Wang Guoying, Chen Zhu, Bartell Tami, Wang Xiaobin
Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA.
Ann & Robert H. Lurie Children's Hospital of Chicago Research Center, Chicago, USA.
Curr Environ Health Rep. 2014 Mar 1;1(1):78-89. doi: 10.1007/s40572-013-0004-6.
Metabolic syndrome (MetS) affects more than 47 million people in the U.S. Even more alarming, MetS, once regarded as an "adult problem", has become increasingly common in children. To date, most related research and intervention efforts have occurred in the adult medicine arena, with limited understanding of the root causes and lengthy latency of MetS. This review highlights new science on the early life origins of MetS, with a particular focus on exposure to two groups of environmental toxicants: endocrine disrupting chemicals (EDCs) and metals during the prenatal and early postnatal periods, and their specific effects and important differences in the development of MetS. It also summarizes available data on epigenetic effects, including the role of EDCs in the androgen/estrogen pathways. Emerging evidence supports the link between exposures to environmental toxicants during early life and the development of MetS later in life. Additional research is needed to address important research gaps in this area, including prospective birth cohort studies to delineate temporal and dose-response relationships, important differences in the effects of various environmental toxicants and their joint effects on MetS, as well as epigenetic mechanisms underlying the effects of specific toxicants such as EDCs and metals.
代谢综合征(MetS)在美国影响着超过4700万人。更令人担忧的是,MetS曾被视为“成人问题”,如今在儿童中也越来越普遍。迄今为止,大多数相关研究和干预措施都集中在成人医学领域,对MetS的根本原因和漫长潜伏期了解有限。本综述重点介绍了关于MetS早期生命起源的新科学,特别关注产前和产后早期接触两类环境毒物:内分泌干扰化学物质(EDCs)和金属,以及它们在MetS发展过程中的具体影响和重要差异。它还总结了关于表观遗传效应的现有数据,包括EDCs在雄激素/雌激素途径中的作用。新出现的证据支持早期生命中接触环境毒物与后期MetS发展之间的联系。需要进一步研究来填补该领域的重要研究空白,包括前瞻性出生队列研究,以确定时间和剂量反应关系、各种环境毒物的影响及其对MetS的联合作用的重要差异,以及EDCs和金属等特定毒物影响的表观遗传机制。