摘要
目的 探讨邻苯二甲酸酯(phthalates,PAEs)暴露和代谢综合征(metabolic syndrome,MetS)风险之间的关系。方法 基于PubMed、Web of Science、Embase、Cochrane Library、Research Gate和中国知网(CNKI)数据库,检索建库至2024年3月7日有关PAEs暴露与MetS风险关系的流行病学研究,采用Meta分析方法合并估计值。结果 Meta分析显示,PAEs代谢物的MetS风险分别为邻苯二甲酸单苄基酯(mono-benzyl phthalate,MBzP)(OR=1.14,95%CI:1.00~1.30)、邻苯二甲酸单(3-羧基丙基)酯(mono-carboxypropyl phthalate,MCPP)(OR=1.21,95%CI:1.06~1.38)、邻苯二甲酸单羧辛基酯(mono-carboxyoctyl phthalate,MCOP)(OR=1.25,95%CI:1.08~1.44)、邻苯二甲酸单(2-乙基-5-羟基己基)酯[mono (2-ethyl-5-hydroxy-hexyl)phthalate,MEHHP](OR=1.18,95%CI:1.03~1.36)。亚组分析结果显示,年龄≥19岁组中,MBzP(OR=1.14, 95%CI:1.00~1.30)、 MCPP (OR=1.21, 95%CI:1.06~1.38)、 MCOP (OR=1.25,95%CI:1.08~1.44)和MEHHP (OR=1.18,95%CI:1.03~1.36)与患MetS风险呈正相关;性别分组显示,在女性比例≥50%的分组MCPP (OR=1.40, 95%CI:1.11~1.76)、 MCOP (OR=1.31, 95%CI:1.04~1.65)和MEHHP (OR=1.30,95%CI:1.05~1.60),以及在女性比例<50%的分组中MCOP (OR=1.21,95%CI:1.01~1.45)与患MetS的风险呈正相关;发达地区中,MBzP (OR=1.15,95%CI:1.00~1.32)、MCPP (OR=1.20,95%CI:1.05~1.38)、MCOP (OR=1.24,95%CI:1.07~1.44)和MEHHP(OR=1.22,95%CI:1.05~1.41)与患MetS的风险呈正相关;身体活动未调整组中,MCPP (OR=1.22,95%CI:1.05~1.41)、MCOP (OR=1.24,95%CI:1.07~1.44)、MEHHP (OR=1.18,95%CI:1.03~1.36)和邻苯二甲酸单(2-乙基-5-氧基己基)酯[mono-(2-ethyl-5-oxohexyl) phthalate,MEOHP](OR=1.14,95%CI:1.00~1.30)与患MetS的风险呈正相关;研究设计亚组分析显示,在横断面分组中MCPP(OR=1.20, 95%CI:1.00~1.30)、 MCOP (OR=1.24, 95%CI:1.00~1.30)、 MEHHP (OR=1.18, 95%CI:1.00~1.30)和MEOHP (OR=1.14,95%CI:1.00~1.30)与患MetS的风险呈正相关。结论 PAEs代谢产物的暴露会增加MetS的患病风险,尤其是关注成人、发达国家、不经常做体育锻炼的人群,应做好预防措施。
Objective This study aims to investigate the association between Phthalates(PAEs) exposure and the risk of Metabolic syndrome(MetS). Methods Based on PubMed, Web of Science, Embase, Cochrane Library, Research Gate databases and China National Knowledge Infrastructure(CNKI), epidemiological studies on the association between PAEs exposure and MetS risk were searched up to March 7, 2024. The estimated values were combined by meta-analysis. Results The meta-analysis revealed that the risk of MetS associated with PAE metabolites was as follows: mono-benzyl phthalate(MBzP)(OR=1. 14, 95%CI: 1. 00–1. 30), mono-carboxypropyl phthalate(MCPP)(OR=1. 21, 95%CI: 1. 06 – 1. 38), mono-carboxyoctyl phthalate(MCOP)(OR=1. 25, 95%CI: 1. 08 – 1. 44), and mono-(2-ethyl-5-hydroxyhexyl) phthalate(MEHHP)(OR=1. 18,95%CI: 1. 03 – 1. 36). Subgroup analyses indicated a positive correlation between MBzP(OR=1. 14, 95%CI:1. 00 – 1. 30), MCPP(OR=1. 21, 95%CI: 1. 06 – 1. 38), MCOP(OR=1. 25, 95%CI: 1. 08 – 1. 44), and MEHHP(OR=1. 18, 95%CI: 1. 03–1. 36) with MetS risk among individuals aged 19 and older. Gender-based subgroup analysis showed that in groups with a female proportion ≥50%, MCPP(OR=1. 40, 95%CI: 1. 11–1. 76), MCOP(OR=1. 31, 95%CI: 1. 04 – 1. 65), and MEHHP(OR=1. 30, 95%CI: 1. 05 – 1. 60) were positively associated with MetS risk;similarly, in groups with a female proportion <50%, MCOP(OR=1. 21,95%CI: 1. 01–1. 45) exhibited a positive correlation. In developed regions, MBzP(OR=1. 15, 95%CI: 1. 00–1. 32), MCPP(OR=1. 20, 95%CI: 1. 05 – 1. 38), MCOP(OR=1. 24, 95%CI: 1. 07 – 1. 44), and MEHHP(OR=1. 22, 95%CI: 1. 05–1. 41) were positively associated with MetS risk. Among individuals not adjusting for physical activity, MCPP(OR=1. 22, 95%CI: 1. 05 – 1. 41), MCOP(OR=1. 24, 95%CI: 1. 07 – 1. 44),MEHHP(OR=1. 18, 95%CI: 1. 03 – 1. 36), and mono-(2-ethyl-5-oxohexyl) phthalate(MEOHP)(OR=1. 14, 95%CI: 1. 00–1. 30) showed a positive correlation with MetS risk. Analysis based on study design indicated that in cross-sectional studies, MCPP(OR=1. 20, 95%CI: 1. 00 – 1. 30), MCOP(OR=1. 24, 95%CI:1. 00–1. 30), MEHHP(OR=1. 18, 95%CI: 1. 00–1. 30), and MEOHP(OR=1. 14, 95%CI: 1. 00–1. 30) were positively associated with MetS risk. Conclusions PAEs exposure increases the risk of MetS, especially in adults, individuals in developed countries, and those with infrequent physical activity. Preventive measures should be emphasized for these populations.
作者
柳春雨
王磊
郭丽琼
刘琪思婧
李维霞
冯媛媛
丛相茹
孟建卫
宋善军
李彭辉
LIU Chunyu;WANG Lei;GUO Liqiong;LIU Qisijing;LI Weixia;FENG Yuanyuan;CONG Xiangru;MENG Jianwei;SONG Shanjun;LI Penghui(School of Environmental Science and Safety Engineering,Tianjin University of Technology,Tianjin 300384,China;不详)
出处
《中国预防医学杂志》
CAS
CSCD
2024年第10期1249-1258,共10页
Chinese Preventive Medicine
基金
中国博士后科学基金面上资助项目(2020M670667)
河北省矿产资源与生态环境监测重点实验室开放基金项目(HBMREEM202302)。
