The association between bisphenol A exposure and type-2 diabetes: a world systematic review

The present study was conducted to systematically review, analyze, and interpret all the relevant evidence in the literature on the possible link between exposure to bisphenol A (BPA) and the risk of type-2 diabetes mellitus (T2DM). We developed a comprehensive search strategy and used it to search Web of Science, Scopus, PubMed, and Google Scholar up to March 31, 2016, producing 3108 hits, of which 13 original papers were included. Findings of these studies were quite controversial; few studies indicated a significant positive association between BPA exposure and T2DM, while some other failed to detect such a relationship. Overall, it can be suggested that chance is unlikely the plausible explanation for the observed association between BPA exposure and T2DM. This was mainly because even in the negative studies some clues could be found in favor of a statistically significant relationship between BPA and T2DM. Additionally, some of the studies had shortcomings in defining the exposure and outcome measures, which, if present, might have led to underestimating the relationship between BPA exposure and T2DM. The theoretical plausibility of such a relationship found earlier in animal studies also supports this point. However, more definitive answer requires the conduct of future longitudinal studies, in which the possible association between BPA exposure and T2DM is assessed over much longer periods of time with more temporally robust BPA measurements. In addition, it would be quite beneficial if future studies be conducted in areas where data is still lacking (e.g., South America, Australia/Oceania, and Europe). Graphical abstract ᅟ.