Stein · PloS one 2023 · case-control study · n=149

Bisphenol-A and phthalate metabolism in children with neurodevelopmental disorders.

Cited 24 times in the scientific literature.

Level 4 - case-series / case-control

Case-control metabolomic study

PubMed 37703261 · doi:10.1371/journal.pone.0289841 · record verified 2026-08-26

What was done

Urine samples were collected from children recruited at Rutgers-NJ Medical School clinics across three groups: autism spectrum disorder (ASD, n = 66), attention-deficit/hyperactivity disorder (ADHD, n = 46), and healthy controls (CTR, n = 37). Mass spectrometry metabolomics were used to assess the efficiency of 12 glucuronidation pathways, specifically focusing on plasticizers bisphenol-A (BPA) and diethylhexyl phthalate (DEHP/MEHP).

What was found

Metabolome analysis showed metabolic separation among all three groups. Of the 12 glucuronidation pathways tested, only the BPA and DEHP pathways distinguished the clinical groups from controls. Glucuronidation efficiency for BPA was reduced by 11% in the ASD group (p = 0.020) and by 17% in the ADHD group (p < 0.001) relative to controls. DEHP glucuronidation showed similar decreasing trends that did not reach statistical significance.

Why it matters

This study provides biochemical evidence that children with ASD or ADHD have compromised enzymatic clearance of BPA, potentially leading to increased internal tissue exposure to environmental plasticizers.

Limits

Single-center cross-sectional design cannot establish temporality or determine whether metabolic differences are causative or secondary to diet, lifestyle, or medication. Total sample size was modest (n = 149 across three groups), and external environmental exposure levels were not controlled.

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