Le Magueresse-Battistoni Brigitte, Vidal Hubert, Naville Danielle
Univ Lyon, CarMeN Laboratory, INSERM U1060, INRA U1397, INSA Lyon, Université Claude Bernard Lyon1, Oullins, France.
Front Endocrinol (Lausanne). 2018 Oct 2;9:582. doi: 10.3389/fendo.2018.00582. eCollection 2018.
Obesity and diabetes have reached epidemic proportions the past few decades and continue to progress worldwide with no clear sign of decline of the epidemic. Obesity is of high concern because it is the main risk factor for a number of non-communicable diseases such as cardiovascular diseases and type 2 diabetes. Metabolic diseases constitute a major challenge as they are associated with an overall reduced quality of life and impose a heavy economic burden on countries. These are multifactorial diseases and it is now recognized that environmental exposure to man-made chemical pollutants is part of the equation. Yet, risk assessment procedures are based on a one-by-one chemical evaluation which does not meet the specificities of the multi-exposure scenario of life, e.g., a combined and long-term exposure to even the smallest amounts of chemicals. Indeed, it is assumed that environmental exposure to chemicals will be negligible based on the low potency of each chemical and that they do not interact. Within this mini-review, strong evidences are brought that exposure to low levels of multiple chemicals especially those shown to interfere with hormonal action, the so-called endocrine disrupting compounds do trigger metabolic disturbances in conditions in which no effect was expected if considering the concentration of each individual chemical in the mixture. This is known as the cocktail effect. It means that risk assessment procedures are not protective enough and thus that it should be revisited for the sake of Public Health.
在过去几十年中，肥胖和糖尿病已达到流行程度，且在全球范围内仍在持续发展，没有明显的流行趋势下降迹象。肥胖备受关注，因为它是心血管疾病和2型糖尿病等多种非传染性疾病的主要风险因素。代谢性疾病构成了一项重大挑战，因为它们与整体生活质量下降相关，并给各国带来沉重的经济负担。这些是多因素疾病，现在人们认识到，环境中接触人造化学污染物是其中的一部分原因。然而，风险评估程序是基于逐一的化学评估，这不符合生活中多暴露场景的特殊性，例如，即使是长期接触极少量的化学物质。事实上，基于每种化学物质的低毒性以及它们之间不相互作用的假设，人们认为环境中接触化学物质的影响可以忽略不计。在这篇小型综述中，有力证据表明，接触低水平的多种化学物质，尤其是那些被证明会干扰激素作用的物质，即所谓的内分泌干扰化合物，在考虑混合物中每种单独化学物质的浓度时预计不会产生影响的情况下，确实会引发代谢紊乱。这就是所谓的鸡尾酒效应。这意味着风险评估程序的保护力度不够，因此为了公众健康，应该重新审视该程序。
