内分泌干扰化学物质与非酒精性脂肪性肝病的关联:系统评价和荟萃分析。
The association between endocrine disrupting chemicals and nonalcoholic fatty liver disease: A systematic review and meta-analysis.
机构信息
School of Public Health, Zunyi Medical University, Zunyi, Guizhou 563000, PR China.
School of Public Health, Zunyi Medical University, Zunyi, Guizhou 563000, PR China.
出版信息
Pharmacol Res. 2024 Jul;205:107251. doi: 10.1016/j.phrs.2024.107251. Epub 2024 Jun 9.
Nonalcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease worldwide. Epidemiological studies have reported that exposure of the population to environmental endocrine-disrupting chemicals (EDCs) is associated with NAFLD. However, EDCs are of different types, and there are inconsistencies in the relevant evidence and descriptions, which have not been systematically summarized so far. Therefore, this study aimed to determine the association between population exposure to EDCs and NAFLD. Three databases, including PubMed, Web of science, and Embase were searched, and 27 articles were included in this study. Methodological quality, heterogeneity, and publication bias of the included studies were assessed using the Newcastle-Ottawa scale, I statistics, Begg's test, and Egger's test. The estimated effect sizes of the included studies were pooled and evaluated using the random-effects model (I > 50 %) and the fixed-effects model ( I < 50 %). The pooled-estimate effect sizes showed that population exposure to Phthalates (PAEs) (OR = 1.18, 95 % CI:1.03-1.34), cadmium (Cd) (OR = 1.37, 95 % CI:1.09-1.72), and bisphenol A (OR = 1.43, 95 % CI:1.24-1.65) were positively correlated with the risk of NAFLD. Exposure to mercury (OR =1.46, 95 % CI:1.17-1.84) and Cd increased the risk of "elevated alanine aminotransferase". On the contrary, no significant association was identified between perfluoroalkyl substances (OR =0.99, 95 % CI:0.93-1.06) and NAFLD. However, female exposure to perfluorooctanoic acid (OR =1.82, 95 % CI:1.01-3.26) led to a higher risk of NAFLD than male exposure. In conclusion, this study revealed that EDCs were risk factors for NAFLD. Nonetheless, the sensitivity analysis results of some of the meta-analyses were not stable and demonstrated high heterogeneity. The evidence for these associations is limited, and more large-scale population-based studies are required to confirm these findings.
非酒精性脂肪性肝病 (NAFLD) 是全球慢性肝病的主要原因之一。 流行病学研究表明,人群接触环境内分泌干扰化学物质 (EDCs) 与 NAFLD 有关。 然而,EDCs 有不同的类型,相关证据和描述也不一致,迄今为止尚未进行系统总结。 因此,本研究旨在确定人群接触 EDCs 与 NAFLD 之间的关系。 我们检索了三个数据库,包括 PubMed、Web of science 和 Embase,并纳入了 27 篇文章进行研究。 使用纽卡斯尔-渥太华量表、I 统计量、Begg 检验和 Egger 检验评估纳入研究的方法学质量、异质性和发表偏倚。 使用随机效应模型(I > 50%)和固定效应模型(I < 50%)对纳入研究的估计效应大小进行合并和评估。 合并估计效应大小表明,人群接触邻苯二甲酸酯(PAEs)(OR = 1.18,95%CI:1.03-1.34)、镉(Cd)(OR = 1.37,95%CI:1.09-1.72)和双酚 A(OR = 1.43,95%CI:1.24-1.65)与 NAFLD 风险呈正相关。 接触汞(OR = 1.46,95%CI:1.17-1.84)和 Cd 增加了“丙氨酸氨基转移酶升高”的风险。 相反,全氟烷基物质(OR = 0.99,95%CI:0.93-1.06)与 NAFLD 之间没有显著关联。 然而,女性接触全氟辛酸(OR = 1.82,95%CI:1.01-3.26)导致 NAFLD 的风险高于男性接触。 总之,本研究表明 EDCs 是 NAFLD 的危险因素。 然而,一些荟萃分析的敏感性分析结果不稳定,且存在高度异质性。 这些关联的证据有限,需要更多大规模的基于人群的研究来证实这些发现。