Abstract：
Bisphenol A (BPA) is a widespread environmental pollutant linked to detrimental effects on human health and reduced life expectancy following chronic exposure. This prospective cohort study aimed to examine the association between BPA exposure and mortality in American adults and to explore the potential mitigating effects of dietary quality on BPA-related mortality. This study utilized data from 8761 American adults in the 2003-2016 National Health and Nutrition Examination Survey (NHANES). Urinary BPA levels were employed to assess BPA exposure, and dietary quality was evaluated using the Healthy Eating Index-2015 (HEI-2015). All-cause, cardiovascular disease (CVD), and cancer mortality statuses were determined until December 31, 2019, resulting in a cumulative follow-up of 80,564 person-years. The results showed that the highest tertile of urinary BPA levels corresponded to a 36% increase in all-cause mortality and a 62% increase in CVD mortality compared to the lowest tertile. In contrast, the highest tertile of HEI-2015 scores was associated with a 29% reduction in all-cause mortality relative to the lowest tertile. Although no significant interaction was found between HEI-2015 scores and urinary BPA levels concerning mortality, the association between HEI-2015 scores and both all-cause and CVD mortality was statistically significant at low urinary BPA levels. Continuous monitoring of BPA exposure is crucial for evaluating its long-term adverse health effects. Improving dietary quality can lower all-cause mortality and decrease the risk of all-cause and CVD mortality at low BPA exposure levels. However, due to the limited protective effect of dietary quality against BPA exposure, minimizing BPA exposure remains a vital goal.
摘要：
双酚A（BPA）是一种广泛存在的环境污染物，与长期暴露后对人类健康的有害影响和预期寿命的降低有关。这项前瞻性队列研究旨在研究美国成年人BPA暴露与死亡率之间的关系，并探讨饮食质量对BPA相关死亡率的潜在缓解作用。这项研究利用了2003-2016年全国健康和营养检查调查（NHANES）中8761名美国成年人的数据。尿BPA水平用于评估BPA暴露，并使用健康饮食指数-2015(HEI-2015)评估饮食质量。所有原因，心血管疾病（CVD），并在2019年12月31日之前确定癌症死亡率状况,导致累积随访80,564人年.结果表明，与最低的三位数相比，最高的尿BPA水平对应的全因死亡率增加了36％，CVD死亡率增加了62％。相比之下,HEI-2015评分的最高四分位数与全因死亡率相对于最低四分位数降低29%相关.尽管在HEI-2015评分和尿中BPA水平与死亡率之间没有发现显著的相互作用，HEI-2015评分与低尿BPA水平的全因死亡率和CVD死亡率之间的关联具有统计学意义.持续监测BPA暴露对于评估其长期不良健康影响至关重要。在低BPA暴露水平下，改善饮食质量可以降低全因死亡率，并降低全因死亡率和CVD死亡率的风险。然而,由于膳食质量对双酚A暴露的保护作用有限，减少BPA暴露仍然是一个重要的目标。
