Among adults aged 60 and younger, BPA exposure is associated with increased MMA, and MMA accounts for a modest proportion (4.41%) of the BPA-CVD association, independent of vitamin B12 levels.
BPA was significantly and positively associated with MMA levels, independent of vitamin B12 status.
MMA statistically mediated a small but significant portion of the total BPA-cardiovascular disease association.
Network toxicology analyses identified 1124 potential target genes linked to BPA's impact on mitochondria, with significant enrichment in the propionate metabolism pathway.
The study used a cross-sectional design drawing on NHANES data from adults aged 60 years and younger.
This research suggests that exposure to bisphenol A (BPA), a chemical commonly found in plastics and food packaging, is linked to higher blood levels of methylmalonic acid (MMA) in adults aged 60 and under, and that this relationship holds even when accounting for vitamin B12 levels, which are the most well-known driver of MMA. MMA is a metabolic byproduct that has been associated with cardiovascular disease risk, and the study found that MMA explains about 4.41% of the statistical link between BPA exposure and cardiovascular disease. The researchers also used computational network analysis to identify over 1,000 genes potentially involved in how BPA affects mitochondria, pointing to a specific metabolic pathway (propionate metabolism) as a plausible biological mechanism. This research matters because it suggests that environmental chemical exposures like BPA may influence metabolic markers beyond just diet and genetics. While MMA has traditionally been studied in the context of B12 deficiency, this study raises the possibility that chemical pollutants could also raise MMA levels and contribute—even modestly—to cardiovascular disease risk through this pathway. The finding that only about 4% of the BPA-CVD link runs through MMA also indicates that other mechanisms likely account for the majority of BPA's cardiovascular effects. Because this is a cross-sectional study (meaning it looks at one point in time rather than following people over years), it cannot prove that BPA causes higher MMA or cardiovascular disease—only that these factors are statistically associated. The findings highlight a potentially underappreciated pathway connecting everyday chemical exposures to heart health and suggest that future longitudinal and experimental research is warranted to better understand these relationships.
Zhang Y, Feng Y, Xiao S, Li Z. (2026). Association between bisphenol A exposure, methylmalonic acid, and cardiovascular disease among adults aged 60 and younger.. Ecotoxicology and environmental safety. https://doi.org/10.1016/j.ecoenv.2026.120790