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Open AccessArticle

Association of Urinary Levels of Bisphenols A, F, and S with Endometriosis Risk: Preliminary Results of the EndEA Study

1
Instituto de Investigación Biosanitaria ibs, E-18012 Granada, Spain
2
General Surgery, San Cecilio University Hospital, E-18016 Granada, Spain
3
Gynaecology and Obstetrics Unit, ‘San Cecilio’ University Hospital, E-18016 Granada, Spain
4
Gynaecology and Obstetrics Unit, ‘Virgen de las Nieves’ University Hospital, E-18014 Granada, Spain
5
CIBER de Epidemiología y Salud Pública (CIBERESP), E-28029 Madrid, Spain
6
Radiology and Physical Medicine Department, University of Granada, E-18016 Granada, Spain
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Nuclear Medicine Unit, ‘San Cecilio’ University Hospital, E-18016 Granada, Spain
8
Digestive Medicine Unit, ‘San Cecilio’ University Hospital, E-18012 Granada, Spain
9
CIBER Enfermedades Hepáticas y Digestivas (CIBEREHD), E-28029 Madrid, Spain
*
Authors to whom correspondence should be addressed.
These authors equally contributed to this work.
Int. J. Environ. Res. Public Health 2020, 17(4), 1194; https://doi.org/10.3390/ijerph17041194
Received: 16 December 2019 / Revised: 10 February 2020 / Accepted: 11 February 2020 / Published: 13 February 2020
(This article belongs to the Special Issue Impact of Environmental Levels of Bisphenol A on Health)
Aim: The aim of this study was to explore associations of urinary concentrations of bisphenols A (BPA), S (BPS), and F (BPF) and of thiobarbituric acid reactive substances (TBARS) with the risk of endometriosis in women of childbearing age. Methods: This case–control study enrolled 124 women between January 2018 and July 2019: 35 women with endometriosis (cases) and 89 women without endometriosis undergoing abdominal surgery for other reasons (controls). Endometriosis was diagnosed (cases) or ruled out (controls) by laparoscopic inspection of the pelvis and the biopsy of suspected lesions (histological diagnosis). Fasting urine samples were collected before surgery to determine concentrations of BPA, BPS, BPF, and TBARS. Associations of bisphenol and TBARS concentrations with endometriosis risk were explored with multivariate logistic and linear regression analyses. Results: After adjustment for urinary creatinine, age, BMI, parity, and residence, endometriosis risk was increased with each 1 log unit of BPA [OR 1.5; 95%CI 1.0–2.3] and Σbisphenols [OR 1.5; 95%CI 0.9–2.3] but was not associated with the presence of BPS and BPF. Classification of the women by tertiles of exposure revealed statistically significant associations between endometriosis risk and the second tertile of exposure to BPA [OR 3.7; 95%CI 1.3–10.3] and Σbisphenols [OR 5.4; 95%CI 1.9–15.6]. In addition, TBARS concentrations showed a close-to-significant relationship with increased endometriosis risk [OR 1.6; 95%CI 1.0–2.8], and classification by TBARS concentration tertile revealed that the association between endometriosis risk and concentrations of BPA [OR 2.0; 95%CI 1.0–4.1] and Σbisphenols [OR 2.2; 95%CI 1.0–4.6] was only statistically significant for women in the highest TBARS tertile (>4.23 μM). Conclusion: Exposure to bisphenols may increase the risk of endometriosis, and oxidative stress may play a crucial role in this association. Further studies are warranted to verify these findings. View Full-Text
Keywords: bisphenol A; bisphenol F; bisphenol S; endocrine disruption; endometriosis; oxidative stress bisphenol A; bisphenol F; bisphenol S; endocrine disruption; endometriosis; oxidative stress
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Peinado, F.M.; Lendínez, I.; Sotelo, R.; Iribarne-Durán, L.M.; Fernández-Parra, J.; Vela-Soria, F.; Olea, N.; Fernández, M.F.; Freire, C.; León, J.; Pérez-Cabrera, B.; Ocón-Hernández, O.; Artacho-Cordón, F. Association of Urinary Levels of Bisphenols A, F, and S with Endometriosis Risk: Preliminary Results of the EndEA Study. Int. J. Environ. Res. Public Health 2020, 17, 1194.

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