重金属暴露与肥胖之间的关联：一项系统综述和荟萃分析。
The association between heavy metal exposure and obesity: A systematic review and meta-analysis.
作者信息
Zangiabadian Moein, Jolfayi Amir Ghaffari, Nejadghaderi Seyed Aria, Amirkhosravi Ladan, Sanjari Mojgan
机构信息
Endocrinology and Metabolism Re-Search Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
出版信息
J Diabetes Metab Disord. 2023 Oct 28;23(1):11-26. doi: 10.1007/s40200-023-01307-0. eCollection 2024 Jun.
BACKGROUND
Obesity and metabolic syndrome are global health concerns associated with development of different types of diseases and serious health threats in the long term. Their metabolic imbalance can be attributable to inherited and environmental factors. As a considerable environmental agent, heavy metals exposure can predispose individuals to diseases like obesity. This systematic review and meta-analysis aimed to evaluate the association between heavy metals exposure and the risk of obesity.
METHODS
PubMed/MEDLINE, EMBASE and Web of Science were systematically searched until December 17, 2022. Only observational studies that evaluated heavy metals exposure and obesity were included. Studies were excluded if they assessed maternal or prenatal exposure, the mixture of heavy metals and other chemicals, reported the association with overweight or other diseases, and undesirable study designs. The Joanna Briggs Institute checklist was used for quality assessment. The pooled adjusted odds ratio (aOR) and the pooled standardized mean difference (SMD) with their 95% confidence intervals (CIs) were calculated, respectively. The publication bias was evaluated using Egger's and Begg's tests.
RESULTS
Twenty studies (n = 127755), four case-control and sixteen analytical cross-sectional studies, were included. Lead exposure was significantly associated with a lower risk of obesity (aOR: 0.705, 95% CI: 0.498-0.997), while mercury (aOR: 1.458, 95% CI: 1.048-2.031) and barium (aOR: 1.439, 95% CI: 1.142-1.813) exposure increased the risk of obesity. No significant publication bias was found and the studies had a low risk of bias.
CONCLUSION
Overall, lead exposure reduced obesity risk, while mercury and barium exposure raised it. Further large-scale observational studies are recommended to determine the roles of heavy metals in obesity.Study registration ID: CRD42023394865.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s40200-023-01307-0.
背景
肥胖和代谢综合征是全球性的健康问题，与不同类型疾病的发生以及长期严重的健康威胁相关。它们的代谢失衡可能归因于遗传和环境因素。作为一种重要的环境因素，接触重金属会使个体易患肥胖等疾病。本系统评价和荟萃分析旨在评估重金属暴露与肥胖风险之间的关联。
方法
系统检索了截至2022年12月17日的PubMed/MEDLINE、EMBASE和Web of Science数据库。仅纳入评估重金属暴露与肥胖的观察性研究。如果研究评估的是母体或产前暴露、重金属与其他化学物质的混合物、报告的与超重或其他疾病的关联以及不良的研究设计，则将其排除。使用乔安娜·布里格斯研究所核对清单进行质量评估。分别计算合并调整优势比（aOR）和合并标准化均数差（SMD）及其95%置信区间（CI）。使用Egger检验和Begg检验评估发表偏倚。
结果
纳入了20项研究（n = 127755），其中4项病例对照研究和16项分析性横断面研究。铅暴露与较低的肥胖风险显著相关（aOR：0.705，95%CI：0.498 - 0.997），而汞（aOR：1.458，95%CI：1.048 - 2.031）和钡（aOR：1.439，95%CI：1.142 - 1.813）暴露增加了肥胖风险。未发现显著的发表偏倚，且研究的偏倚风险较低。
结论
总体而言，铅暴露降低了肥胖风险，而汞和钡暴露则增加了肥胖风险。建议进一步开展大规模观察性研究以确定重金属在肥胖中的作用。研究注册号：CRD42023394865。
补充信息
在线版本包含可在10.1007/s40200 - 023 - 01307 - 0获取的补充材料。
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