Exposome: time for transformative research
Exposome: time for transformative research
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DOI：
10.1002/sim.5496
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发表时间：
2012-09-28
影响因子：
2
通讯作者：
Sundaram, Rajeshwari
中科院分区：
文献类型：
--
作者：
Louis, Germaine M. Buck;Sundaram, Rajeshwari
预期寿命是衡量人口健康的总体指标，在美国，无论是出生时还是65岁时，预期寿命都反映了几十年来的积极轨迹[1]。尽管有这些改善，但预期寿命因社会人口特征和是否有足够的医疗服务而异。鉴于目前在美国和地球仪其他国家发生的肥胖流行病，对持续可持续性提高预期寿命的担忧有所增加[2，3]。例如，在2010年，包括美国在内的所有50个州报告的肥胖患病率为20%或更高，其中12个州报告的患病率为30%或更高[2]。总体而言，目前估计美国约有33%的成年人和17%的儿童肥胖[4]。人口健康的其他显著变化包括生育率随时间的显著下降[5]，这部分但不完全归因于文化规范和生育行为的变化。事实上，不断发展的证据表明人类生育力的暂时下降，生育力被定义为男性和女性生殖的生物能力，无论怀孕意图如何[6]。在过去的几十年里，支持男性生育力下降的证据包括精液质量下降以及生殖器-泌尿系统畸形和睾丸癌的发病率增加，所有这些都被假设起源于子宫或所谓的TDS或睾丸发育不全综合征[7]。这一概念框架最近已扩大到妇女。具体而言，卵巢发育不全综合征（ODS）假定女性生育力在受孕时或子宫内建立，在青春期前或生殖期出现早期损伤，分别表现为青春期或妇科和妊娠疾病的发生或进展的改变[8]。假设人类生殖力可能与生存呈正相关，如最近报道的精液质量[9]，其下降可能是人类健康的“关键临界点”，如最近建议的[10]，强调了新研究范式的重要性，如评估生殖力早期起源及其对整个生命周期健康的影响。
Life expectancy is an overall measure of population health, and has reflected a positive trajectory for several decades in the United States when estimated either at birth or 65 years of age [1]. Despite such improvements, life expectancy varies by socio-demographic characteristics and the availability of adequate medical care. Concerns about the continual sustainability for improving life expectancy have grown in light of the obesity epidemic currently occurring in the United States and in other countries across the globe [2, 3]. For example in 2010, all 50 States comprising the United States reported an obesity prevalence of 20% or more, with 12 states reporting a prevalence of 30% or more [2]. Overall, approximately 33% of adults and 17% of children in the United States are currently estimated to be obese [4].Other notable changes in population health include the marked reduction in fertility rates over time [5], which has partially but not entirely been attributed to changes in cultural norms and behaviors regarding childbearing practices. In fact, an evolving body of evidence is suggestive of temporal declines in human fecundity, which is defined as the biologic capacity of men and women for reproduction irrespective of pregnancy intentions [6]. The body of evidence supporting a decline in male fecundity over the past few decades includes diminished semen quality and increasing rates of genital-urinary malformations and testicular cancer, all of which are hypothesized to originate in utero or the so-called TDS or testicular dysgenesis syndrome [7]. This conceptual framework has recently been extended to women. Specifically, the ovarian dysgenesis syndrome (ODS) posits that female fecundity is established at conception or in utero with early impairments arising during prepubertal or reproductive years as manifested by alterations in the onset or progression of puberty or gynecologic and gravid disorders, respectively [8]. Assuming that human fecundity may be positively associated with survival as recently reported for semen quality [9], its decline may be at a ‘critical tipping point’for human health as recently suggested [10] underscoring the importance of new research pardigms such as the exposome for assessing the early origins of fecundity and its implications for health across the lifespan.