Epidemiological studies

流行病学研究
  • 文章类型: Journal Article
    综述目的:证据表明内分泌干扰物(EDCs)在发育敏感期具有神经毒性。我们概述了儿科人群神经影像学研究,这些研究检查了产前和儿童期EDC暴露对大脑的影响。最近发现:我们发现了46项使用磁共振成像(MRI)检查EDC对大脑的影响的研究。这些研究表明,产前接触邻苯二甲酸盐,有机磷农药(OPs),具有全球和区域大脑结构变化的多芳烃和持久性有机污染物。很少有研究表明与产前OP暴露相关的功能MRI改变。然而,对其他EDC组的研究,例如双酚,和那些检查童年暴露的结论较少。这些发现强调了产前EDC暴露对大脑发育的潜在深远和持久的影响。强调需要更好的监管和策略来减少暴露和减轻影响。需要更多的研究来检查出生后暴露于EDC对脑成像的影响。
    PURPOSE OF REVIEW: Evidence suggests neurotoxicity of endocrine disrupting chemicals (EDCs) during sensitive periods of development. We present an overview of pediatric population neuroimaging studies that examined brain influences of EDC exposure during prenatal period and childhood. RECENT FINDINGS: We found 46 studies that used magnetic resonance imaging (MRI) to examine brain influences of EDCs. These studies showed associations of prenatal exposure to phthalates, organophosphate pesticides (OPs), polyaromatic hydrocarbons and persistent organic pollutants with global and regional brain structural alterations. Few studies suggested alteration in functional MRI associated with prenatal OP exposure. However, studies on other groups of EDCs, such as bisphenols, and those that examined childhood exposure were less conclusive. These findings underscore the potential profound and lasting effects of prenatal EDC exposure on brain development, emphasizing the need for better regulation and strategies to reduce exposure and mitigate impacts. More studies are needed to examine the influence of postnatal exposure to EDC on brain imaging.
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  • 文章类型: Systematic Review
    背景:科学文献报道了西兰花消费与患几种癌症的风险之间的负相关;然而,各研究的结果并不完全一致.对观察性研究进行了系统评价和荟萃分析,以确定西兰花消费与癌症风险之间的关系,目的是阐明西兰花消费对癌症的有益生物学效应。
    方法:PubMed/MEDLINE,WebofScience,Scopus,Cochrane图书馆(中央),和Epidemonikos数据库被搜索以确定所有发表的论文,评估西兰花消费对癌症风险的影响。对纳入研究的引文追逐作为补充搜索策略进行。使用纽卡斯尔-渥太华量表评估个体研究中的偏倚风险。采用随机效应模型荟萃分析对结果进行定量综合,I2指数用于评估异质性。
    结果:荟萃分析包括23项病例对照研究(n=12,929例,18,363例对照;n=31,292例)和12项队列研究(n=699,482例)。结果表明,在病例对照研究(OR:0.64,95%CI从0.58到0.70,p<0.001;Q=35.97,p=0.072,I2=30.49%-中度异质性;τ2=0.016)和队列研究(RR:0.89,95%CI从0.82到0.96,p=0.003;τ333=13.51,p=低0.2)。亚组分析表明,仅在病例对照研究中,西兰花在特定部位癌症中的潜在益处。
    结论:总之,研究结果表明,患有某种癌症的人消耗的西兰花较少,表明西兰花对癌症具有保护性生物学作用。更多研究,尤其是队列研究,有必要阐明西兰花对几种癌症的可能有益作用。
    BACKGROUND: The scientific literature has reported an inverse association between broccoli consumption and the risk of suffering from several types of cancer; however, the results were not entirely consistent across studies. A systematic review and meta-analysis of observational studies were conducted to determine the association between broccoli consumption and cancer risk with the aim of clarifying the beneficial biological effects of broccoli consumption on cancer.
    METHODS: PubMed/MEDLINE, Web of Science, Scopus, Cochrane Library (CENTRAL), and Epistemonikos databases were searched to identify all published papers that evaluate the impact of broccoli consumption on the risk of cancer. Citation chasing of included studies was conducted as a complementary search strategy. The risk of bias in individual studies was assessed using the Newcastle-Ottawa Scale. A random-effects model meta-analysis was employed to quantitatively synthesize results, with the I2 index used to assess heterogeneity.
    RESULTS: Twenty-three case-control studies (n = 12,929 cases and 18,363 controls; n = 31,292 individuals) and 12 cohort studies (n = 699,482 individuals) were included in the meta-analysis. The results suggest an inverse association between broccoli consumption and the risk of cancer both in case-control studies (OR: 0.64, 95% CI from 0.58 to 0.70, p < 0.001; Q = 35.97, p = 0.072, I2 = 30.49%-moderate heterogeneity; τ2 = 0.016) and cohort studies (RR: 0.89, 95% CI from 0.82 to 0.96, p = 0.003; Q = 13.51, p = 0.333, I2 = 11.21%-low heterogeneity; τ2 = 0.002). Subgroup analysis suggested a potential benefit of broccoli consumption in site-specific cancers only in case-control studies.
    CONCLUSIONS: In summary, the findings indicate that individuals suffering from some type of cancer consumed less broccoli, suggesting a protective biological effect of broccoli on cancer. More studies, especially cohort studies, are necessary to clarify the possible beneficial effect of broccoli on several types of cancer.
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  • 文章类型: Systematic Review
    通过吸入途径的六价铬的毒性和致癌性是公认的。然而,关于口服铬对人体健康的潜在影响,已经出现了科学争论。评估摄入铬与普通人群健康不良影响之间联系的流行病学研究有限。近年来,已经出现了大量的生物监测研究,评估体液和组织中铬含量与健康结果之间的关系。本系统综述汇集了过去十年中发表的流行病学和生物监测证据,这些证据涉及与口服铬有关的普通人群的健康影响。总的来说,回顾了65项研究。产前铬暴露与正常胎儿发育之间似乎呈负相关。在成年人中,响应铬暴露,氧化应激和生化改变的参数增加,而对正常肾功能的影响是相互矛盾的。尿路上皮癌的风险不容忽视。然而,关于内部铬浓度和各种组织和系统异常的发现是,在大多数情况下,有争议。环境监测以及大型队列研究和使用多种生物标志物的生物监测可以填补科学空白。
    The toxicity and carcinogenicity of hexavalent chromium via the inhalation route is well established. However, a scientific debate has arisen about the potential effects of oral exposure to chromium on human health. Epidemiological studies evaluating the connection between ingested chromium and adverse health effects on the general population are limited. In recent years, a wealth of biomonitoring studies has emerged evaluating the associations between chromium levels in body fluids and tissues and health outcomes. This systematic review brings together epidemiological and biomonitoring evidence published over the past decade on the health effects of the general population related to oral exposure to chromium. In total, 65 studies were reviewed. There appears to be an inverse association between prenatal chromium exposure and normal fetal development. In adults, parameters of oxidative stress and biochemical alterations increase in response to chromium exposure, while effects on normal renal function are conflicting. Risks of urothelial carcinomas cannot be overlooked. However, findings regarding internal chromium concentrations and abnormalities in various tissues and systems are, in most cases, controversial. Environmental monitoring together with large cohort studies and biomonitoring with multiple biomarkers could fill the scientific gap.
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  • 文章类型: Meta-Analysis
    尽管人类端粒长度(TL)的变化与环境细颗粒物(PM2.5)之间的关联已被证明,相关文献之间仍然存在分歧。我们的研究对流行病学研究进行了系统的回顾和荟萃分析,以在彻底的数据库搜索后调查室外PM2.5暴露对人类TL的健康影响。为了量化与PM2.5暴露量每增加10μg/m3相关的TL变化的总体效应估计,我们专注于两个主要主题,PM2.5的户外长期暴露和产前暴露。此外,由于数据有限,我们纳入了短期PM2.5暴露及其对TL的影响的总结.我们的定性分析包括20项研究,有483,600名参与者。荟萃分析显示,室外PM2.5暴露与较短的人类TL之间存在统计学上的显着关联,总体长期暴露的合并影响估计值(β)为-0.12(95%CI:-0.20,-0.03,I2=95.4%),产前暴露的-0.07(95%CI:-0.15,0.00,I2=74.3%)。总之,我们的研究结果表明,室外PM2.5暴露可能有助于TL缩短,在特定的亚组中观察到值得注意的关联,提示各种研究变量的影响。较大,使用标准化方法的高质量研究对于进一步加强这些结论是必要的。
    Although the association between changes in human telomere length (TL) and ambient fine particulate matter (PM2.5) has been documented, there remains disagreement among the related literature. Our study conducted a systematic review and meta-analysis of epidemiological studies to investigate the health effects of outdoor PM2.5 exposure on human TL after a thorough database search. To quantify the overall effect estimates of TL changes associated with every 10 μg/m3 increase in PM2.5 exposure, we focused on two main topics, which were outdoor long-term exposure and prenatal exposure of PM2.5. Additionally, we included a summary of short-term PM2.5 exposure and its impact on TL due to limited data availability. Our qualitative analysis included 20 studies with 483,600 participants. The meta-analysis showed a statistically significant association between outdoor PM2.5 exposure and shorter human TL, with pooled impact estimates (β) of -0.12 (95% CI: -0.20, -0.03, I2= 95.4%) for general long-term exposure and -0.07 (95% CI: -0.15, 0.00, I2= 74.3%) for prenatal exposure. In conclusion, our findings suggest that outdoor PM2.5 exposure may contribute to TL shortening, and noteworthy associations were observed in specific subgroups, suggesting the impact of various research variables. Larger, high-quality studies using standardized methodologies are necessary to strengthen these conclusions further.
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  • 文章类型: English Abstract
    This paper summarizes the currently available knowledge on the impact of infrasound (IS) and low frequency noise (LFN) on human health and well-being. This narrative review of the literature data was based on the selected, mostly, peer-reviewed research papers, review articles, and meta-analyses that were published in 1971-2022. It has been focused on the results of epidemiological studies concerning the annoyance related to infrasound and low frequency noise, as well as their impact on the cardiovascular system and sleep disorders. Particular attention was also paid to the latest research results and specific sources of IS and LFN, i.e., wind turbines. Med Pr Work Health Saf. 2023;74(5):409-23.
    Niniejsza praca podsumowuje dostępną wiedzę na temat wpływu infradźwięków i hałasu niskoczęstotliwościowego (HNcz) na zdrowie i samopoczucie ludzi. Podstawą tego narracyjnego przeglądu piśmiennictwa były wybrane, głównie recenzowane prace badawcze, artykuły poglądowe i metaanalizy opublikowane w latach 1971–2022. Uwagę skoncentrowano na wynikach badań epidemiologicznych dotyczących dokuczliwości przypisywanej infradźwiękom i HNcz, a także ich wpływowi na układ sercowo-naczyniowy i zaburzenia snu. Szczególną uwagę poświęcono także ostatnim wynikom badań i swoistym źródłom infradźwięków i HNcz, tj. turbinom wiatrowym. Med Pr Work Health Saf. 2023;74(5):409–23.
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  • 文章类型: Journal Article
    幽门螺杆菌(H.pylori)是全球范围内最常见的细菌感染,也是慢性胃炎的主要病因之一,消化性溃疡疾病,和胃肿瘤。抗生素的大量应用没有测试,特别是在SARS-CoV-2大流行的最后几年,可能导致抗生素耐药性急剧增加,并降低根除幽门螺杆菌感染的效果。幽门螺杆菌对抗生素耐药的流行病学机制尚不清楚。应加大抗生素政策力度,优化治疗方案,应定期监测不同地理区域的幽门螺杆菌耐药性。强烈建议根据药敏试验进行个体化治疗,应选择最佳治疗方案。编码抗生素靶蛋白的基因中的突变是幽门螺杆菌抗性的显著危险因素。幽门螺杆菌根除失败的诊断和处方治疗中的医源性错误是其他重要的危险因素。知晓率低和对正确治疗的依从性影响H.pylori耐药率。需要对抗生素耐药性进行流行病学监测并采用新的治疗策略。针对幽门螺杆菌的有效疫苗的发现可以减轻世界上日益增长的抗生素耐药性的压力。
    Helicobacter pylori (H. pylori) is the most common bacterial infection worldwide and one of the main etiological factors of chronic gastritis, peptic ulcer disease, and stomach neoplasms. The mass application of antibiotics without testing, especially during the last years of the pandemic of SARS-CoV-2, could lead to a dramatic increase in antibiotic resistance and reduced effectiveness of eradication regimens for H. pylori infection. The epidemiology of H. pylori resistance to antibiotics still has unclear mechanisms. Antibiotic policy should be intensified to optimize treatment, and regular monitoring of resistance of H. pylori in different geographical regions should be conducted. Individualized treatment according to susceptibility testing is strongly advisable, and the best treatment regimens should be selected. The mutations in the genes encoding the antibiotic target protein are significant risk factors for H. pylori resistance. Iatrogenic errors in diagnosis and prescribing treatment for the failure of H. pylori eradication are other important risk factors. The low level of awareness and compliance with the correct treatment influence the rate of H. pylori resistance. Epidemiological surveillance of antibiotic resistance and the adoption of new treatment strategies are needed. The discovery of an efficient vaccine against H. pylori could reduce the pressure of the world\'s growing antibiotic resistance.
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  • 文章类型: English Abstract
    事实上,流行病学是一门动态发展的医学科学,位于知识和生物信息学的社会和生物分支的交叉点。新的数据来源,新方法为流行病学家创造了独特的机会。在几个相邻学科的交界处进行的流行病学研究的数量正在增加,这需要医学知识不同分支的专家之间的和谐互动。全球死亡率结构向慢性非传染性疾病的转变极大地影响了流行病学研究的媒介。许多干预性流行病学项目旨在评估预防心血管疾病的新方法的有效性。代谢和肿瘤疾病。然而,近年来,每年与影响约10亿人的不记得的感染和夺走50万人生命的斗争变得更加重要。当前的COVID-19大流行也影响了传染病和慢性非传染病的流行病学。目前也非常重视研究社会影响,经济和环境因素对人类健康的影响。人口平均预期寿命的增加有助于老年人流行病学的发展。新项目是在药物流行病学领域启动的,旨在研究药物的有效性。审查国内外出版物,考虑流行病学领域的当前趋势和成就。引用检索引擎,如PubMed,谷歌学者,使用CyberLeninka。分析了当前流行病学研究的方向。强调了现代流行病学发展面临的挑战和发展前景。
    Actually, the epidemiology is a dynamically developing medical science located at the intersection of social and biological branches of knowledge and bio-informatics. The new sources of data, the new methods create unique opportunities for epidemiologist. The number of epidemiological studies carrying out at the junction of several adjacent disciplines is increasing that requires harmonious interaction of specialists of different branches of medical knowledge. The change of the structure of global mortality towards chronic non-communicable diseases significantly affected the vector of epidemiological studies. Many interventional epidemiological projects are targeted to evaluation of effectiveness of new methods of prevention of cardiovascular, metabolic and oncological diseases. However, in recent years, the fight against unremembered infections affecting about 1 billion of people and taking away lives of 0.5 million people annually gained new importance. The current COVID-19 pandemic also affected epidemiology of communicable and chronic non-communicable diseases. Great attention is also currently attended to studying influence of social, economic and environmental factors on human health. The increase of average life expectancy of population contributes to development of epidemiology of the elderly. The new projects are initiated in the field of pharmacoepidemiology targeted to studying effectiveness of medications. The review of national and foreign publications considering current trends and achievements in the field of epidemiology. The reference retrieval engines such as PubMed, Google Scholar, CyberLeninka were used. The current directions of epidemiological research are analyzed. The challenges and development prospects of development of modern epidemiology are highlighted.
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  • 文章类型: Journal Article
    目的:本范围综述旨在探讨当前的文献,以描述耳鼻咽喉头颈外科(OtoHNS)中的短期手术旅行(STST)对外科手术的贡献,教育,以及低收入和中等收入国家(LMICs)基于可持续性的成果。我们的目标是利用这些数据来综合成功的STST的各个方面,并希望塑造未来的全球努力。
    方法:数据源包括OvidMEDLINE,OvidEmbase,OvidCochrane中央控制试验登记册,OvidCochrane系统评价数据库,还有Scopus.
    方法:从开始到2021年10月14日,对多个数据库进行了全面搜索。我们纳入了初步研究,探索LMIC内部全球短期手术努力的任何手术或教育成果。然后提取数据来评估存在的异质性文献,表征手术,教育,和基于可持续性的结果。
    结果:47项研究纳入最终分析。大多数出版物都集中在手术干预上(47个中的39个;82.9%);13项(27.7%)研究将教育作为主要目标,12项(25.5%)研究将可持续性视为重要目标。在94位第一和最后一位作者中,第一作者为零,只有最后一位作者与LMIC有关联.26项研究(55%)提到在随访中发现了任何患者,从一天到五年不等。
    结论:我们的范围审查表明,大多数STST主要集中在外科手术上,缺乏适当的长期随访。然而,提供的基于结果的可用信息有助于确定短期全球手术计划的特征因素.
    方法:N/A喉镜,2023年。
    This scoping review aims to explore the current body of literature to characterize how short-term surgical trips (STSTs) in Otolaryngology-Head and Neck Surgery (OtoHNS) contribute to surgical, educational, and sustainability-based outcomes in low- and middle-income countries (LMICs). We aim to use these data to synthesize aspects of STSTs that are successful with the hopes of shaping future global efforts.
    Data sources included Ovid MEDLINE, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus.
    A comprehensive search was conducted on several databases from inception to October 14, 2021. We included primary studies exploring any surgical or educational outcomes of global short-term surgical endeavors within LMICs. Data were then extracted to evaluate the heterogenous body of literature that exists, characterizing the surgical, educational, and sustainability-based outcomes.
    Forty-Seven studies were included in the final analysis. Most publications were focused on surgical interventions (39 of 47; 82.9%); 13 (27.7%) studies included education as the primary aim and 12 (25.5%) considered sustainability a significant aim. Of the 94 first and last authors, there were zero first authors and only one last author with an LMIC affiliation. Twenty-six studies (55%) mentioned that any patients were seen in follow-up, ranging from one day to five years.
    Our scoping review demonstrates that most STSTs have focused primarily on surgical procedures with a lack of appropriate long-term follow-up. However, the available outcome-based information presented helps identify factors that characterize a strong short-term global surgical program.
    NA Laryngoscope, 134:32-39, 2024.
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  • 文章类型: Journal Article
    颗粒物(PM)被认为是一种宫内毒素,可以穿过血液-胎盘屏障并在胎儿血液中循环,影响胎儿发育,并牵涉到胎盘和宫内炎症,和氧化损伤。然而,PM暴露与不良妊娠结局之间的关系尚不清楚,我们的目的是系统地回顾妊娠期PM暴露与妊娠期糖尿病或妊娠期高血压疾病发展之间联系的毒理学证据。包括妊娠高血压和先兆子痫。搜索PubMed和ScienceDirect,直到2022年1月。在确定的204项研究中,168人被排除在外。其余文章进行了全文评估,经过评估,27人被纳入审查。大多数研究表明PM暴露与妊娠期高血压之间存在关联,收缩压和舒张压,先兆子痫,和妊娠期糖尿病。由于基线浓度的异质性,这些结果应谨慎解释。PM2.5和PM10的浓度分别为3.3μg/m3至85.9μg/m3和21.8μg/m3至92.2μg/m3。此外,关键暴露时间在研究中并不一致,十分之五的观察性研究报告妊娠中期是妊娠高血压疾病的关键时期,12项观察性研究中有10项报告妊娠早期或中期为妊娠期糖尿病的关键时期。总的来说,研究结果支持孕期PM暴露与不良妊娠结局之间的关联,强调需要进一步研究以确定关键暴露期和潜在机制。
    Particulate matter (PM) is considered an intrauterine toxin that can cross the blood-placental barrier and circulate in fetal blood, affecting fetal development, and implicating placental and intrauterine inflammation, and oxidative damage. However, the relationship between PM exposure and adverse pregnancy outcomes is still unclear and our aim was to systematically review toxicological evidence on the link between PM exposure during pregnancy and the development of gestational diabetes mellitus or hypertensive disorders of pregnancy, including gestational hypertension and pre-eclampsia. PubMed and Science Direct were searched until January 2022. Of the 204 studies identified, 168 were excluded. The remaining articles were assessed in full-text, and after evaluation, 27 were included in the review. Most of the studies showed an association between PM exposure and gestational hypertension, systolic and diastolic blood pressure, pre-eclampsia, and gestational diabetes mellitus. These results should be interpreted with caution due to the heterogeneity of baseline concentrations, which ranged from 3.3 μg/m3 to 85.9 μg/m3 and from 21.8 μg/m3 to 92.2 μg/m3, respectively for PM2.5 and PM10. Moreover, critical exposure periods were not consistent among studies, with five out of ten observational studies reporting the second trimester as the critical period for hypertensive disorders of pregnancy, and ten out of twelve observational studies reporting the first or second trimester as the critical period for gestational diabetes mellitus. Overall, the findings support an association between PM exposure during pregnancy and adverse pregnancy outcomes, highlighting the need for further research to identify the critical exposure periods and underlying mechanisms.
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  • 文章类型: Systematic Review
    背景:人体内镉(Cd)的吸收和积累可能受到某些微量营养素状态的影响,尽管有关微量营养素暴露与Cd身体负担之间关联的现有证据仍然支离破碎且不一致。为了解决这个问题,本文回顾并综合了流行病学研究,这些研究检查了微量营养素暴露与人类Cd负担之间的关系,阐明微量营养素暴露与Cd身体负担之间的潜在关联。
    方法:我们对流行病学研究进行了系统评价,这些研究报告了人群中微量营养素状态与Cd身体负担之间的关联。相关文章是根据PubMed的预定标准选择的,WebofScience,以及2000年至2021年发布的Scopus数据库。评估的暴露包括微量营养素(锌,硒,铁,钙,和维生素)状态或摄入量。感兴趣的结果是血液Cd或尿Cd水平所指示的Cd身体负担。使用JoannaBriggs研究所关键评估工具评估纳入研究的质量。我们从每篇文章中提取数据,包括研究设计,研究地点,研究人群,微量营养素状况,Cd身体负担,以及微量营养素状态与Cd身体负担之间的相关性。
    结果:我们的系统搜索产生了1660篇文章。其中,根据预设的标准选择了44例纳入.这些精选的文章评估了Cd身体负担与七种不同微量营养素之间的关系,即,硒(Se),锌(Zn),钙(Ca),铁(Fe),维生素A,维生素B12和维生素D。大多数研究(n=41)是观察性的,而只有三项是随机对照试验。在评估锌状态的17项研究中,10人报告血清锌水平或摄入量与尿和血液镉水平之间呈负相关。在检验硒水平与镉体负荷之间关系的十项研究中,结果不一致。六项研究表明,血液和尿液中的Cd与血清铁蛋白(SF)呈负相关,身体铁状态的生物标志物。两项研究报道了Ca与血液Cd之间的负相关。
    结论:现有证据的综合表明,某些微量营养素,特别是锌和铁,可能在减轻人群中Cd身体负担方面发挥作用。证据强烈支持锌之间的负相关,Fe,和Cd身体负担,而Se的证据,钙和维生素不足以就它们与Cd身体负担的关系得出明确的结论。此外,观察性研究限制了推断微量营养素与Cd身体负担之间因果关系的能力,强调需要额外的干预研究。我们的审查可能会为营养补充提供指导,控制Cd身体负担,以及未来在全球Cd污染背景下减轻Cd对健康不利影响的研究。
    BACKGROUND: The absorption and accumulation of cadmium (Cd) within the human body can be influenced by the status of certain micronutrients, while available evidence for the association between micronutrient exposure and Cd body burden remains fragmented and inconsistent. To address this issue, this article reviews and synthesizes epidemiological studies that examine the association between micronutrient exposure and Cd burden in humans, to elucidate the potential association between micronutrient exposure and Cd body burden.
    METHODS: We conducted a systematic review of epidemiologic studies reporting the association between micronutrient status and Cd body burden among the population. Relevant articles were selected based on predetermined criteria from PubMed, Web of Science, and Scopus databases published from 2000 to 2021. The exposures that were evaluated included micronutrients (zinc, selenium, iron, calcium, and vitamins) status or intakes of them. The outcome of interest was the Cd body burden as indicated by blood Cd or urinary Cd levels. The quality of included studies was assessed using The Joanna Briggs Institute critical appraisal tool. We extracted data from each article, including study design, study site, study population, micronutrient status, Cd body burden, and the correlations between micronutrient status and Cd body burden.
    RESULTS: Our systematic search yielded 1660 articles. Of these, forty-four were selected for inclusion based on prespecified criteria. These selected articles evaluated the relationship between Cd body burden and seven different micronutrients, namely, selenium (Se), zinc (Zn), calcium (Ca), iron (Fe), vitamin A, vitamin B12, and vitamin D. The majority of studies (n = 41) were observational, while only three were randomized controlled trials. Among the seventeen studies assessing Zn status, ten reported a negative association between serum Zn levels or intake and urinary and blood Cd levels. Results were inconsistent among the ten studies examining the association between Se levels and Cd body burden. Six studies showed that Cd in blood and urine was negatively correlated with serum ferritin (SF), a biomarker of body Fe status. Two studies reported a negative correlation between Ca and blood Cd.
    CONCLUSIONS: This synthesis of available evidence suggests that certain micronutrients, especially Zn and Fe, may play a role in reducing the Cd body burden among populations. The evidence strongly supports a negative association between Zn, Fe, and Cd body burden, whereas evidence for Se, Ca and vitamins is insufficient to draw definitive conclusions regarding their relationship with Cd body burden. In addition, observational studies limit the ability to infer a causal relationship between micronutrients and Cd body burden, highlighting the need for additional intervention studies. Our review may inform nutrient supplementation guidance, control of Cd body burden, and future research to mitigate the adverse health effects of Cd in the context of global Cd pollution.
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