这是关于产前邻苯二甲酸盐暴露与儿童心脏代谢风险关联的第一个试点荟萃分析。在MEDLINE进行了系统的文献检索,WebofScience和CNKI(中国国家知识基础设施)至2023年6月5日。最终纳入了总共7项研究,涉及5746名儿童(2646名女孩和3100名男孩)。四个,三项和两项研究调查了母亲邻苯二甲酸盐暴露对儿童血压(BP)的影响,血脂和血糖概况,分别。初步荟萃分析表明,邻苯二甲酸二-2-乙基己酯(DEHP)代谢物暴露与儿童z收缩压下降有关(SBP,β=-0.169,95%CI=-0.338-0.001)。此外,汇总结果显示,产前∑DEHP暴露与z-SBP(β=-0.109,95%CI=-0.163至-0.055)和z-舒张BP(DBP,女孩的β=-0.126,95%CI=-0.182至-0.069)。此外,女性MEP暴露与z-SBP相关(β=-0.227,95%CI=-0.387至-0.066)。汇总结果显示,产前∑DEHP暴露与甘油三酯之间存在正相关关系(β=0.103,95%CI=0.028-0.178)。总体结果显示,在整个妊娠期暴露于∑DEHP与男孩胰岛素(β=-0.074,95%CI=-0.144至-0.004)和葡萄糖(β=-0.129,95%CI=-0.199至-0.058)的减少有关。有趣的是,在青春期男孩中,产前邻苯二甲酸单-3-羧丙基酯(MCPP)暴露与葡萄糖呈负相关(β=-3.749,95%CIs=-6.758~-0.741),但在青春期后儿童中没有发现.总之,产前邻苯二甲酸盐暴露会干扰性别差异儿童的心血管风险,并受青春期影响.总的来说,产前∑DEHP与女孩的收缩压和男孩的胰岛素和葡萄糖呈负相关,但增加了甘油三酯水平.
This is the first pilot meta-analysis on the association of prenatal phthalate exposure with childhood cardiometabolic risks. A systematic literature search was performed in MEDLINE, Web of Science and CNKI (Chinese National Knowledge Infrastructure) until June 5, 2023. A total of seven studies with 5746 children (2646 girls and 3100 boys) were finally included. Four, three and two studies investigated the effects of maternal phthalate exposure on childhood blood pressure (BP), blood lipids and blood glucose profiles, respectively. The pilot meta-analysis suggested that di-2-ethylhexyl phthalate (DEHP) metabolite exposure was associated with a decrease in childhood z-systolic BP (SBP, β = -0.169, 95% CI = -0.338-0.001). Furthermore, the pooled results showed negative relationships of prenatal ∑DEHP exposure with z-SBP (β = -0.109, 95% CI = -0.163 to -0.055) and z-diastolic BP (DBP, β = -0.126, 95% CI = -0.182 to -0.069) in girls. In addition, MEP exposure was associated with z-SBP in girls (β = -0.227, 95% CI = -0.387 to -0.066). The pooled result showed a positive relationship between prenatal ∑DEHP exposure and triglycerides (β = 0.103, 95% CI = 0.028-0.178). The overall results revealed that exposure to ∑DEHP throughout gestation was associated with a decrease in insulin (β = -0.074, 95% CI = -0.144 to -0.004) and glucose (β = -0.129, 95% CI = -0.199 to -0.058) in boys. Interestingly, there was an inverse relationship of prenatal mono- 3 -carboxypropyl phthalate (MCPP) exposure with glucose in pubertal boys (β = -3.749, 95% CIs = -6.758 to -0.741) but not found in postpubertal children. In conclusion, prenatal phthalate exposure interfered with cardiovascular risk in children with gender-specific differences and was influenced by puberty. Overall, prenatal ∑DEHP was negatively associated with systolic blood pressure in girls and with insulin and glucose in boys but increased the level of triglycerides.