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啮齿动物早期接触双酚A与肥胖相关结局的系统评价和荟萃分析

Systematic Review and Meta-Analysis of Early-Life Exposure to Bisphenol A and Obesity-Related Outcomes in Rodents.

作者信息

Wassenaar Pim Nicolaas Hubertus, Trasande Leonardo, Legler Juliette

机构信息

Department of Chemistry and Biology, Institute for Environmental Studies, Vrije Universiteit Amsterdam , Amsterdam, Netherlands.

Department of Pediatrics, New York University School of Medicine , New York, New York, USA.

出版信息

Environ Health Perspect. 2017 Oct 5;125(10):106001. doi: 10.1289/EHP1233.

Abstract

BACKGROUND

Early-life exposure to bisphenol A (BPA) has been implicated to play a role in the development of obesity.

OBJECTIVE

A systematic review with meta-analyses of experimental rodent studies was conducted to answer the following question: does early-life exposure to BPA affect the obesity-related outcomes body weight, fat (pad) weight, and circulating and tissue levels of triglycerides, free fatty acids (FFA), and leptin?

METHODS

The methodology was prespecified in a rigorous protocol using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) approach. Using PubMed and EMBASE, we identified 61 articles that met the inclusion criteria. The risk of bias and the methodological quality of these articles were assessed using the SYRCLE Risk of Bias tool, and a confidence-rating methodology was used to score the quality of evidence. Meta-analyses were performed using random effect models and standardized mean differences (SMDs), or, where possible, mean differences (MDs) were calculated.

RESULTS

Overall summary estimates indicated significant positive associations between BPA and fat weight [SMD=0.67 (95% CI: 0.53, 0.81)], triglycerides [SMD=0.97 (95% CI: 0.53, 1.40)], and FFA [SMD=0.86 (95% CI: 0.50, 1.22)], and a nonsignificant positive association with leptin levels [MD=0.37 (95% CI: -0.14, 0.87)] and a significant negative association with body weight were estimated [MD=-0.22 (95% CI: -0.37, -0.06)]. Subgroup analyses revealed stronger positive associations for most outcome measures in males and at doses below the current U.S. reference dose of 50μg/kg/d compared with doses above the reference dose. It should be noted that there was substantial heterogeneity across studies for all outcomes assessed and that there was insufficient information to assess risk of bias for most studies.

CONCLUSIONS

Findings from our systematic review suggest that early-life exposure to BPA may increase adiposity and circulating lipid levels in rodents. https://doi.org/10.1289/EHP1233.

摘要

背景

早年暴露于双酚A(BPA)被认为在肥胖症的发生发展中起作用。

目的

进行一项对啮齿动物实验研究的系统评价和荟萃分析,以回答以下问题:早年暴露于双酚A是否会影响与肥胖相关的指标,即体重、脂肪(垫)重量以及甘油三酯、游离脂肪酸(FFA)和瘦素的循环及组织水平?

方法

采用实验室动物实验系统评价中心(SYRCLE)方法,在一个严格的方案中预先确定了方法。通过PubMed和EMBASE,我们识别出61篇符合纳入标准的文章。使用SYRCLE偏倚风险工具评估这些文章的偏倚风险和方法学质量,并采用置信度评分方法对证据质量进行评分。使用随机效应模型和标准化均数差(SMD)进行荟萃分析,或者在可能的情况下计算均数差(MD)。

结果

总体汇总估计表明,双酚A与脂肪重量[SMD = 0.67(95%CI:0.53,0.81)]、甘油三酯[SMD = 0.97(95%CI:0.53,1.40)]和游离脂肪酸[SMD = 0.86(95%CI:0.50,1.22)]之间存在显著正相关,与瘦素水平存在非显著正相关[MD = 0.37(95%CI:-0.14,0.87)],与体重存在显著负相关[MD = -0.22(95%CI:-0.37,-0.06)]。亚组分析显示,与高于参考剂量相比,在雄性以及低于美国当前参考剂量50μg/kg/d的剂量下,大多数结局指标的正相关更强。应当指出的是,对于所有评估的结局,各研究之间存在很大的异质性,并且大多数研究没有足够的信息来评估偏倚风险。

结论

我们的系统评价结果表明,早年暴露于双酚A可能会增加啮齿动物的肥胖和循环脂质水平。https://doi.org/10.1289/EHP1233

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3373/5933326/4a4418a834d1/EHP1233_f1.jpg

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