Association of urinary concentrations of bisphenols with type 2 diabetes mellitus: A case-control study

Environ Pollut. 2018 Dec;243(Pt B):1719-1726. doi: 10.1016/j.envpol.2018.09.093. Epub 2018 Sep 24.


Bisphenols, as synthetic chemicals, have been widely detected in environmental and human samples. Epidemiological studies have reported relationships between bisphenol A (BPA) and type 2 diabetes mellitus (T2DM), but results are inconsistent. Additionally, the associations between other bisphenols (i.e., the substitutes of BPA) with T2DM have been scarcely reported. A case-control study was conducted to examine the associations of urinary bisphenols with T2DM by investigating 8 bisphenols in urine samples of 251 T2DM cases and 251 controls and using different statistic models. Urinary bisphenol AF (BPAF) and bisphenol S (BPS) concentrations were significantly positively associated with T2DM in the log-transformed statistical models and adjusted odd ratios (ORs) were separately 4.95 [95% confidence interval (CI): 3.15, 7.79] and 1.73 (95% CI: 1.37, 2.18), which was consistent with the results in categorical models (OR = 2.03; 95% CI: 1.31, 3.15; p = 0.001 for BPAF; OR = 3.83; 95% CI: 2.37, 6.20; p < 0.001 for BPS). In addition, in the categorical models, elevated odds of T2DM were observed in the second BPA quartile (OR = 2.58; 95% CI: 1.38, 4.80) and the third quartile (OR = 1.89; 95% CI: 1.03, 3.46), but not in the fourth quartile, which reflected a nonlinear association between urinary BPA and T2DM. Similarly, only significant positive association with T2DM was found in the second quartile of the sum of bisphenols (OR = 2.07; 95% CI: 1.12, 3.82). In the sensitivity analyses, the associations of bisphenols with T2DM remained consistent except for BPAF in the categorical model. Our study suggested that several urinary bisphenols were positively associated with T2DM.

Keywords: Bisphenol A; Bisphenols; T2DM.

MeSH terms

  • Adult
  • Aged
  • Benzhydryl Compounds / urine*
  • Case-Control Studies
  • Diabetes Mellitus, Type 2 / chemically induced
  • Diabetes Mellitus, Type 2 / urine*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Phenols / urine*
  • Sulfones / urine*


  • Benzhydryl Compounds
  • Phenols
  • Sulfones
  • bis(4-hydroxyphenyl)sulfone
  • bisphenol A
  • 4,4'-hexafluorisopropylidene diphenol