Association between urinary environmental phenols and the prevalence of cardiovascular diseases in US adults.

Environmental phenols, as endocrine disruptors, are used widely in personal care and consumer products. However, few studies have examined the association between phenol exposure, including bisphenol A (BPA), benzophenone-3 (BP-3), and triclosan, and the prevalence of cardiovascular diseases (CVD). This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (2003-2012). Urinary BPA, BP-3, and triclosan were measured with liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). The CVD was defined as a composite of 5 self-reported cardiovascular outcomes, including congestive heart failure, coronary heart disease, angina pectoris, heart attack or stroke. Multivariable logistic regression models were used to examine the association between phenols and the prevalence of CVD. A total of 8164 participants were enrolled, and 740 (9.1%) were diagnosed of CVD. The average levels of BPA, BP-3, and triclosan concentrations were 3.38, 202.63, and 99.27 ng/mL respectively. Per 1-unit increasement in log-transformed urinary BPA was associated with increased risk of CVD after adjusting all covariates (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.01 to 1.18, P < 0.05). Compared with the lowest quartile (< 0.9), the multivariable-adjusted OR was 1.30 (1.03 to 1.65, P < 0.05) in the highest quartile (> 3.8). Restricted spline models confirmed that the association between BPA and the risk of CVD was non-linear (P = 0.045). Only BPA was associated with the risk of CVD, following a J-curve shaped relationship.