Original Article

The Association Between Bisphenol A and Polycystic Ovarian Syndrome: A Case-Control Study

Abstract

Polycystic ovarian syndrome (PCOS) is an endocrine metabolic disorder with unclear etiopathogenesis among reproductive age women. Evidences show genetic susceptibility and environmental factors were associated with PCOS. The aim of this study was to find the association between urinary concentrations of Bisphenol-A as an endocrine disrupting chemical (EDC) and PCOS. A case-control study was conducted in 51 samples in each group. All cases were selected from women who diagnosed with PCOS at Gynecology and infertility center. The control group was selected from women who had clinical file in the center due to previous problem and came for routine check-up and pap smear. The participants were asked to collect a first-morning urine sample before any medical interventions. Total BPA in urine were measured with High Performance Liquid Chromatography (HPLC) method. Comparison of BPA level between two groups shows significantly higher level in PCOS group compared with control group (3.34 ± 2.63 vs 1.43 ± 1.57 ng/mL, P-value <0.001). Using logistic regression analysis, BPA as the main dependent variable, was significantly associated with PCOS with adjusted Odds Ratio (OR) equal to 1.53 (95% CI: 1.14-2.05, P-value =0.004). The results of this study indicated that BPA may play a major role in the PCOS pathogenesis. Further investigations with better design are necessary to confirm this association.

Tehrani FR, Simbar M, Tohidi M, Hosseinpanah F, Azizi F. The prevalence of polycystic ovary syndrome in a community sample of Iranian population: Iranian PCOS prevalence study. Reprod Biol Endocrinol 2011;9:39.

Brassard M, AinMelk Y, Baillargeon J-P. Basic infertility including polycystic ovary syndrome. Med Clin North Am 2008;92:1163-92.

Wild RA. Long-term health consequences of PCOS. Hum Reprod Update 2002;8:231-41.

ESHRE TR, Group A-SPCW. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004;81:19-25.

Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocr Rev 2012;33:981-1030.

de Melo AS, Dias SV, de CarvalhoCavalli R, Cardoso VC, Bettiol H, Barbieri MA, et al. Pathogenesis of polycystic ovary syndrome: multifactorial assessment from the foetal stage to menopause. Reproduction 2015;150:R11-R24.

Colborn T, VomSaal FS, Soto AM. Developmental effects of endocrine-disrupting chemicals in wildlife and humans. Environ Health Perspect 1993;101:378-84.

Rubin BS. Bisphenol A: an endocrine disruptor with widespread exposure and multiple effects. J Steroid Biochem Mol Biol 2011;127:27-34.

Crews D, McLachlan JA. Epigenetics, evolution, endocrine disruption, health, and disease. Endocrinology 2006;147:s4-10.

Takeuchi T, Tsutsumi O, Ikezuki Y, Kamei Y, Osuga Y, Fujiwara T, et al. Elevated serum bisphenol A levels under hyperandrogenic conditions may be caused by decreased UDP-glucuronosyltransferase activity. Endocr J 2006;53:485-91.

Quesada I, Fuentes E, Viso-León MC, Soria B, Ripoll C, Nadal A. Low doses of the endocrine disruptor bisphenol-A and the native hormone 17β-estradiol rapidly activate transcription factor CREB. FASEB J 2002;16:1671-3.

Rutkowska A, Rachoń D. BisphenolA (BPA) and its potential role in the pathogenesis of the polycystic ovary syndrome (PCOS). Gynecol Endocrinol 2014;30:260-5.

Zhou W, Liu J, Liao L, Han S, Liu J. Effect of bisphenol A on steroid hormone production in rat ovarian theca-interstitial and granulosa cells. Mol Cell Endocrinol 2008;283:12-8.

Déchaud H, Ravard C, Claustrat F, de la Perrière AB, Pugeat M. Xenoestrogen interaction with human sex hormone-binding globulin (hSHBG) 1. Steroids 1999;64:328-34.

Wang T, Li M, Chen B, Xu M, Xu Y, Huang Y, et al. Urinary bisphenol A (BPA) concentration associates with obesity and insulin resistance. J Clin Endocrinol Metab 2011;97:E223-7.

Jayashree S, Indumathi D, Akilavalli N, Sathish S, Selvaraj J, Balasubramanian K. Effect of Bisphenol-A on insulin signal transduction and glucose oxidation in liver of adult male albino rat. Environ Toxicol Pharmacol 2013;35:300-10.

Fernández M, Bourguignon N, Lux-Lantos V, Libertun C. Neonatal exposure to bisphenol a and reproductive and endocrine alterations resembling the polycystic ovarian syndrome in adult rats. Environ Health Perspect 2010;118:1217-22.

Takeuchi T, Tsutsumi O, Ikezuki Y, Takai Y, Taketani Y. Positive relationship between androgen and the endocrine disruptor, bisphenol A, in normal women and women with ovarian dysfunction. Endocr J 2004;51:165-9.

Kandaraki E, Chatzigeorgiou A, Livadas S, Palioura E, Economou F, Koutsilieris M, et al. Endocrine disruptors and polycystic ovary syndrome (PCOS): elevated serum levels of bisphenolA in women with PCOS. J Clin Endocrinol Metab 2010;96:E480-4.

Tsutsumi O. Assessment of human contamination of estrogenic endocrine-disrupting chemicals and their risk

for human reproduction. J Steroid Biochem Mol Biol 2005;93:325-30.

Vagi SJ, Azziz-Baumgartner E, Sjödin A, Calafat AM, Dumesic D, Gonzalez L, et al. Exploring the potential association between brominated diphenyl ethers, polychlorinated biphenyls, organochlorine pesticides, perfluorinated compounds, phthalates, and bisphenol a in polycystic ovary syndrome: a case–control study. BMC Endocr Disord 2014;14:86.

Yang M, Kim S-Y, Lee S-M, Chang S-S, Kawamoto T, Jang J-Y, et al. Biological monitoring of bisphenol A in a Korean population. Arch Environ Contam Toxicol 2003;44:0546-51.

He Y, Miao M, Herrinton LJ, Wu C, Yuan W, Zhou Z, et al. Bisphenol A levels in blood and urine in a Chinese population and the personal factors affecting the levels. Environ Res 2009;109:629-33.

Akın L, Kendirci M, Narin F, Kurtoglu S, Saraymen R, Kondolot M, et al. The endocrine disruptor bisphenol A may play a role in the aetiopathogenesis of polycystic ovary syndrome in adolescent girls. Acta Paediatr 2015;104:e171-e7.

Ye X, Kuklenyik Z, Needham LL, Calafat AM. Automated on-line column-switching HPLC-MS/MS method with peak focusing for the determination of nine environmental phenols in urine. Anal Chem 2005;77:5407-13.

Völkel W, Colnot T, Csanády GA, Filser JG, Dekant W. Metabolism and kinetics of bisphenol A in humans at low doses following oral administration. Chem Res Toxicol 2002;15:1281-7.

Cooper GS, Klebanoff MA, Promislow J, Brock JW, Longnecker MP. Polychlorinated biphenyls and menstrual cycle characteristics. Epidemiology 2005;16:191-200.

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IssueVol 55, No 12 (2017) QRcode
SectionOriginal Article(s)
Keywords
Polycystic ovarian syndrome Bisphenol A Case-control study HPLC

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How to Cite
1.
Hossein Rashidi B, Amanlou M, Behrouzi Lak T, Ghazizadeh M, Haghollahi F, Bagheri M, Eslami B. The Association Between Bisphenol A and Polycystic Ovarian Syndrome: A Case-Control Study. Acta Med Iran. 2018;55(12):759-764.