Exposure to bisphenols and phthalates and association with oxidant stress, insulin resistance, and endothelial dysfunction in children

Pediatr Res. 2017 Jun;81(6):857-864. doi: 10.1038/pr.2017.16. Epub 2017 Jan 18.


Background: The health effects of bisphenol A (BPA) and di-(2-ethylhexyl) phthalate (DEHP) have been studied extensively in children. The impact of other chemicals in these two classes has not been investigated as fully.

Methods: We conducted a cross-sectional pilot study of 10-13 y old healthy children. We assessed descriptive, univariable, and multivariable associations of urinary metabolites of bisphenols and phthalates with oxidant stress, insulin resistance, body mass, and endothelial dysfunction. Possible associations with brachial artery distensibility, pulse wave velocity (markers of vascular stiffness), and serum endothelial cell-derived microparticle levels were also assessed.

Results: We enrolled 41 participants, 12.1 ± 1.0 y, most of whom were Mexican Americans (42%) or other Hispanics (34%). Increased BPA levels were associated with increased levels of F2-isoprostane (ng/ml) (P = 0.02), with a similar trend for DEHP metabolites. Each log unit increase of high molecular weight (HMW) phthalate metabolites was associated with a 0.550 increase in Homeostatic Model Assessment of insulin resistance (HOMA-IR) units (P = 0.019) and altered circulating levels of activated endothelial cell-derived microparticles (% per ml) (P = 0.026). Bisphenol S (BPS), a replacement for BPA, was associated with increased albumin (mg):creatinine (g) ratio (P = 0.04). Metabolites of HMW phthalates were also associated with decreased brachial artery distensibility (P = 0.047).

Conclusion: Exposure to bisphenols and phthalates, including a BPA replacement, is associated with increased oxidant stress, insulin resistance, albuminuria, as well as disturbances in vascular function in healthy children.

MeSH terms

  • Adolescent
  • Benzhydryl Compounds / toxicity*
  • Child
  • Cross-Sectional Studies
  • Diethylhexyl Phthalate / toxicity*
  • Endothelium, Vascular / drug effects*
  • Endothelium, Vascular / physiopathology
  • Female
  • Humans
  • Insulin Resistance*
  • Male
  • Oxidative Stress / drug effects*
  • Phenols / toxicity*
  • Pilot Projects


  • Benzhydryl Compounds
  • Phenols
  • Diethylhexyl Phthalate
  • bisphenol A