School of Public Health, University of Illinois at Chicago, Chicago, IL, United States; Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, University of Illinois at Chicago, Chicago, IL, United States.
School of Public Health, University of Illinois at Chicago, Chicago, IL, United States; Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, University of Illinois at Chicago, Chicago, IL, United States; Jesse Brown Veterans Affairs Medical Center, Chicago, IL, United States.
Adv Pharmacol. 2021;92:419-456. doi: 10.1016/bs.apha.2021.04.002. Epub 2021 Jun 9.
Afflicting hundreds of millions of individuals globally, diabetes mellitus is a chronic disorder of energy metabolism characterized by hyperglycemia and other metabolic derangements that result in significant individual morbidity and mortality as well as substantial healthcare costs. Importantly, the impact of diabetes in the United States is not uniform across the population; rather, communities of color and those with low income are disproportionately affected. While excessive caloric intake, physical inactivity, and genetic susceptibility are undoubted contributors to diabetes risk, these factors alone fail to fully explain the rapid global rise in diabetes rates. Recently, environmental contaminants acting as endocrine-disrupting chemicals (EDCs) have been implicated in the pathogenesis of diabetes. Indeed, burgeoning data from cell-based, animal, population, and even clinical studies now indicate that a variety of structurally distinct EDCs of both natural and synthetic origin have the capacity to alter insulin secretion and action as well as global glucose homeostasis. This chapter reviews the evidence linking EDCs to diabetes risk across this spectrum of evidence. It is hoped that improving our understanding of the environmental drivers of diabetes development will illuminate novel individual-level and policy interventions to mitigate the impact of this devastating condition on vulnerable communities and the population at large.
糖尿病影响着数亿全球人口,是一种能量代谢慢性紊乱的疾病,其特征是高血糖和其他代谢紊乱,导致个体发病率和死亡率显著上升,医疗保健费用大幅增加。重要的是,在美国,糖尿病的影响并非在所有人群中都均匀分布;相反,有色人种社区和低收入人群受到的影响不成比例。虽然过量的卡路里摄入、缺乏身体活动和遗传易感性无疑是糖尿病风险的因素,但这些因素本身并不能完全解释糖尿病发病率在全球范围内的迅速上升。最近,作为内分泌干扰化学物质 (EDCs) 的环境污染物被认为与糖尿病的发病机制有关。事实上,越来越多的细胞、动物、人群甚至临床研究数据表明,各种具有不同结构的天然和合成来源的 EDC 具有改变胰岛素分泌和作用以及全球葡萄糖稳态的能力。本章综述了将 EDC 与糖尿病风险联系起来的证据,这些证据涉及各个方面。希望提高我们对糖尿病发展的环境驱动因素的理解,将为减轻这种破坏性疾病对弱势社区和整个人群的影响提供新的个体和政策干预措施。