PDF(Pubmed)
Abstract：
Per-/polyfluoroalkyl substances (PFASs) are persistent organic pollutants and suspected endocrine disruptors.
The aim of this work was to conduct a systematic review with meta-analysis to summarise the associations between prenatal or childhood exposure to PFASs and childhood overweight/obesity.
The search was performed on the bibliographic databases PubMed and Embase with text strings containing terms related to prenatal, breastfeeding, childhood, overweight, obesity, and PFASs. Only papers describing a biomonitoring study in pregnant women or in children up to 18 years that assessed body mass index (BMI), waist circumference (WC), or fat mass in children were included. When the estimates of the association between a PFAS and an outcome were reported from at least 3 studies, a meta-analysis was conducted; moreover, to correctly compare the studies, we developed a method to convert the different effect estimates and made them comparable each other. Meta-analyses were performed also stratifying by sex and age, and sensitivity analyses were also performed.
In total, 484 and 779 articles were retrieved from PubMed and Embase, respectively, resulting in a total of 826 articles after merging duplicates. The papers included in this systematic review were 49: 26 evaluating prenatal exposure to PFASs, 17 childhood exposure, and 6 both. Considering a qualitative evaluation, results were conflicting, with positive, negative, and null associations. 30 papers were included in meta-analyses (19 prenatal, 7 children, and 4 both). Positive associations were evidenced between prenatal PFNA and BMI, between PFOA and BMI in children who were more than 3 years, and between prenatal PFNA and WC. Negative associations were found between prenatal PFOS and BMI in children who were 3 or less years, and between PFHxS and risk of overweight. Relatively more consistent negative associations were evidenced between childhood exposure to three PFASs (PFOA, PFOS, and PFNA) and BMI, in particular PFOS in boys. However, heterogeneity among studies was high.
Even though heterogeneous across studies, the pooled evidence suggests possible associations, mostly positive, between prenatal exposure to some PFASs and childhood BMI/WC; and relatively stronger evidence for negative associations between childhood exposure to PFASs and childhood BMI.
The aim of this work was to conduct a systematic review with meta-analysis to summarise the associations between prenatal or childhood exposure to PFASs and childhood overweight/obesity.
The search was performed on the bibliographic databases PubMed and Embase with text strings containing terms related to prenatal, breastfeeding, childhood, overweight, obesity, and PFASs. Only papers describing a biomonitoring study in pregnant women or in children up to 18 years that assessed body mass index (BMI), waist circumference (WC), or fat mass in children were included. When the estimates of the association between a PFAS and an outcome were reported from at least 3 studies, a meta-analysis was conducted; moreover, to correctly compare the studies, we developed a method to convert the different effect estimates and made them comparable each other. Meta-analyses were performed also stratifying by sex and age, and sensitivity analyses were also performed.
In total, 484 and 779 articles were retrieved from PubMed and Embase, respectively, resulting in a total of 826 articles after merging duplicates. The papers included in this systematic review were 49: 26 evaluating prenatal exposure to PFASs, 17 childhood exposure, and 6 both. Considering a qualitative evaluation, results were conflicting, with positive, negative, and null associations. 30 papers were included in meta-analyses (19 prenatal, 7 children, and 4 both). Positive associations were evidenced between prenatal PFNA and BMI, between PFOA and BMI in children who were more than 3 years, and between prenatal PFNA and WC. Negative associations were found between prenatal PFOS and BMI in children who were 3 or less years, and between PFHxS and risk of overweight. Relatively more consistent negative associations were evidenced between childhood exposure to three PFASs (PFOA, PFOS, and PFNA) and BMI, in particular PFOS in boys. However, heterogeneity among studies was high.
Even though heterogeneous across studies, the pooled evidence suggests possible associations, mostly positive, between prenatal exposure to some PFASs and childhood BMI/WC; and relatively stronger evidence for negative associations between childhood exposure to PFASs and childhood BMI.
摘要：
背景：过-/多氟烷基物质（PFAS）是持久性有机污染物和可疑的内分泌干扰物。
目的：这项工作的目的是通过荟萃分析进行系统评价，以总结产前或儿童暴露于PFAS与儿童超重/肥胖之间的关系。
方法：在文献数据库PubMed和Embase上进行搜索，文本字符串包含与产前相关的术语，母乳喂养,童年,超重,肥胖，和PFAS。仅有描述孕妇或18岁以下儿童评估体重指数（BMI）的生物监测研究的论文，腰围（WC），或包括儿童的脂肪量。当至少有3项研究报告了PFAS与结果之间的关联估计值时，进行了荟萃分析；此外，为了正确比较研究，我们开发了一种方法来转换不同的效果估计，并使它们相互可比。还进行了Meta分析，按性别和年龄分层，并进行了敏感性分析.
结果：总计，从PubMed和Embase检索到484和779篇文章，分别,合并重复项后，共产生826篇文章。本系统综述中包含的论文是49:26评估PFASs的产前暴露，17童年暴露，6两个考虑到定性评估，结果相互矛盾，积极的,负,和null关联。30篇论文被纳入荟萃分析(19例产前，7个孩子,和4两者）。产前PFNA和BMI之间存在正相关，在3岁以上儿童的PFOA和BMI之间，产前PFNA和WC之间。在3岁或3岁以下的儿童中，产前全氟辛烷磺酸和BMI之间存在负相关，以及PFHxS和超重风险之间的关系。在儿童暴露于三种PFAS之间证明了相对更一致的负面关联(PFOA，全氟辛烷磺酸,和PFNA)和BMI，尤其是男孩的全氟辛烷磺酸。然而,研究之间的异质性很高。
结论：尽管不同的研究，汇集的证据表明可能的关联，大多是积极的，产前暴露于某些PFAS与儿童BMI/WC之间的差异；以及相对更强的证据表明儿童暴露于PFAS与儿童BMI之间存在负相关。
目的：这项工作的目的是通过荟萃分析进行系统评价，以总结产前或儿童暴露于PFAS与儿童超重/肥胖之间的关系。
方法：在文献数据库PubMed和Embase上进行搜索，文本字符串包含与产前相关的术语，母乳喂养,童年,超重,肥胖，和PFAS。仅有描述孕妇或18岁以下儿童评估体重指数（BMI）的生物监测研究的论文，腰围（WC），或包括儿童的脂肪量。当至少有3项研究报告了PFAS与结果之间的关联估计值时，进行了荟萃分析；此外，为了正确比较研究，我们开发了一种方法来转换不同的效果估计，并使它们相互可比。还进行了Meta分析，按性别和年龄分层，并进行了敏感性分析.
结果：总计，从PubMed和Embase检索到484和779篇文章，分别,合并重复项后，共产生826篇文章。本系统综述中包含的论文是49:26评估PFASs的产前暴露，17童年暴露，6两个考虑到定性评估，结果相互矛盾，积极的,负,和null关联。30篇论文被纳入荟萃分析(19例产前，7个孩子,和4两者）。产前PFNA和BMI之间存在正相关，在3岁以上儿童的PFOA和BMI之间，产前PFNA和WC之间。在3岁或3岁以下的儿童中，产前全氟辛烷磺酸和BMI之间存在负相关，以及PFHxS和超重风险之间的关系。在儿童暴露于三种PFAS之间证明了相对更一致的负面关联(PFOA，全氟辛烷磺酸,和PFNA)和BMI，尤其是男孩的全氟辛烷磺酸。然而,研究之间的异质性很高。
结论：尽管不同的研究，汇集的证据表明可能的关联，大多是积极的，产前暴露于某些PFAS与儿童BMI/WC之间的差异；以及相对更强的证据表明儿童暴露于PFAS与儿童BMI之间存在负相关。
