The Association between Bisphenol A Exposure and Obesity in Children—A Systematic Review with Meta-Analysis
Department of Nursing, College of Nursing, Gachon University, 191 Hambakmoeiro, Yeonsu-gu, Incheon City 21936, Korea
Department of Preventive Medicine, College of Medicine, Korea University, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Korea
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(14), 2521; https://doi.org/10.3390/ijerph16142521
Received: 11 June 2019 / Revised: 6 July 2019 / Accepted: 11 July 2019 / Published: 15 July 2019
(This article belongs to the Special Issue Environmental Factors, Children’s Health and Safety)
Bisphenol A (BPA) is an environmental chemical that has adverse effects on health, probably causing childhood obesity. However, this association remains controversial, and it is difficult to find evidence for direct causality between environmental exposure and disease using epidemiological studies. In this study, we sought to elucidate the possible causality between BPA exposure and childhood obesity by conducting two meta-analyses showing bidirectional associations, including exposure effect by obesity and obesity risk by exposure. Articles published up to September 2017 were searched in PubMed, Embase, and Cochrane Library. We evaluated observational studies that included measurements of urinary BPA concentration and BMI or body weight. Of 436 articles, a total of 13 studies were included in the meta-analysis. Two meta-analyses were performed to investigate the association between BPA exposure and childhood obesity. The results showed that the relatively high-exposed group had a significantly higher risk of childhood obesity than the relatively low-exposed group (odds ratio = 1.566, 95% confidence interval [CI]: 1.097 to 2.234, p = 0.014). However, the obese group showed no significant difference in the BPA concentration when compared to the normal group (standardized mean difference = 0.166, 95% CI: −0.121 to 0.453, p = 0.257). This study suggested possible causality between BPA exposure and childhood obesity using data from epidemiological studies and showed that BPA exposure itself increased the risk of obesity in children.