Abstract：
The relation between pesticides exposure and metabolic syndrome (MetS) has not been clearly identified. Performing a systematic review and meta-analysis, PubMed, Cochrane Library, Embase, and ScienceDirect were searched for studies reporting the risk of MetS following pesticides exposure and their contaminants. We included 12 studies for a total of 6789 participants, in which 1981 (29.1%) had a MetS. Overall exposure to pesticides and their contaminants increased the risk of MetS by 30% (95CI 22%-37%). Overall organochlorine increased the risk of MetS by 23% (14-32%), as well as for most types of organochlorines: hexachlorocyclohexane increased the risk by 53% (28-78%), hexachlorobenzene by 40% (0.01-80%), dichlorodiphenyldichloroethylene by 22% (9-34%), dichlorodiphenyltrichloroethane by 28% (5-50%), oxychlordane by 24% (1-47%), and transnonchlor by 35% (19-52%). Sensitivity analyses confirmed that overall exposure to pesticides and their contaminants increased the risk by 46% (35-56%) using crude data or by 19% (10-29%) using fully-adjusted model. The risk for overall pesticides and types of pesticides was also significant with crude data but only for hexachlorocyclohexane (36% risk increase, 17-55%) and transnonchlor (25% risk increase, 3-48%) with fully-adjusted models. Metaregressions demonstrated that hexachlorocyclohexane increased the risk of MetS in comparison to most other pesticides. The risk increased for more recent periods (Coefficient = 0.28, 95CI 0.20 to 0.37, by year). We demonstrated an inverse relationship with body mass index and male gender. In conclusion, pesticides exposure is a major risk factor for MetS. Besides organochlorine exposure, data are lacking for other types of pesticides. The risk increased with time, reflecting a probable increase of the use of pesticides worldwide. The inverse relationship with body mass index may signify a stockage of pesticides and contaminants in fat tissue.
摘要：
农药暴露与代谢综合征（MetS）之间的关系尚未明确确定。进行系统评价和荟萃分析，PubMed,科克伦图书馆,Embase,和ScienceDirect进行了搜索，以研究报告农药暴露及其污染物后MetS的风险。我们纳入了12项研究，共6789名参与者，其中1981年（29.1%）有MetS。总体上接触农药及其污染物会使MetS的风险增加30％（95CI22％-37％）。整体有机氯使MetS的风险增加了23％（14-32％），以及大多数类型的有机氯:六氯环己烷增加了53%(28-78%)的风险,六氯苯减少40%(0.01-80%)，二氯二苯基二氯乙烯减少22%（9-34%），二氯二苯基三氯乙烷减少28%（5-50%），羟氯丹增加24%（1-47%），和反式氯35%（19-52%）。敏感性分析证实，使用粗略数据，总体暴露于农药及其污染物的风险增加了46%(35-56%)，使用完全调整模型，风险增加了19%(10-29%)。总体农药和农药类型的风险在粗略数据下也很显著，但只有六氯环己烷(风险增加36%，17-55%)和反式氯(风险增加25%，3-48%）与完全调整的模型。Metaregressions表明，与大多数其他农药相比，六氯环己烷增加了MetS的风险。最近一段时间的风险增加（系数=0.28，95CI0.20至0.37，按年度划分）。我们证明了体重指数和男性之间的反比关系。总之,农药暴露是MetS的主要危险因素。除了有机氯暴露,缺乏其他类型农药的数据。风险随着时间的推移而增加，反映了全球农药使用的可能增加。与体重指数的反比关系可能表示脂肪组织中农药和污染物的储备。
