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Bisphenol A (BPA) is a high volume production chemical used in the manufacture of polycarbonate plastics and epoxy resins. Recent experimental studies have suggested that BPA affects glucose metabolism through diverse mechanisms including insulin resistance, pancreatic β-cell dysfunction, adipogenesis, inflammation and oxidative stress. Prediabetes is a stage earlier in the hyperglycemia continuum associated with increased future risk of developing diabetes. Therefore, we examined the association between BPA exposure and prediabetes among subjects free of diabetes. We examined the association between urinary BPA levels and prediabetes in 3,516 subjects from the National Health and Nutritional Examination Survey 2003-2008. Urinary BPA levels were examined in tertiles. Prediabetes was defined as fasting glucose concentration 100-125 mg/dL or 2-h glucose concentration of 140-199 mg/dL or an A1C value of 5.7-6.4 %. Overall, we observed a positive association between higher levels of urinary BPA and prediabetes, independent of potential confounders including body mass index, alcohol intake, blood pressure and serum cholesterol levels. Compared to tertile 1 (referent), the multivariate-adjusted odds ratio (95 % confidence interval) of prediabetes associated with tertile 3 of BPA was 1.34 (1.03-1.73), p-trend = 0.02. In subgroup analysis, this association was stronger among women and obese subjects. Higher urinary BPA levels are found to be associated with prediabetes independent of traditional diabetes risk factors. Future prospective studies are needed to confirm or disprove this finding.

Background: Bisphenol A (BPA) is a common chemical used in the manufacture of polycarbonate plastics and epoxy resins, and > 93% of U.S. adults have detectable levels of urinary BPA. Recent animal studies have suggested that BPA exposure may have a role in several mechanisms involved in the development of cardiovascular disease (CVD), including weight gain, insulin resistance, thyroid dysfunction, endothelial dysfunction, and oxidative stress. However, few human studies have examined the association between markers of BPA exposure and CVD. Peripheral arterial disease (PAD) is a subclinical measure of atherosclerotic vascular disease and a strong independent risk factor for CVD and mortality., Objective: We examined the association between urinary BPA levels and PAD in a nationally representative sample of U.S. adults., Methods: We analyzed data from 745 participants in the National Health and Nutritional Examination Survey 2003-2004. We estimated associations between urinary BPA levels (in tertiles) and PAD (ankle-brachial index < 0.9, n = 63) using logistic regression models adjusted for potential confounders (age, sex, race/ethnicity, education, smoking, body mass index, diabetes mellitus, hypertension, urinary creatinine, estimated glomerular filtration rate, and serum cholesterol levels)., Results: We observed a significant, positive association between increasing levels of urinary BPA and PAD before and after adjusting for confounders. The multivariable-adjusted odds ratio for PAD associated with the highest versus lowest tertile of urinary BPA was 2.69 (95% confidence interval: 1.02, 7.09; p-trend = 0.01)., Conclusions: Urinary BPA levels were significantly associated with PAD, independent of traditional CVD risk factors.

Background: Bisphenol A (BPA) is a common chemical used in the manufacture of polycarbonate plastics and epoxy resins, with >93% of US adults having detectable BPA levels in urine. Recent animal studies have suggested that BPA exposure may have a role in several mechanisms involved in the development of hypertension, including weight gain, insulin resistance, thyroid dysfunction, endothelial dysfunction, and oxidative stress. However, no previous human study has examined the association between markers of BPA exposure and hypertension., Methods: We examined urinary BPA levels in 1380 subjects from the National Health and Nutritional Examination Survey 2003-2004. Main outcome-of-interest was hypertension, defined as blood pressure-reducing medication use and/or blood pressures >140/90 mm of Hg (n = 580)., Results: We observed a positive association between increasing levels of urinary BPA and hypertension independent of confounding factors such as age, gender, race/ethnicity, smoking, body mass index (BMI), diabetes mellitus and total serum cholesterol levels. Compared to tertile 1 (referent), the multivariate-adjusted odds ratio (95% confidence interval) of hypertension associated with tertile 3 was 1.50 (1.12-2.00); P-trend = 0.007. The association was consistently present in subgroup analyses by race/ethnicity, smoking status, BMI, and diabetes mellitus., Conclusions: Urinary BPA levels are associated with hypertension, independent of traditional risk factors.

High cystatin C levels among patients without clinically recognized chronic kidney disease (CKD) may identify patients who are at preclinical stages of CKD. Higher body mass index (BMI) has been found to be associated with increased risk of CKD. However, the association between BMI and high cystatin C levels is not clear. The authors examined participants older than 20 years from the National Health and Nutrition Examination Survey 1999 to 2002 (N=2583, 50.2% women). BMI was categorized as <25 kg/m(2), 25-29.9 kg/m(2), and ≥30 kg/m(2) . Main outcome was high cystatin C (>1 mg/dL) among patients without clinically recognized CKD (estimated glomerular filtration rate <60 mL/min/1.73 m(2) or microalbuminuria). Higher BMI was positively associated with high cystatin C, independent of age, sex, race-ethnicity, education, smoking, alcohol intake, cholesterol, and C-reactive protein levels. Compared with patients with BMI <25 kg/m(2) (referent), the multivariable odds ratio (95% confidence interval) of high cystatin C was 2.53 (1.79-3.58) (P trend <.0001 among patients with BMI ≥30 kg/m(2)). The association between BMI and high cystatin C persisted in subgroup analyses by sex, race-ethnicity, and among those without diabetes or hypertension. Among US adults without clinically recognized CKD, higher BMI levels were independently associated with high cystatin C levels., (© 2011 Wiley Periodicals, Inc.)

Previous animal studies have suggested that mild reductions in renal function, even before the development of clinically recognized chronic kidney disease (CKD), are associated with hypertension. However, few studies have examined this hypothesis in humans. We therefore examined the association between serum cystatin C levels and hypertension among subjects without clinically recognized CKD in a large multiethnic sample of US adults. We examined the National Health and Nutrition Examination Survey 1999-2002 participants >20 years of age (n = 2583, 54.5% women) without clinically recognized CKD (defined as an estimated glomerular filtration rate <60 mL/min/1.73 m(2) or microalbuminuria). Serum cystatin C levels were categorized into quartiles (<0.76 mg/L, 0.76-0.86 mg/L, 0.87-0.97 mg/L, and >0.97 mg/L). Hypertension was defined as blood pressure (BP)-reducing medication use or having systolic BP ≥ 140 mm Hg and/or diastolic BP ≥ 90 mm Hg. Higher serum cystatin C levels were found to be associated with hypertension in women, but not men. After adjusting for age, race-ethnicity, education, smoking, alcohol intake, body mass index, diabetes, total cholesterol and C-reactive protein, the odds ratio (95% confidence interval) of hypertension comparing quartile 4 of cystatin C to quartile 1 (referent) was 2.04 (1.13-3.69); P trend = .02 in women and 0.86 (0.53-1.41); P trend = .51 in men. In a representative sample of US adults, mild reductions in kidney function as measured by higher serum cystatin C levels among subjects without clinically recognized CKD are associated with hypertension in women, but not men., (Copyright © 2011 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.)

Objective: Serum insulin-like growth factor (IGF)-1 may have a role in the maintenance of glucose homeostasis. We examined the association between serum IGF-1 and diabetes in a representative sample of U.S. adults., Research Design and Methods: Third National Health and Nutrition Examination Survey (NHANES III) participants aged ≥ 18 years (n = 5,511) were the subjects of the study. The main outcome was the presence of diabetes (n = 387)., Results: Lower serum IGF-1 levels were positively associated with diabetes after adjusting for age, sex, race/ethnicity, education, smoking, alcohol intake, BMI, hypertension, glomerular filtration rate, and serum cholesterol. Compared with quartile 4 of IGF-1 (referent), the odds ratio (OR) of diabetes associated with quartile 1 was OR 2.16 (95% CI 1.24-3.76); P-trend = 0.002. However, the observed association between IGF-1 and diabetes was present only in those < 65 years of age (OR = 3.05; P-trend = 0.006) and disappeared in those ≥ 65 years of age (OR = 0.51; P-trend = 0.18); P-interaction = 0.0056., Conclusions: Low IGF-1 levels are associated with diabetes among young subjects.

Background: Insulin-like growth factor (IGF-1) has been associated with cardiovascular disease, hypertension and diabetes in previous studies. However, the association between IGF-1 and chronic kidney disease (CKD) has not been previously studied. Therefore, we examined the association between serum IGF-1 and CKD in a representative sample of US adults., Methods: We conducted a cross-sectional study of 5388 Third National Health and Nutrition Examination Survey (NHANES III) participants aged ≥20 years of age (55.2% women). Serum IGF-1 was categorized into quartiles for the analysis. CKD (n = 241) was defined as an estimated glomerular filtration rate of <60 mL/min/1.73/m(2)., Results and Conclusion: Higher serum IGF-1 levels were positively associated with CKD after adjusting for age, sex, race/ethnicity, education levels, smoking, alcohol intake, body mass index, diabetes, hypertension and serum cholesterol. Compared to quartile 1 of IGF-1 (referent), the odds ratio (95% confidence interval) of CKD associated with quartile 4 was 2.66 (1.18-5.99); p trend = 0.008. Subgroup analysis that examined the relation between IGF-1 and CKD by gender showed a consistent positive association. In summary, increasing levels of serum IGF-1 were positively associated with CKD in a representative sample of US adults. Our results suggest that IGF-1 might be a predictor of CKD in Western populations.

Previous studies analyzing acculturation and cardiovascular risk were restricted to individual race/ethnic groups and did not fully account for potential confounders. We examined the independent association between acculturation and hypertension in a contemporary multiethnic sample that included white, black, Latino, and Asian individuals. We examined 51,048 participants in the 2007 California Health Interview Survey who were >18 years, 59.5% of whom were women. The main exposure-of-interest was acculturation score, a summary measure of the additive effect of 4 variables (country of birth, parents' country of birth, language at home, and duration of stay in the United States) ranged from 0 (least acculturation) to 4 (highest acculturation). We found that increased acculturation was associated with hypertension, independent of age, gender, race/ethnicity, education, smoking, alcohol, physical activity, body mass index, and diabetes. Compared with those with the lowest acculturation (score of 0), the multivariable odds ratio (95% confidence interval) of hypertension among those with the highest acculturation (score of 4) was 1.78 (1.50-2.11). This association between acculturation and hypertension was consistent in subgroup analyses by gender, education, smoking, alcohol intake, and body mass index. Increased Western acculturation was found to be positively associated with hypertension in a multiethnic sample, independent of confounders., (Copyright © 2010 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.)

Background/aim: Serum gamma-glutamyltransferase (GGT), a biomarker of oxidative stress, is associated with an increased risk of diabetes and hypertension. However, it is not known whether higher serum GGT is independently associated with chronic kidney disease (CKD). Therefore, we examined the association between serum GGT levels and CKD in a representative sample of US adults., Methods: We conducted a cross-sectional study of 9,516 National Health and Nutrition Examination Survey 1999-2002 participants >or=18 years of age (52.40% women). Serum GGT was categorized into quartiles for the analysis. CKD (n = 622) was defined as an estimated glomerular filtration rate of <60 ml/min/1.73 m(2)., Results and Conclusion: Higher serum GGT levels were not associated with CKD after adjusting for age, sex, race/ethnicity, education levels, smoking, alcohol intake, body mass index (BMI), diabetes, hypertension and serum cholesterol. Compared to quartile 1 of GGT, the odds ratio (95% confidence interval) of CKD associated with quartile 4 was 1.02 (0.81-1.28); p trend = 0.377. Subgroup analyses that examined the relation between GGT and CKD by gender, alcohol intake, and BMI categories also showed a consistent null association. In summary, there was no association between increasing levels of serum GGT and CKD in a sample of US adults., (Copyright 2010 S. Karger AG, Basel.)