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双酚A暴露对妊娠期糖尿病风险的影响:观察性研究的荟萃分析

Impact of bisphenol A exposure on the risk of gestational diabetes: a meta-analysis of observational studies.

作者信息

Koushki Mehdi, Doustimotlagh Amir Hossein, Amiri-Dashatan Nasrin, Farahani Masoumeh, Chiti Hossein, Vanda Razieh, Aramesh Shahintaj

机构信息

Department of Clinical Biochemistry, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.

Department of Clinical Biochemistry, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran.

出版信息

J Diabetes Metab Disord. 2024 Sep 2;23(2):2173-2182. doi: 10.1007/s40200-024-01485-5. eCollection 2024 Dec.

Abstract

PURPOSE

A growing number of evidence have assessed the association between bisphenol A (BPA) as an endocrine-disrupting agent and the risk of gestational diabetes (GDM). This meta-analysis aimed to reassess the data on the association of BPA levels in women with GDM compared to the control.

METHODS

A comprehensive literature search was conducted in Medline, Embase, Scopus, and Web of Science to extract relevant published studies up to May 2024. 12 articles were included in the meta-analysis. DerSimonian and Liard random-effects model was used to estimate the pooled odds ratio (OR). Sensitivity analysis was conducted to assess the robustness of the pooled results by removing each study from the pooled effect size. Subgroup analyses were performed depending on the subgroups of gestational age, GDM trimester, BMI, study design and geographical area.

RESULTS

The results showed that there was no significant association between circulating and urinary BPA concentrations with the risk of GDM (OR: 0.79; 95% CI 0.60-1.04;  = 0.095). No significant heterogeneity was found among the studies. Using Begg's correlation ( = 0.95) and Egger's linear regression ( = 0.86) tests, no publication bias was observed. The sensitivity analysis shows that our findings were completely robust and stable. Meta-regression indicated a significant association between BPA levels and study design and geometric mean as an index of the risk of GDM.

CONCLUSION

The present meta-analysis demonstrates exposure to BPA was associated with a reduced risk of GDM. Further studies are needed for obtain the reliable results.

摘要

目的

越来越多的证据评估了双酚A(BPA)作为一种内分泌干扰物与妊娠期糖尿病(GDM)风险之间的关联。本荟萃分析旨在重新评估与对照组相比,患有GDM的女性体内BPA水平关联的数据。

方法

在Medline、Embase、Scopus和Web of Science中进行了全面的文献检索,以提取截至2024年5月的相关已发表研究。12篇文章被纳入荟萃分析。采用DerSimonian和Liard随机效应模型来估计合并优势比(OR)。通过从合并效应量中剔除每项研究来进行敏感性分析,以评估合并结果的稳健性。根据胎龄、GDM孕期、体重指数、研究设计和地理区域等亚组进行亚组分析。

结果

结果显示,循环和尿液中的BPA浓度与GDM风险之间无显著关联(OR:0.79;95%CI 0.60 - 1.04;P = 0.095)。研究之间未发现显著异质性。使用Begg相关性检验(P = 0.95)和Egger线性回归检验(P = 0.86),未观察到发表偏倚。敏感性分析表明我们的研究结果完全稳健且稳定。Meta回归表明BPA水平与研究设计以及作为GDM风险指标的几何平均数之间存在显著关联。

结论

本荟萃分析表明,暴露于BPA与GDM风险降低有关。需要进一步研究以获得可靠结果。

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