Study On The Correlation And Influencing Factors Between Bisphenol A Exposure Behavior And Polycystic Ovary Syndrome

Objectives: 1.To compare the difference of BPA exposure behavior score and urine BPA content between PCOS Group and control group,and to analyze the correlation between BPA exposure behavior score and urine BPA content and the occurrence of PCOS.2.To explore the influencing factors of BPA exposure behavior.Methods: 1.In this study,a hospital-based case-control study was performed in a cohort of women with polycystic ovarian syndrome and controls who met the inclusion criteria and were seen at the First Affiliated Hospital of Kunming Medical University,the First People’s Hospital of Yunnan Province and the First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine between June 2022 and December 2022.A self-administered questionnaire and a self-administered Bisphenol A Exposure Behavior Scale(BPAEBS)were employed to measure the BPA exposure behavior of the target population;10 ml of urine was also collected from the target population to measure the urine BPA content.2.Statistical methods Epidata was used to construct the database,enter the data,and use SPSS 26 software for statistical analysis,with normally distributed measures described by mean ± standard deviation( ± s)and non-normally distributed measures by median(M),arithmetic mean ± standard deviation( ±s)and geometric mean(G).Spearman’s rank correlation was used to calculate the correlation between BPA exposure behavior scores and the occurrence of PCOS,while the chi-square test was used for the comparison of rates,the rank sum test was used for the comparison of non-normally distributed data,and dichotomous logistic regression analysis was used for the analysis of influencing factors,and the χ2 test and logistic regression were used to estimate and compare the strength of the association(OR and 95% CI)between urinary BPA levels and the risk of developing PCOS.A p-value less than 0.05 is statistically significant.Results: 1.A total of 194 people were investigated in the study,of whom 95 were in the PCOS group and 99 in the control group,with a mean age of 26.86±4.77 years.The difference in age between the two groups was not statistically significant(P>0.05)and was homogeneous.The BPA exposure behavior exposure rate and urine BPA level detection rate were 100% in both the PCOS and control groups.2.The score of the BPA exposure behavior scale was higher in the PCOS group than in the control group(1.750 vs.1.375),and the difference was statistically significant(Z=-8.095,P ﹤ 0.01);Spearman’s rank correlation analysis showed that the occurrence of PCOS was positively correlated with the total score of BPA exposure behavior scale and the scores of the first,third and fourth dimensions of the scale.The correlation coefficients were 0.583,0.570,0.354,and 0.547,respectively,and the differences were statistically significant.3.After adjusting for age,education,occupation,and BMI,the BPA Exposure Behavior Scale score ≤1.31 was used as the control group,and the BPA Exposure Behavior Scale score was divided into groups of 1.32-1.56 and 1.57-1.81 and >1.81.The OR(95% CI)for the occurrence of PCOS was 1.636(0.561-4.772)and 23.974(8.082-71.118)and 37.024(10.278-133.372),respectively,and the risk of PCOS was increased as the BPA Exposure Behavior Scale score increased.4.In women with PCOS,the proportion of LH/FSH > 2 in the high BPA exposure group was significantly higher than that in the low BPA exposure group(35.6% VS30.2%)(P < 0.05),further analysis of the correlation between BPA exposure score and sex hormone level showed that the BPA exposure score was positively correlated with LH/FSH and serum total testosterone(T)(r= 0.176,0.221,P < 0.05).5.Dichotomous logistic regression results showed that(1)BMI Index and education level were the influencing factors of BPA high exposure in PCOS patients(P < 0.05);(2)Age and education were the influencing factors of high BPA exposure in the control group(P < 0.05).6.The urinary BPA levels were higher in the PCOS group than in the control group of women,and the urinary BPA level(corrected for creatinine)was 39.38 μg/g Cr in the PCOS group and 31.86 μg/g Cr in the control group(corrected for creatinine),with statistically significant differences(Z=-1.994,P﹤0.05);Similarly,after adjusting for the aforementioned confounding factors,the OR(95% CI)for the occurrence of PCOS was 1.254(0.507~3.101)and 1.254(0.507~3.101)in the BPA concentration 19.93~34.72 μg/g Cr and 34.73~59.41 μg/g Cr groups and >59.41 μg/g Cr group,respectively,using BPA content ≤19.92 μg/g Cr as the reference group.The OR(95% CI)for PCOS was 1.254(0.507 to 3.101)and 1.366(0.553 to 3.373)and 2.245(0.897 to 5.617)in the BPA group and >59.41 μg/g Cr group,respectively.Moreover,the risk of PCOS increased with the increase in BPA level.Conclusions: 1.The BPA exposure behavior and urine BPA content in women with PCOS were higher than those in the control group,there was a positive correlation between the occurrence of PCOS and BPA exposure,especially in the use of BPA-releasing containers and packaging and special environment High BPA exposure and high urinary BPA content were associated with PCOS.2.In PCOS patients,sex hormone levels were different in high and low BPA exposure behavior group,and BPA exposure behavior score was positively correlated with LH/FSH value and serum total testosterone(T).3.In this study,we found that the influencing factors of high BPA exposure in patients with PCOS were different from those in the control group.BMI index and education level were the influencing factors of high BPA exposure in patients with PCOS,while in the control group,BMI Index and education level were the influencing factors of high BPA exposure in patients with PCOS,age and education were the influencing factors of high BPA exposure.