Bisphenol A is not associated with a 5-year incidence of type 2 diabetes: a prospective nested case-control study

Acta Diabetol. 2018 Apr;55(4):369-375. doi: 10.1007/s00592-018-1104-4. Epub 2018 Jan 31.


Aims: The relationship between bisphenol A (BPA) and diabetes remains controversial. This study aims to investigate whether serum BPA level could predict the 5-year incidence of type 2 diabetes (T2D).

Methods: A nested case-control study was performed among Chinese who participated in the environment, inflammation and metabolic diseases study (2008-2013). Of the 3510 subjects who were free of diabetes, 232 subjects developed diabetes during the 5-year follow-up. Cases and controls were matched for age and gender by a ratio of 1:1. Homoeostasis model assessment was used to estimate basal β-cell function (HOMA-β) and insulin resistance (HOMA-IR). Participants were stratified into tertiles based on low, median and high baseline serum BPA levels. Regression models were used to analyze the relationship between serum BPA concentration and the incidence of T2D.

Results: At baseline, no significant difference in serum BPA concentration was observed between patients with T2D and controls [1.3 (0.3, 3.7) vs. 1.6 (0.4, 3.9) μmol/L, P = 0.199]; serum BPA concentration was positively associated with fasting plasma glucose (r = 0.27, P < 0.001); however, neither HOMA-β nor HOMA-IR correlated with serum BPA concentration. During the follow-up, baseline BPA levels could not predict the 5-year T2D incidence, whether or not adjusted for the potential confounders such as body mass index and blood pressure. [Low BPA tertile was the reference, OR 0.66 (95% CI 0.30, 1.44) for median, OR 0.93 (95% CI 0.41, 2.13) for high.] CONCLUSION: BPA is not associated with a 5-year T2D incidence. These data do not support previous cross-sectional study that BPA exerted a detrimental effect on glucose metabolism.

Keywords: Bisphenol A; Prospective study; Risk; Type 2 diabetes.

MeSH terms

  • Aged
  • Benzhydryl Compounds / blood*
  • Blood Glucose / metabolism
  • Body Mass Index
  • Case-Control Studies
  • China / epidemiology
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Insulin Resistance
  • Male
  • Middle Aged
  • Phenols / blood*
  • Prognosis


  • Benzhydryl Compounds
  • Blood Glucose
  • Phenols
  • bisphenol A