Association between Exposure to p,p'-DDT and Its Metabolite p,p'-DDE with Obesity: Integrated Systematic Review and Meta-Analysis.
Association between Exposure to p,p'-DDT and Its Metabolite p,p'-DDE with Obesity: Integrated Systematic Review and Meta-Analysis.
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DOI：
10.1289/ehp527
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发表时间：
2017-09-18
影响因子：
10.4
通讯作者：
La Merrill MA
中科院分区：
文献类型：
--
作者：
Cano-Sancho G;Salmon AG;La Merrill MA
肥胖症在所有国家的流行率都在上升，成为世界范围内一个重大的公共卫生问题。越来越多的证据表明，肥胖与持久性污染物有关，如杀虫剂DDT及其代谢物p，p‘-DDE。我们的目标是系统地回顾有关接触杀虫剂DDT及其代谢物与肥胖之间关系的文献，以得出危险识别结论。我们应用了一种基于系统综述的策略来识别和整合来自流行病学、体内和体外研究的证据。来自前瞻性流行病学研究的证据通过荟萃分析进行了定量综合。我们对证据主体进行了评级，并整合了证据流，以系统地开发危险识别结论。我们确定了七项流行病学研究，报告了暴露于p，p‘-DDE和通过体重指数(BMI)z分数评估的肥胖症之间的前瞻性关联。Meta分析结果显示，p，p‘-DDE暴露与BMI z得分呈正相关(p，p’-DDE每对数增加BMI z得分(95%CI：0.01，0.25))。两项研究构成了主要的活体证据。这两项研究都报告了暴露于p，p‘-DDT与啮齿动物肥胖增加之间的正相关关系。我们确定了19项体内研究和7项体外研究，这些研究支持p，p‘-DDT和p，p’-DDE致肥胖效应的生物学合理性。我们将p，p‘-DDT和p，p’-DDE归类为“推定”会对人类造成肥胖，基于中等水平的主要人类证据，中等水平的主要体内证据，以及来自体内和体外研究的中等水平的支持证据。Https://doi.org/10.1289/EHP527
The prevalence of obesity is increasing in all countries, becoming a substantial public health concern worldwide. Increasing evidence has associated obesity with persistent pollutants such as the pesticide DDT and its metabolite p,p′-DDE. Our objective was to systematically review the literature on the association between exposure to the pesticide DDT and its metabolites and obesity to develop hazard identification conclusions. We applied a systematic review-based strategy to identify and integrate evidence from epidemiological, in vivo, and in vitro studies. The evidence from prospective epidemiological studies was quantitatively synthesized by meta-analysis. We rated the body of evidence and integrated the streams of evidence to systematically develop hazard identification conclusions. We identified seven epidemiological studies reporting prospective associations between exposure to p,p′-DDE and adiposity assessed by body mass index (BMI) z-score. The results from the meta-analysis revealed positive associations between exposure to p,p′-DDE and BMI z-score ( BMI z-score (95% CI: 0.01, 0.25) per log increase of p,p′-DDE). Two studies constituted the primary in vivo evidence. Both studies reported positive associations between exposure to p,p′-DDT and increased adiposity in rodents. We identified 19 in vivo studies and 7 in vitro studies that supported the biological plausibility of the obesogenic effects of p,p′-DDT and p,p′-DDE. We classified p,p′-DDT and p,p′-DDE as “presumed” to be obesogenic for humans, based on a moderate level of primary human evidence, a moderate level of primary in vivo evidence, and a moderate level of supporting evidence from in vivo and in vitro studies. https://doi.org/10.1289/EHP527