Impact of Bisphenol A on the levels of vascular calcification biomarkers in Type 2 Diabetes Mellitus with vascular complications: A Case-control Study

Abstract

Abstract Bisphenol A (BPA) is a chemical that disrupts the endocrine system and is found in various plastic products that are routinely used. Recent research suggests that BPA develops insulin resistance, which results in type 2 diabetes mellitus (T2DM), which also causes vascular complications. Vascular calcification (VC) is the primary concern in T2DM and diabetic vascular complications. Fetuin-A (FTA) and Osteoprotegerin (OPG) are the VC biomarkers in T2DM. The association of BPA with T2DM and its associated vascular complications are limited in human studies. Our study aims to associate systemic BPA levels with FTA and OPG in T2DM and diabetic vascular complications. Diabetic vascular complications such as cardiovascular disease (CVD) and diabetic nephropathy (DN) were confirmed by carotid intima-media thickness (CIMT) and urine microalbuminuria (UMA), respectively. Serum and urinary FTA, OPG and BPA levels were measured by enzyme-linked immunosorbent assay (ELISA) kit. The biochemical parameters were performed using standard protocols. We found increased levels of serum (p < 0.001) and urinary BPA (p < 0.001) in T2DM, along with lower levels of serum and urinary FTA (p < 0.001) and enhanced levels of OPG (p < 0.001) in the study groups. Serum and urinary BPA levels were highly associated with serum FTA (p < 0.001), urinary FTA (p < 0.01), serum OPG (p < 0.001) and urinary OPG (p < 0.001) in our study groups. Our study demonstrates an association between increased serum and urinary BPA levels, poor diabetic and lipid profile, and insulin resistance. It is especially significant with lower FTA and enhanced OPG in patients with T2DM and its associated vascular complications.