The association of bisphenol A exposure with premature ovarian insufficiency: a case–control study

Abstract

Background

A few epidemiological investigations and animal studies have demonstrated that bisphenol A (BPA) may affect female reproductive health. However, no epidemiologic study has investigated the relationship between BPA exposure and the risk of premature ovarian insufficiency (POI).

Methods

In this case–control study, urinary concentrations of BPA and serum levels of reproductive hormone were measured. Associations between BPA concentrations and the risk of POI and POI-related hormone levels were estimated.

Results

Among BPA quartiles, no obvious association was found between BPA levels and the risk of POI (p = 0.603). Although the adjusted odds ratio (OR) of POI was slightly increased for participants in the highest BPA concentration quartile, the association was not statistically significant (OR = 1.282, 95% confidence interval [CI] 0.615–2.049 for the highest vs. lowest quartile, p = 0.508). Although follicle stimulating hormone (FSH) and anti-Mullerian hormone (AMH) levels showed no tendency of an association with BPA (p = 0.941 and p = 0.876 for FSH and AMH, respectively), the highest quartile of luteinizing hormone was significantly positively associated with BPA levels (OR = 1.333, 95% CI 0.986–1.803, p = 0.042).

Conclusions

The urinary concentrations of BPA determined in this study were consistent with the range of exposure currently observed in Chinese women. However, BPA exposure at a relatively low level is not associated with POI in Chinese women. Further epidemiological studies are needed to confirm our findings.

摘要

背景：一些流行病学调查和动物研究表明, 双酚A（BPA）可能会影响女性生殖健康。但是, 没有流行病学研究调查过BPA暴露与早发性卵巢功能不全（POI）风险之间的关系。方法：在本病例对照研究中, 测定了尿液中的双酚A浓度和血清中的生殖激素水平。估计了BPA浓度与POI风险和POI相关激素水平之间的关联。结果：在BPA四分位数中, 未发现BPA水平与POI风险之间存在明显的关联（p=0.603）。尽管最高BPA浓度四分位数的参与者的POI调整后的优势比（OR）略有增加, 但相关性在统计学上并不显著（OR=1.282, 最高四分位数比最低四分位数的95％置信区间[CI] 0.615–2.049, p=0.508）。尽管卵泡刺激素（FSH）和抗苗勒氏管激素（AMH）的水平与BPA无关（FSH和AMH分别为p=0.941和p=0.876）, 但促黄体生成素的最高四分位数与BPA水平呈显著正相关（OR=1.333, 95％CI 0.986-1.803, p=0.042）。结论：本研究确定的尿液中双酚A的浓度与目前在中国女性中观察到的暴露范围一致。但是, 中国妇女双酚A暴露水平相对较低与POI无关。需要进一步的流行病学研究来证实我们的发现。

Keywords:

• Premature ovarian insufficiency
• bisphenol A
• reproductive hormones
• female reproductive health
• women

Acknowledgements

The authors thank the acquisition and recruitment team: Jiehong Zheng (Maternal and Child Health Care and Family Planning Service Centre of Jiangbei District of Ningbo City), Lianhong Zhu (Tongxiang First People’s Hospital), Dan Xu (Anji Maternal and Child Health Care Hospital), Jianfang Chen (Maternal and Child Health Care Hospital of Xiuzhou District of Jiaxing City), Hong Xu (Tongxiang Maternal and Child Health Care Hospital), JieRu Yang (Zhuji Center Hospital), Wenxian Xu and Jiahuan Huang (Women’s Hospital, School of Medicine, Zhejiang University), and Shun Xu (Quzhou Maternal and Child Health Care Hospital).

Potential conflict of interest

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by National Natural Science Foundation of China [Grant number 21876151], [Grant number 81703236], [Grant number 81873810]; Program for Zhejiang Province Medicine and Health Technology Projects [Grant number 2018KY437], [Grant number WKJ-ZJ-1621]; Chinese Medicine Research Program of Zhejiang Province [Grant number 2018ZA078].