Bisphenol A in polycystic ovary syndrome and its association with liver-spleen axis

Giovanni Tarantino, Rossella Valentino, Carolina Di Somma, Vittoria D'Esposito, Federica Passaretti, Genoveffa Pizza, Valentina Brancato, Francesco Orio, Pietro Formisano, Annamaria Colao, Silvia Savastano

Research output: Contribution to journalArticlepeer-review


Context Bisphenol A, one of the highest-volume chemicals currently available, is known to act as endocrine disruptor and alters several metabolic functions, including inflammatory pathways. Elevated serum levels of bisphenol A have been found in women with polycystic ovary syndrome (PCOS) and a role of low-grade chronic inflammation has been recently reported in the pathogenesis of this syndrome. Increased spleen volume, a reliable and stable index of chronic inflammation, was strictly associated with the severity of hepatic steatosis (HS) in obese subjects, determining the so-called liver-spleen axis. Objective To evaluate the contribution of increased serum bisphenol A levels to low-grade chronic inflammation, HS and hyperandrogenism in women with PCOS. Design, setting and participants Forty lean and overweight/obese premenopausal women with PCOS and 20 healthy age-matched women were consecutively enrolled in a cross-sectional study from 2009 to 2011 at the Federico II University Hospital in Naples. Measurements Bisphenol A, homoeostasis model assessment of insulin resistance (HoMA-IR), laboratory liver tests, testosterone, sex hormone-binding globulin, free androgen index (FAI), C-reactive protein, interleukin-6, and the ultrasound quantification of HS and spleen longitudinal diameter. Results Independently of body weight, higher bisphenol A levels in PCOS women were associated with higher grades of insulin resistance, HS, FAI and inflammation, spleen size showing the best correlation. At multivariate analysis, spleen size and FAI were the best predictors of bisphenol A (β coefficients 0·379, P = 0·007 and 0·343, P = 0·014, respectively). Conclusions In premenopausal women with PCOS, we evidenced an association of serum bisphenol A levels with HS and markers of low-grade inflammation, in particular with spleen size, unravelling the presence of the liver-spleen axis in this syndrome.

Original languageEnglish
Pages (from-to)447-453
Number of pages7
JournalClinical Endocrinology
Issue number3
Publication statusPublished - Mar 2013

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism


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