Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain.
Department of Public Health, Division of Health Sciences, Universidad del Norte, Km 5 vía Puerto Colombia, Barranquilla, Colombia.
Environ Pollut. 2024 Jun 1;350:124044. doi: 10.1016/j.envpol.2024.124044. Epub 2024 Apr 25.
Phthalates may be associated with an increased risk of cardiometabolic diseases by interfering with glucose and lipid metabolism and by promoting adipogenesis. This study aimed to perform a systematic review and meta-analysis of the association between phthalate exposure and subclinical carotid atherosclerosis, using surrogate markers such as carotid intima-media thickness (IMT) and carotid plaques. The literature search was performed using four databases (Web of Science, Medline, PubMed, and Scopus), and this systematic review includes all available observational studies until July 6th, 2023. The Joanna Briggs Institute critical appraisal tool was used to assess the risk of bias. Meta-analyses were performed, and random effects models were used. Six high-quality cross-sectional studies and 2570 participants aged 12 to 70 were included. Six phthalate metabolites showed significant associations with subclinical carotid atherosclerosis. Exposure to MBzP, ΣDEHP, and MnBP was associated with increased carotid IMT. Exposure to MEP was associated with a higher prevalence of carotid plaques, and MiBP was associated with a lower prevalence. Mixed results were observed for MMP in older adults. The meta-analyses showed a high degree of heterogeneity, and the results are based on single studies. This study accurately describes the evidence of this association to date, suggesting that phthalates are associated with increased carotid IMT and a higher prevalence of carotid plaques. Further research is needed to elucidate this association, as phthalates are still used in the manufacture of everyday products, humans continue to be exposed to them, and atherosclerosis is a public health concern.
邻苯二甲酸酯可能通过干扰葡萄糖和脂质代谢以及促进脂肪生成，与心血管代谢疾病的风险增加有关。本研究旨在通过使用颈动脉内膜中层厚度（IMT）和颈动脉斑块等替代标志物，对邻苯二甲酸酯暴露与亚临床颈动脉粥样硬化之间的关联进行系统评价和荟萃分析。文献检索使用了四个数据库（Web of Science、Medline、PubMed 和 Scopus），本系统评价包括截至 2023 年 7 月 6 日所有可用的观察性研究。使用 Joanna Briggs 研究所的批判性评估工具评估偏倚风险。进行了荟萃分析，并使用随机效应模型。纳入了 6 项高质量的横断面研究和 2570 名年龄在 12 至 70 岁的参与者。6 种邻苯二甲酸酯代谢物与亚临床颈动脉粥样硬化有显著关联。暴露于 MBzP、ΣDEHP 和 MnBP 与颈动脉 IMT 增加有关。暴露于 MEP 与颈动脉斑块的患病率增加有关，而 MiBP 与颈动脉斑块的患病率降低有关。在老年人中，MMP 的结果存在混合。荟萃分析显示存在高度异质性，结果基于单项研究。本研究准确描述了迄今为止该关联的证据，表明邻苯二甲酸酯与颈动脉 IMT 增加和颈动脉斑块患病率增加有关。需要进一步的研究来阐明这种关联，因为邻苯二甲酸酯仍被用于制造日常产品，人类继续接触它们，而动脉粥样硬化是一个公共卫生关注点。
