Arisawa Kokichi
Department of Preventive Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School.
J Med Invest. 2018;65(3.4):151-161. doi: 10.2152/jmi.65.151.
The author reviewed recent reports about the blood levels and dietary intake of polychlorinated dibenzo-p-dioxins (PCDDs)/furans (PCDFs)/dioxin-like polychlorinated biphenyls (DL-PCBs) to investigate the trends of dioxin exposure, and epidemiologic studies on the associations of blood levels of dioxins with metabolic diseases. In recent years, dietary intake of dioxins has been decreasing, and the means are equal to or less than 1.0 pg Toxic Equivalents (TEQ)/kg/day in the general populations of several countries. The blood levels of dioxins are also decreasing, probably because of reduced dietary intake. Many cross-sectional studies reported positive associations between blood levels of some isomers or TEQ-based concentrations of PCDDs/PCDFs/DL-PCBs and diabetes in general populations. Three cohort studies on populations with heavy exposure and two nested case-control studies on general populations have also been published, but the results are inconsistent. Three large-scale cross-sectional studies and two cohort studies reported an association between blood levels of some isomers or TEQ-based concentrations of PCDDs/PCDFs/DL-PCBs and metabolic syndrome. In addition, three cross-sectional studies reported significant positive associations with gout/hyperuricemia. Further prospective studies and experimental studies are needed to establish cause-effect relationships, and to clarify the biological mechanisms for the association between background exposure to dioxins and potential health effects. J. Med. Invest. 65:151-161, August, 2018.
作者回顾了近期关于多氯二苯并对二恶英(PCDDs)/呋喃(PCDFs)/类二恶英多氯联苯(DL-PCBs)血液水平和膳食摄入量的报告,以调查二恶英暴露趋势,以及关于二恶英血液水平与代谢疾病关联的流行病学研究。近年来,二恶英的膳食摄入量一直在下降,在几个国家的普通人群中,平均值等于或低于1.0皮克毒性当量(TEQ)/千克/天。二恶英的血液水平也在下降,这可能是由于膳食摄入量减少所致。许多横断面研究报告称,普通人群中某些异构体的血液水平或基于TEQ的PCDDs/PCDFs/DL-PCBs浓度与糖尿病之间存在正相关。关于高暴露人群的三项队列研究和关于普通人群的两项巢式病例对照研究也已发表,但结果并不一致。三项大规模横断面研究和两项队列研究报告了某些异构体的血液水平或基于TEQ的PCDDs/PCDFs/DL-PCBs浓度与代谢综合征之间的关联。此外,三项横断面研究报告了与痛风/高尿酸血症的显著正相关。需要进一步的前瞻性研究和实验研究来建立因果关系,并阐明二恶英背景暴露与潜在健康影响之间关联的生物学机制。《医学调查杂志》65:151 - 161,2018年8月。