Bisphenol A in the Urine: Association with Urinary Creatinine, Impaired Kidney Function, Use of Plastic Food and Beverage Storage Products but Not with Serum Anti-Müllerian Hormone in Ovarian Malignancies

Abstract

Bisphenol A (BPA) is a high-production-volume industrial chemical and component of commonly used plastic products. However, it is also an endocrine-disrupting chemical that can negatively affect human health. It is not yet known whether it is associated with the development of epithelial ovarian cancer (EOC), a severe and highly fatal human disease. Therefore, the purpose of this study was to determine the concentrations of BPA in the urine of women with EOC or epithelial borderline ovarian tumors (EBOTs) using gas chromatography tandem mass spectrometry (GC-MS/MS) and find their possible associations with kidney function at the molecular level, urine and blood biochemical parameters related to metabolism, anti-Müllerian hormone (AMH) (a marker of ovarian reserve/fertility), and lifestyle habits determined via a questionnaire in comparison to healthy controls. The results suggest that the unadjusted or urine-specific-gravity-adjusted BPA levels were significantly increased in women with EOC/EBOT. The unadjusted BPA was significantly positively associated with urinary creatinine (p = 0.007) in all women with EOC/EBOT after adjustment for age, body mass index, and pregnancy using multiple linear regression analysis. This may be related to kidney injury. However, no association was found between urinary BPA and serum AMH levels in women. Women with ovarian malignancies were more exposed to plastic products for storing foods and drinks. Some lifestyle habits, including refilling plastic bottles, correlate with higher urinary BPA levels across the entire cohort of women. When considering EOC or EBOT, it is necessary to consider the potential higher exposure of women to BPA, as reflected in their urine and lifestyle habits.

Keywords: anti-Müllerian hormone; bisphenol A; borderline ovarian tumor; female exposure; kidney function; lifestyle habits; ovarian cancer; thrombocytes; urine.

Figure 1

Urine biochemical parameters related to kidney function according to total urinary BPA levels (µg/L) in women in the control group (controls), EOC/EBOT group 1 (OC-young), and EOC/EBOT group 2 (OC-older). (a) Urine specific gravity (USG), (b) U-creatinine (mmol/L), and (c) the U-NAG/creatinine ratio (μkat/mol) (Shapiro–Wilk test followed by Mann–Whitney test, p < 0.05). The multiple linear regression analysis of the association between BPA and urinary creatinine or the NAG/creatinine ratio, adjusted for age, BMI, and pregnancy status, showed that log-transformed unadjusted BPA values were significantly associated with urinary creatinine only.

Figure 2

Blood biochemical parameters related to total urinary BPA levels (µg/L) for control group (controls), EOC/EBOT group 1 (OC-young), and EOC/EBOT group 2 (OC-older) women. (a) Triglycerides (mmol/L) and (b) the mean platelet volume (MPV) (fL) (Shapiro–Wilk test followed by Mann–Whitney test, p < 0.05). However, the multiple linear regression analysis of the association between BPA and MPV or triglycerides, adjusted for age, BMI, and pregnancy status, showed that log-transformed unadjusted or USG-adjusted BPA concentrations were not significantly associated with MPV or blood triglycerides in women.