**3. Bisphenol A and human health**

Searching in the literature an increasing number of studies are found containing data coming from epidemiological studies on the association between BPA exposure and healthy outcomes. Unfortunately, this number is still limited, and results are coming from cross-sectional trials that limit their interpretability for pathology with long latency periods like cardiovascular diseases or diabetes. An example of number of publication per year, found in PubMed, is shown in **Figure 2**.

Six cross-sectional analyses of data from the US National Health and Nutrition Examination Survey (NHANES) reported associations of BPA exposure with self-reported diagnosis of pre-existing cardiovascular disease, hypertension, obesity, diabetes, and liver-enzyme abnormalities [10–15]. Two other studies in the US [16] and China [17] reported an association between BPA exposure and coronary disease at the time of diagnosis and obesity and insulin resistance, respectively. In addition, a study found associations between urine BPA and immune function and allergy [18]. These cross-sectional analyses have the same weaknesses that limit their interpretation. One of the major limitations of these studies could be assigned to the problem relating to sampling procedure (single spot urine) reflecting only recent BPA exposure and not on a long period (months or years) much more useful to assess the exposure effect on cardiovascular disease and diabetes pathologies.

Progressive exposure to BPA can affect adiposity, glucose or insulin regulation, lipid profiles or other end-points relating to diabetes or metabolic syndrome [19–27].

Finally, BPA could have a negative effect on the heart: stimulating estrogen concentration and modifying free calcium concentration control inside heart cells in women. Provoking an increase of Ca2+ release from sarcoplasmic reticule that could cause arrhythmias that in some case could degenerate into infarction [28].

**Figure 2.** Number of publication on BPA (2000–2015). Source: PubMed.
