BPS and BPF linked to metabolic alterations independent of adiposity in Thai children and adolescents

BACKGROUND: Bisphenol A (BPA) and its structural substitutes, bisphenol S (BPS) and bisphenol F (BPF), are widely used endocrine-disrupting chemicals. While BPA exposure has been linked to metabolic disorders, evidence regarding BPA substitutes in children remains limited, particularly in Southeast Asia. METHODS: We conducted a cross-sectional study among Thai children and adolescents aged 7-18 years classified as normal weight (NW) or overweight/obese (OW/OB). Urinary BPA, BPS, and BPF concentrations were measured using liquid chromatography-tandem mass spectrometry. Anthropometric measurements, body composition, fasting glucose, insulin, lipid profiles, and liver enzymes were assessed. Associations between urinary bisphenol concentrations and metabolic parameters were analyzed using multivariable regression models. RESULTS: A total of 114 participants were included (26 normal weight and 88 overweight/obese). BPA was detected in all (100%) urine samples, whereas BPS and BPF were detected in 50.0% and 53.6% of participants, respectively. Creatinine-adjusted urinary concentrations of BPA, BPS, and BPF did not differ significantly between NW vs. OW/OB. Higher urinary BPS and BPF concentrations were associated with higher fasting insulin levels (aGMR 1.13; 95%CI 1.05-1.20; p = 0.001) and higher LDL cholesterol levels (aGMR 5.82; 95%CI 0.52-11.11; p = 0.032), respectively. In contrast, higher urinary BPA concentrations were associated with lower fasting insulin levels (aGMR 0.77; 95%CI 0.66-0.90; p = 0.001). CONCLUSIONS: Exposure to BPA and its substitutes, BPS and BPF, were associated with distinct metabolic alterations independent of weight status. BPS was associated with hyperinsulinemia, while BPF was associated with elevated LDL cholesterol.