Association Between Urinary Bisphenols and Body Composition Among American Adults: Cross-Sectional National Health and Nutrition Examination Survey Study (Preprint)

Bisphenol A (BPA), bisphenol S (BPS), and bisphenol F (BPF) are widely used in various consumer products. They are environmental contaminants with estrogenic properties that have been linked to various health outcomes. Understanding their impact on body composition is crucial for identifying potential health risks and developing preventive strategies. However, most current studies have only focused on their relationship with BMI. This study aimed to investigate the association between urinary levels of BPA, BPS, and BPF and body composition, including BMI, lean mass, and fat mass, in a large population-based sample. We conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey 2003-2016. Body composition data were assessed using dual-energy X-ray absorptiometry, which provided precise measurements of lean mass, fat mass, and other indicators. We used multivariate linear regression models to estimate the associations, adjusting for potential confounders such as age, gender, race, socioeconomic factors, and lifestyle variables. The results revealed significant associations between bisphenol exposure and body composition. After adjusting for covariates, BPS showed a positive association with BMI, with quartiles 3 and 4 having 0.91 (95% CI 0.34-1.48) and 1.15 (95% CI 0.55-1.74) higher BMI, respectively, compared with quartile 1 (<i>P</i>&lt;.001). BPA was negatively associated with total lean mass (TLM) and appendicular lean mass, with quartiles 2, 3, and 4 having –7.85 (95% CI –11.44 to –4.25), –12.33 (95% CI –16.12 to –8.54), and –11.08 (95% CI –15.16 to –7.01) lower TLM, respectively, compared with quartile 1 (<i>P</i>&lt;.001). BPS was negatively associated with TLM, with quartiles 3 (β=–10.53, 95% CI –16.98 to –4.08) and 4 (β=–11.14, 95% CI –17.83 to –4.45) having significantly lower TLM (<i>P</i>=.005). Both BPA and BPS showed a positive dose-response relationship with trunk fat (BPA: <i>P</i>=.002; BPS: <i>P</i>&lt;.001) and total fat (BPA: <i>P</i>&lt;.001; BPS: <i>P</i>=.01). No significant association was found between BPF and any body composition parameter. This large-sample study highlights the associations between urinary levels of BPA and BPS and alterations in body composition, including changes in lean mass, fat mass, and regional fat distribution. These findings underscore the importance of understanding the potential health risks associated with bisphenol exposure and emphasize the need for targeted interventions to mitigate adverse effects on body composition.