Beyond medication adherence: bisphenol exposure and its relationship with good glycemic control in type 2 diabetes.

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Acta Diabetologica Pub Date : 2026-09-21 DOI:10.1007/s00592-026-02794-2

Julia Matzenbacher Dos Santos, Jason Dechant, Jiayi Zhu, Tapan Seth, Jeffrey Rohay, Thiago Gomes Heck, Jacqueline Dunbar-Jacob

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引用次数: 0

Abstract

Background: The prevalence of type 2 diabetes (T2D) continues to rise alongside complications associated with chronic hyperglycemia. While antihyperglycemic medications are central to glycemic control, exposure to bisphenol-A (BPA) and bisphenol-S (BPS), used to coat food packages, may influence disease progression. This study aimed to test a dietary survey to estimate BPA and BPS among T2D individuals and evaluate BPA and BPS associations with levels of glycated hemoglobin (HbA1C).

Methods: Medication adherence of 382 T2D patients (63.68 ± 10.52 yrs., 7.43 ± 1.36% HbA1C) treated with oral anti-hyperglycemic therapy was assessed with electronic Drug Exposure Monitors. Dietary behavior was evaluated using the Connor dietary survey. Plasma BPA and BPS levels were measured using ELISA assay. Multivariate analyses examined variables related with HbA1C, accounting for modifiable (BMI, diet, physical activity, medication adherence, BPA/BPS levels) and non-modifiable factors (age, sex, race).

Results: The Connor dietary survey did not effectively estimate BPS or BPA levels. BPS, not BPA, was associated with HbA1C when adjusted by non-modifiable variables (β-coefficient = 0.14, P = 0.045), along with medication adherence (β-coefficient = -0.12, P = 0.048). However, when modifiable variables were included in the adjustment, cholesterol and saturated fats intake (β-coefficient = -0.14, P = 0.045), and medication adherence (β-coefficient = -0.16, P = 0.012) were associated with HbA1C.

Conclusion: Levels of BPS are positively associated with HbA1c, even after accounting for non-modifiable factors, diet, and medication adherence, well-established determinants of glycemic control in T2D. Strategies aimed at reducing BPS exposure may complement antihyperglycemic therapy and diet to control HbA1C in T2D.

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超越药物依从性：双酚暴露及其与2型糖尿病良好血糖控制的关系。

背景：2型糖尿病（T2D）的患病率持续上升，同时伴有慢性高血糖相关并发症。虽然降糖药物是控制血糖的核心，但暴露于用于包裹食品包装的双酚a （BPA）和双酚s （BPS）可能会影响疾病的进展。本研究旨在测试一项饮食调查，以评估T2D患者的BPA和BPS，并评估BPA和BPS与糖化血红蛋白（HbA1C）水平的关系。方法：对382例T2D患者（63.68±10.52年）的服药依从性进行分析。（7.43±1.36%）的糖化血红蛋白（HbA1C）接受口服降糖治疗后，用电子药物暴露监测仪进行评估。饮食行为通过康纳饮食调查进行评估。采用ELISA法测定血浆BPA和BPS水平。多变量分析检查了与HbA1C相关的变量，考虑了可改变的（BMI、饮食、体育活动、药物依从性、BPA/BPS水平）和不可改变的因素（年龄、性别、种族）。结果：康纳饮食调查没有有效地估计BPS或BPA水平。经不可修改变量（β-系数= 0.14,P = 0.045）和药物依从性（β-系数= -0.12,P = 0.048）校正后，BPS（而非BPA）与HbA1C相关。然而，当调整中包含可修改变量时，胆固醇和饱和脂肪摄入量（β-系数= -0.14,P = 0.045）和药物依从性（β-系数= -0.16,P = 0.012）与HbA1C相关。结论：BPS水平与HbA1c呈正相关，即使在考虑了不可改变的因素、饮食和药物依从性（t2dm血糖控制的确定因素）后也是如此。旨在减少BPS暴露的策略可以补充抗高血糖治疗和饮食来控制T2D的HbA1C。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Diabetologica 医学-内分泌学与代谢

CiteScore

7.30

自引率

2.60%

发文量

180

审稿时长

2 months

期刊介绍： Acta Diabetologica is a journal that publishes reports of experimental and clinical research on diabetes mellitus and related metabolic diseases. Original contributions on biochemical, physiological, pathophysiological and clinical aspects of research on diabetes and metabolic diseases are welcome. Reports are published in the form of original articles, short communications and letters to the editor. Invited reviews and editorials are also published. A Methodology forum, which publishes contributions on methodological aspects of diabetes in vivo and in vitro, is also available. The Editor-in-chief will be pleased to consider articles describing new techniques (e.g., new transplantation methods, metabolic models), of innovative importance in the field of diabetes/metabolism. Finally, workshop reports are also welcome in Acta Diabetologica.