Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Front Endocrinol (Lausanne). 2021 Nov 11;12:778737. doi: 10.3389/fendo.2021.778737. eCollection 2021.
The exponential global increase in the incidence of obesity may be partly attributable to environmental chemical (EC) exposure. Humans are constantly exposed to ECs, primarily through environmental components. This review compiled human epidemiological study findings of associations between blood and/or urinary exposure levels of ECs and anthropometric overweight and obesity indices. The findings reveal research gaps that should be addressed. We searched MEDLINE (PubMed) for full text English articles published in 2006-2020 using the keywords "environmental exposure" and "obesity". A total of 821 articles were retrieved; 102 reported relationships between environmental exposure and obesity indices. ECs were the predominantly studied environmental exposure compounds. The ECs were grouped into phenols, phthalates, and persistent organic pollutants (POPs) to evaluate obesogenic roles. In total, 106 articles meeting the inclusion criteria were summarized after an additional search by each group of EC combined with obesity in the PubMed and Scopus databases. Dose-dependent positive associations between bisphenol A (BPA) and various obesity indices were revealed. Both individual and summed di(2-ethylhexyl) phthalate (DEHP) and non-DEHP metabolites showed inconsistent associations with overweight and obesity indices, although mono-butyl phthalate (MBP), mono-ethyl phthalate (MEP), and mono-benzyl phthalate (MBzP) seem to have obesogenic roles in adolescents, adults, and the elderly. Maternal exposure levels of individual POP metabolites or congeners showed inconsistent associations, whereas dichlorodiphenyldichloroethylene (DDE) and perfluorooctanoic acid (PFOA) were positively associated with obesity indices. There was insufficient evidence of associations between early childhood EC exposure and the subsequent development of overweight and obesity in late childhood. Overall, human evidence explicitly reveals the consistent obesogenic roles of BPA, DDE, and PFOA, but inconsistent roles of phthalate metabolites and other POPs. Further prospective studies may yield deeper insights into the overall scenario.
肥胖的全球发病率呈指数级增长，部分原因可能与环境化学物质（EC）暴露有关。人类不断暴露于 ECs，主要是通过环境成分。本综述汇总了人类流行病学研究结果，这些结果表明 EC 血液和/或尿液暴露水平与人体超重和肥胖指数之间存在关联。研究结果揭示了一些需要解决的研究空白。我们在 MEDLINE（PubMed）中使用“环境暴露”和“肥胖”这两个关键词，检索了 2006 年至 2020 年发表的全文英文文章。共检索到 821 篇文章，其中 102 篇报道了环境暴露与肥胖指数之间的关系。ECs 是研究最多的环境暴露化合物。根据评估其致肥胖作用的不同，ECs 被分为酚类、邻苯二甲酸酯和持久性有机污染物（POPs）。经过进一步搜索，总共 106 篇符合纳入标准的文章被总结出来，其中将 EC 与肥胖相关的文章按组与肥胖相关的文章分别在 PubMed 和 Scopus 数据库中进行搜索。研究表明，双酚 A（BPA）与各种肥胖指数之间呈剂量依赖性正相关。单独的及总和的邻苯二甲酸二（2-乙基己基）酯（DEHP）和非-DEHP 代谢物与超重和肥胖指数的关联不一致，尽管邻苯二甲酸单丁酯（MBP）、邻苯二甲酸单乙酯（MEP）和邻苯二甲酸单苄酯（MBzP）似乎在青少年、成人和老年人中具有致肥胖作用。个体 POP 代谢物或同系物的母体暴露水平与肥胖指数的关联不一致，而二氯二苯二氯乙烯（DDE）和全氟辛酸（PFOA）与肥胖指数呈正相关。早期儿童 EC 暴露与后期儿童超重和肥胖发展之间的关联证据不足。总体而言，人体证据明确揭示了 BPA、DDE 和 PFOA 的一致致肥胖作用，但邻苯二甲酸代谢物和其他 POPs 的作用则不一致。进一步的前瞻性研究可能会深入了解整体情况。
