纽约大学医学院Leonardo Trasande博士对近3000名体内高浓度尿双酚A(BPA)的儿童和青少年的代表性样本的实验显示，体内高水平BPA与儿童及青少年肥胖有关其有显着的关联，该研究结果在线发表于JAMA杂志。
双酚A，在工业上被用来合成聚碳酸酯(PC)和环氧树脂等材料。20世纪60年代以来就被用于制造塑料(奶)瓶、幼儿用的吸口杯、食品和饮料(奶粉)罐内侧涂层。BPA无处不在，从矿泉水瓶、医疗器械到及食品包装的内里，都有它的身影。
每年，全世界生产2700万吨含有BPA的塑料。但BPA也能导致内分泌失调，威胁着胎儿和儿童的健康。心血管疾病、乳腺癌、前列腺癌、脑神经失调、糖尿病和不孕不育症也被认为与此有关。
在美国人口中，接触到BPA的可能几乎是无处不在，2003 - 2004年美国国家健康与营养检验调查(National Health and Nutrition Examination Survey ，NHANES)中，92.6%的六岁或以上人尿液中有可监测到BPA。另一项综合性的研究调查了灰尘、室内和室外空气、学龄前儿童的食物等，发现99%的BPA来源于食物。此研究还发现，BPA可扰乱多种代谢机制，可能与体重增加有关，但尚缺乏证据。
Trasande博士及其同事进行了一项研究，研究尿中BPA浓度与儿童体重之间的关系。共有3000个年龄在6-19岁的儿童和青少年参与，研究人员测定他们尿液中的BPA和体重，随机挑选2003 - 2008年期间NHANES测量尿中含双酚A的成员。用体重指数(BMI)评价参与者肥胖情况，BMI≥85%为超重，≥90%肥胖 。研究参与者的尿BPA浓度中位数为2.8毫微克/毫升。肥胖的患病率为17.8%(590例)，超重人数百分比是34.1%(1047例)。根据BPA浓度，参加者被分为四组。在均衡种族、年龄、抚养者的教育程度、贫困比率，性别，血清中可替宁水平、热量摄入、看电视的情况以及尿肌酐水平等因素后，尿中BPA水平最低组孩子的肥胖患病率最低(10.3%)，其他组分别为20.1%、19%、22.3%。与第一组相比，第三组和第四组参与者的肥胖发生率分别增加2倍和2.6倍 。
此项研究的领导者Leonardo Trasande说，这是首次发现环境中的化学物与儿童和青少年肥胖有关。由此可见，导致肥胖的不仅仅是不健康的饮食和缺乏运动。
研究人员指出， BPA的问题一直被关注。最近食品和药物管理局已禁止BPA用于婴儿奶粉 。去年，美国食品和药物管理局拒绝禁止BPA在铝罐及其他食品包装中的使用，宣称应采取合理的步骤减少BPA的应用，并继续收集化学物质安全性方面的证据。但是目前似乎没有必要再考虑这种化学物的安全性。
Association Between Urinary Bisphenol A Concentration and Obesity Prevalence in Children and Adolescents
Leonardo Trasande, MD, MPP; Teresa M. Attina, MD, PhD, MPH; Jan Blustein, MD, PhD
Context Bisphenol A (BPA), a manufactured chemical, is found in canned food, polycarbonate-bottled liquids, and other consumer products. In adults, elevated urinary BPA concentrations are associated with obesity and incident coronary artery disease. BPA exposure is plausibly linked to childhood obesity, but evidence is lacking to date.
Objective To examine associations between urinary BPA concentration and body mass outcomes in children.
Design, Setting, and Participants Cross-sectional analysis of a nationally representative subsample of 2838 participants aged 6 through 19 years randomly selected for measurement of urinary BPA concentration in the 2003-2008 National Health and Nutrition Examination Surveys.
Main Outcome Measures Body mass index (BMI), converted to sex- and age-standardized z scores and used to classify participants as overweight (BMI ≥85th percentile for age/sex) or obese (BMI ≥95th percentile).
Results Median urinary BPA concentration was 2.8 ng/mL (interquartile range, 1.5-5.6). Of the participants, 1047 (34.1% [SE, 1.5%]) were overweight and 590 (17.8% [SE, 1.3%]) were obese. Controlling for race/ethnicity, age, caregiver education, poverty to income ratio, sex, serum cotinine level, caloric intake, television watching, and urinary creatinine level, children in the lowest urinary BPA quartile had a lower estimated prevalence of obesity (10.3% [95% CI, 7.5%-13.1%]) than those in quartiles 2 (20.1% [95% CI, 14.5%-25.6%]), 3 (19.0% [95% CI, 13.7%-24.2%]), and 4 (22.3% [95% CI, 16.6%-27.9%]). Similar patterns of association were found in multivariable analyses examining the association between quartiled urinary BPA concentration and BMI z score and in analyses that examined the logarithm of urinary BPA concentration and the prevalence of obesity. Obesity was not associated with exposure to other environmental phenols commonly used in other consumer products, such as sunscreens and soaps. In stratified analysis, significant associations between urinary BPA concentrations and obesity were found among whites (P < .001) but not among blacks or Hispanics.
Conclusions Urinary BPA concentration was significantly associated with obesity in this cross-sectional study of children and adolescents. Explanations of the association cannot rule out the possibility that obese children ingest food with higher BPA content or have greater adipose stores of BPA.
