Exposure to phthalates and bisphenol A is associated with higher risk of cardiometabolic impairment in normal weight children
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Some obese individuals have normal metabolic profile, and some normal-weight persons have impaired metabolic status. Our hypothesis was that one of the potential underlying factors for such differences in cardiometabolic profiles might be the exposure to some environmental chemicals. This study aimed to investigate the association of serum bisphenol A (BPA) and phthalate metabolites with cardiometabolic risk factors in children and adolescents independent of their weight status. This case–control study was conducted on a subsample of 320 participants of a national school-based surveillance program in Iran. We measured serum BPA and phthalate metabolites by gas chromatography mass spectrophotometry. We compared them in children and adolescents with and without excess weight and those with and without cardiometabolic risk factors (80 in each group). We categorized the concentrations of chemicals to tertiles and then we applied logistic regression models after adjustment for potential confounding factors. The concentrations of BPA and some metabolites of phthalates were significantly different in the four groups studied. MEHP concentration was associated with higher odds ratio of cardiometabolic risk factors in participants with normal weight (OR, 95% CI 2.82, 1.001–7.91) and those with excess weight (OR, 95% CI 3.15, 1.27–7.83). MBP concentration increased the odds ratio of cardiometabolic risk factors only in normal weight children and adolescents (OR, 95% CI 6.59, 2.33–18.59, P < 0.001). In participants without cardiometabolic risk factor, MMP and MEHHP were significantly associated with increased risk of excess weight (OR, 95% CI 5.90, 1.21–28.75 and 7.82, 1.5–41.8, respectively). This study showed that the association of BPA and phthalate with cardiometabolic risk factors is independent of the weight status. Our findings suggest that the metabolic impairment in some normal weight children and normal metabolic profile of some obese children can be, in part, related to exposure to these environmental chemicals.
KeywordsChildren and adolescents Obesity Weight Endocrine disruptor chemicals
This study was conducted as the Elite grant of the National Institute for Medical Research Development, assigned to the corresponding author.
The National Institute for Medical Research Development in Iran funded this study (Project number: 958289).
Compliance with ethical standards
The study protocols of the main survey were reviewed and approved by ethical committees and other relevant national regulatory organizations. The Research and Ethics Committee of Isfahan University of Medical Sciences approved the main study (Project number: 194049). The current study was approved by the National Institute for Medical Research Development (Project number: 958289). After complete explanation of the study objectives and protocols, written informed and verbal consents were obtained from the parents and students, respectively.
Conflict of interest
The authors declare that they have no conflict of interest.
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