Rapid reportAssociation between bisphenol A and waist-to-height ratio among children: National Health and Nutrition Examination Survey, 2003–2010
Introduction
Epidemiologic studies have found cross-sectional associations between bisphenol A (BPA), obesity, and related outcomes among adults; [1], [2], [3], [4], [5], [6] and more recently among children [7], [8], [9]. These are important findings given the increased vulnerability of children to BPA [10]. In these pediatric studies investigators defined obesity by using body mass index–based criteria; however, measures of central obesity are suggested to be better discriminators of cardiovascular risk [11], [12]. Therefore, our objective was to determine whether there is a relationship between BPA and waist-to-height ratio (WHR), a measure of central obesity, among children.
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Materials and methods
This cross-sectional analysis of BPA and WHR includes 2836 children ages 6–18 years who participated in the National Health and Nutrition Examination Survey (NHANES) 2003–2010; inclusion required complete data on all covariates. NHANES is a stratified, multistage, probability sample of the civilian, noninstitutionalized U.S. population conducted with approval from the National Center for Health Statistics Research Ethics Review Board. Additional details are available at //www.cdc.gov/nchs/nhanes.htm
Results
Mean age was 12.4 years (95% confidence interval [95% CI] 12.2–12.6). Children were non-Hispanic white (61.5%, 95% CI 56.8–66.2), non-Hispanic black (14.0%, 95% CI: 11.7–16.3), or of other race/ethnicity (24.5%, 95% CI: 20.5–28.6). Geometric mean urinary BPA was 2.6 ng/mL (95% CI 2.4–2.7). In bivariate analyses, BPA was significantly associated with survey year, race/ethnicity and serum cotinine. Mean WHR was 0.49 (95% CI 0.48–0.49).
In adjusted models, greater BPA was associated with increased
Discussion
We observed a statistically significant association between increasing BPA and WHR among a nationally representative sample of children. Although the observed increase of 0.016 in WHR appears small, it represents 15.7% of the interquartile range of WHR and is thus a meaningful change at the population level. These findings corroborate and expand upon previous work [7], [8], [9] by identifying a relationship with central obesity and using a larger sample of children. Although there is still some
Acknowledgment
This work was funded in part by Case Western Reserve University Department of Pediatrics Pilot Grant (to M.B.K.) and the Swetland Center for Environmental Health (to E.M.W.).
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