A, a packaging material of industrialized products, were associated to the annual change in UA levels [51] and the risk for the incidence of HU at six years [51]. Among food groups and components of UPFs, nonalcoholic industrialized beverages appear as the first food group that most contributed to UPFs consumption in this work (33.9%–40.5%) (Supplementary Figs. 1 and 2).
Associations of exposure to perfluoroalkyl substances with serum uric acid change and hyperuricemia among Chinese women: Results from a longitudinal study
2022, ChemosphereCitation Excerpt :Furthermore, stronger associations of serum UA with cardiovascular and metabolic diseases have been observed in females than in males (Fang and Alderman, 2000; Grayson et al., 2011; Tani et al., 2020). Levels of serum UA can be affected by both genetic and environmental factors, such as metals (Sun et al., 2017), residential greenness (Dong et al., 2021), and bisphenol A (Hu et al., 2019). Previous epidemiological studies have reported cross-sectional associations of perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA), the most widely studied PFASs, with elevated serum UA and higher risk of hyperuricemia among occupational (Costa et al., 2009; Rotander et al., 2015; Sakr et al., 2007) and general populations (Arrebola et al., 2019; Gleason et al., 2015; Jain and Ducatman, 2019; Lin et al., 2020; Scinicariello et al., 2020; Shankar et al., 2011).
Association between mixed dioxin exposure and hyperuricemia in U.S. adults: A comparison of three statistical models
2022, ChemosphereCitation Excerpt :However, these factors cannot completely explain the hyperuricemia epidemic. Recently, more attention was focused on the impact of environmental pollutants on hyperuricemia (Hu et al., 2019; Scinicariello et al., 2020; Sun et al., 2017). Dioxins are chemical environmental pollutants that can be divided into three major groups: dioxin-like polychlorinated biphenyls (DL-PCBs); polychlorinated dibenzo-p-dioxins (PCDDs); and polychlorinated dibenzofurans (PCDFs) (Arisawa, 2018).
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2022, Science of the Total EnvironmentCitation Excerpt :BPA has a structure similar to estradiol and acts as an estrogen to exert endocrine activity via several cell signing pathways (Murata and Kang, 2018). It has been repeatedly reported that BPA has been related to various adverse health or diseases in human such as obesity (M. Hao et al., 2018), hyperuricemia (Hu et al., 2019; L. Ma et al., 2018), cardiovascular disease (Mouneimne et al., 2017), attention deficit disorder (Tsai et al., 2020; Yoo et al., 2020), and even cancers (J. Li et al., 2020; Z. Wang et al., 2017). In addition, BPF and TCS have also been shown to have different levels of endocrine activity, which are related to many metabolism-related diseases (Chen et al., 2016; Weatherly and Gosse, 2017).
Association between consumption of ultra-processed foods and hyperuricemia: TCLSIH prospective cohort study
2021, Nutrition, Metabolism and Cardiovascular DiseasesCitation Excerpt :Finally, UPF contain authorized but controversial food additives such as sodium benzoate and sodium nitrite [44]. Animal models have suggested these additives can raise serum uric acid levels [45,46]. Of note, Table 1 demonstrates that participants at baseline with higher UPF consumption had lower prevalence of obesity, hypertension, dyslipidemia and diabetes.
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Co-first authors: Jinbo Hu, Chuan Peng, and Jiayu Li.