血清双酚A浓度与高血压发生风险的关联OA北大核心CSTPCD

[Background]Previous studies have shown that bisphenol A exposure is associated with the risk of hypertension;however,most of them are cross-sectional and the conclusions are not consis-tent. [Objective]To evaluate the association between bisphenol A exposure and the incident risk of hypertension. [Methods]Based on a nested case-control design involving 1990 subjects derived from the Dongfeng-Tongji cohort,a total of 1080 subjects were included in this study after excluding 887 hypertensive cases at baseline and 23 subjects with missing blood pressure data in follow-up vis-its.Epidemiological information was collected through questionnaire survey,and serum bisphenol A concentration was detected by high performance liquid chromatography tandem mass spec-trometry.Logistic regression model was used to analyze the potential association between serum bisphenol A level and the risk of hypertension incidence,and linear regression model was used to analyze the association between serum bisphenol A level and blood pressure changes between baseline and follow-up. [Results]The average age of the 1 080 participants was(62.03±7.45)years,of which 41.1%were male.During the follow-up period,a total of 477(44.2%)developed hypertension.The median serum concentration of bisphenol A in the total population was 3.15 μg·L-1,and the baseline bisphenol A concentration in the new case group(3.24 μg·L-1)was higher than that in the control group(2.98 μg·L-1)(P<0.05).After adjustment for selected covariates,the risk of hypertension increased by 12%(OR=1.12,95%CI:1.02,1.22)for each unit increase in naturally log-transformed bisphenol A;the systolic blood pressure and diastolic blood pressure increased by 1.88(95%CI:1.08,2.69)mmHg and 1.14(95%CI:0.68,1.61)mmHg,respectively.Compared with the low bisphenol A tertile group,the risk of hypertension in the middle tertile and high tertile groups increased by 39%(OR=1.39,95%CI:1.01,1.91)and 40%(OR=1.40,95%CI:1.02,1.93)respectively;the systolic blood pressure increased by 5.91(95%CI:3.06,8.76)mmHg and 5.71(95%CI:2.82,8.59)mmHg,and the diastolic blood pressure increased by 3.09(95%CI:3.06,8.59)mmHg and 2.89(95%CI:1.22,4.57)mmHg,respectively(Ptrend<0.001).A positive association between serum bisphenol A level and hypertension was found among those who were female,never/former smokers,never/former drinkers,without family history of hypertension,with physical exercise,and with prehypertension at baseline(Ptrend<0.05).There was no interaction between selected stratified variables and bisphenol A levels on hypertension(Pinteraction>0.05). [Conclusion]Bisphenol A exposure is positively associated with the risk of hypertension.