Western diet

西方饮食
  • 文章类型: Journal Article
    患有2型糖尿病(T2DM)的人患心力衰竭的风险增加,然而,在这一人群中,预防性心脏护理并不理想。吡哆胺(PM),维生素B6类似物,已被证明在代谢和心血管疾病中发挥保护作用。在这项研究中,我们旨在研究PM是否限制T2DM大鼠的不良心脏重塑和功能障碍.雄性大鼠接受标准饮食或西方饮食(WD)18周以诱发糖尿病前期。一个WD组通过饮用水接受额外的PM(1g/L)。用1小时口服葡萄糖耐量试验评估葡萄糖耐量。使用超声心动图和血流动力学测量评估心功能。对左心室(LV)组织进行组织学检查。与WD喂养的大鼠相比,用PM处理防止了空腹血浆葡萄糖水平的增加(p<0.05)。倾向于使用PM补充来预防LV心脏扩张。在左心室组织中,PM限制了WD喂养大鼠的间质胶原沉积的增加(p<0.05)。与WD喂养的大鼠相比,PM倾向于降低3-硝基酪氨酸并显着降低4-羟基壬烯醛的含量。我们得出的结论是,PM减轻了WD诱导的糖尿病前期大鼠心脏的间质纤维化和氧化应激。
    Individuals with type 2 diabetes mellitus (T2DM) are at an increased risk for heart failure, yet preventive cardiac care is suboptimal in this population. Pyridoxamine (PM), a vitamin B6 analog, has been shown to exert protective effects in metabolic and cardiovascular diseases. In this study, we aimed to investigate whether PM limits adverse cardiac remodeling and dysfunction in rats who develop T2DM. Male rats received a standard chow diet or Western diet (WD) for 18 weeks to induce prediabetes. One WD group received additional PM (1 g/L) via drinking water. Glucose tolerance was assessed with a 1 h oral glucose tolerance test. Cardiac function was evaluated using echocardiography and hemodynamic measurements. Histology on left ventricular (LV) tissue was performed. Treatment with PM prevented the increase in fasting plasma glucose levels compared to WD-fed rats (p < 0.05). LV cardiac dilation tended to be prevented using PM supplementation. In LV tissue, PM limited an increase in interstitial collagen deposition (p < 0.05) seen in WD-fed rats. PM tended to decrease 3-nitrotyrosine and significantly lowered 4-hydroxynonenal content compared to WD-fed rats. We conclude that PM alleviates interstitial fibrosis and oxidative stress in the hearts of WD-induced prediabetic rats.
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  • 文章类型: Journal Article
    肥胖与心血管疾病之间的相关性早已被人们所理解,然而,很少有研究试图确定肥胖饮食对血小板活化或功能的影响。由于血小板驱动凝块形成,心血管事件的终点,我们的目的是通过流式细胞术评估血小板活化标志物,阐明肥胖饮食对血小板表型的纵向影响.男性,断奶小鼠喂食西方饮食(30%千卡蔗糖,40%大卡脂肪,8.0%钠)或对照饮食(7%千卡蔗糖,10%大卡脂肪,0.24%钠)。在12、16和20周的饮食中,收集血小板并染色以显示糖蛋白Ibα(GPIbα),胶原刺激后P-选择素和αIIbβ3(血小板特异性整联蛋白)的构象活性状态。在所有时间点,西方饮食广泛降低了血小板中GPIbα和αIIbβ3的表达,而P-选择素水平不受影响。然而,在GPIb-亚群中,通过西方饮食减少P-选择素。因此,西方饮食持续使血小板向钝化的活化反应,如活性αIIbβ3和P-选择素表面表达降低所示。这项研究首次了解了饮食对血小板活化的影响,并揭示了血小板活化易受饮食干预的影响。
    The correlation between obesity and cardiovascular disease has long been understood, yet scant investigations endeavored to determine the impact of an obesogenic diet on platelet activation or function. As platelets drive clot formation, the terminus of cardiovascular events, we aimed to elucidate the longitudinal effect of an obesogenic diet on platelet phenotype by assessing markers of platelet activation using flow cytometry. Male, weanling mice were fed either a Western diet (30% kcal sucrose, 40% kcal fat, 8.0% sodium) or Control diet (7% kcal sucrose, 10% kcal fat, 0.24% sodium). At 12, 16 and 20 weeks on diets, platelets were collected and stained to visualize glycoprotein Ibα (GPIbα), P-selectin and the conformationally active state of αIIbβ3 (a platelet specific integrin) after collagen stimulation. At all time points, a Western diet reduced GPIbα and αIIbβ3 expression in platelets broadly while P-selectin levels were unaffected. However, P-selectin was diminished by a Western diet in the GPIbα- subpopulation. Thus, a Western diet persistently primed platelets towards a blunted activation response as indicated by reduced active αIIbβ3 and P-selectin surface expression. This study provides a first look at the influence of diet on platelet activation and revealed that platelet activation is susceptible to dietary intervention.
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  • 文章类型: Journal Article
    阿尔茨海默病(AD)的两个主要决定因素是遗传和生活方式。载脂蛋白E(APOE)基因的等位基因在晚发性AD的发生发展中起重要作用,随着APOE4风险的增加,APOE3是中立的,和APOE2降低风险。已经研究了几种可改变的生活方式因素如何改变AD的风险。这些因素包括膳食模式,营养补充剂,如omega-3脂肪酸,还有B族维生素,体育锻炼,肥胖,和维生素D。西方饮食会增加患AD的风险,而地中海和素食/纯素饮食等饮食模式可降低风险。与降低风险相关的食物包括咖啡,水果和蔬菜,全谷物和豆类,鱼,虽然肉类和超加工食品与风险增加有关,尤其是当它们导致肥胖时。在多国生态学研究中,国民饮食中的肉类含量与AD风险的相关性最高。这篇综述强调了饮食模式对AD风险的研究历史。AD的风险可以至少从中年开始改变。具有更大的AD遗传风险的人将通过选择生活方式因素来减少和/或延迟AD的发病率而受益更多。
    The two major determining factors for Alzheimer\'s disease (AD) are genetics and lifestyle. Alleles of the apolipoprotein E (APOE) gene play important roles in the development of late-onset AD, with APOEɛ4 increasing risk, APOEɛ3 being neutral, and APOEɛ2 reducing risk. Several modifiable lifestyle factors have been studied in terms of how they can modify the risk of AD. Among these factors are dietary pattern, nutritional supplements such as omega-3 fatty acids, and B vitamins, physical exercise, and obesity, and vitamin D. The Western diet increases risk of AD, while dietary patterns such as the Mediterranean and vegetarian/vegan diets reduce risk. Foods associated with reduced risk include coffee, fruits and vegetables, whole grains and legumes, and fish, while meat and ultraprocessed foods are associated with increased risk, especially when they lead to obesity. In multi-country ecological studies, the amount of meat in the national diet has the highest correlation with risk of AD. The history of research regarding dietary patterns on risk of AD is emphasized in this review. The risk of AD can be modified starting at least by mid-life. People with greater genetic risk for AD would benefit more by choosing lifestyle factors to reduce and/or delay incidence of AD.
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  • 文章类型: English Abstract
    UNASSIGNED: Proinflammatory diet contributes to greater symptomatology in patients with knee osteoarthritis (KOA); however, in Mexico there seems to be no evidence of the dietary inflammatory role, being a country with high prevalence of overweight and obesity with an inclination towards a Western diet.
    UNASSIGNED: To analyze the relationship between dietary inflammatory index (DII) and KOA symptomatology in Mexican patients.
    UNASSIGNED: Analytical cross-sectional study in 100 patients aged 40 to 70 years. Pain, stiffness, and functionality were evaluated with the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the DII was calculated from the semi-quantitative food consumption frequency questionnaire (QFCFQ). For its analysis, linear regression was calculated.
    UNASSIGNED: DII was significantly associated with pain (p = 0.001, R² = 0.118), functionality (p = 0.003, R² = 0.087) and WOMAC score (p = 0.001, R² = 0.099). In the second linear regression model with the dependent variable functionality, waist circumference (WC) was adjusted obtaining an R² = 0.144 and higher significance p = 0.001.
    UNASSIGNED: Proinflammatory DII was related to greater pain, lower functionality and a high WOMAC score, which is why the anti-inflammatory diet could be considered as a support for the treatment of the patient with KOA.
    UNASSIGNED: la dieta proinflamatoria contribuye a una mayor sintomatología en pacientes con osteoartritis de rodilla (OAR); sin embargo, en México parece no existir evidencia del papel inflamatorio dietético, pues es un país con alta prevalencia de sobrepeso y obesidad con inclinación hacia una dieta occidental.
    UNASSIGNED: analizar la relación del índice inflamatorio dietético (IID) con la sintomatología de OAR en pacientes mexicanos.
    UNASSIGNED: estudio transversal, analítico en 100 pacientes de 40 a 70 años. Se evaluó el dolor, la rigidez y la funcionalidad con el Western Ontario and McMaster Universities Arthritis Index (WOMAC) y el IID se calculó a partir del cuestionario semicuantitativo de frecuencia de consumo de alimentos (CSFC). Para su análisis, se calculó regresión lineal.
    UNASSIGNED: el IID se asoció significativamente con dolor (p = 0.001, R² = 0.118), funcionalidad (p = 0.003, R² = 0.087) y puntaje del WOMAC (p = 0.001, R² = 0.099). En el segundo modelo de regresión lineal con la variable dependiente funcionalidad, se ajustó la circunferencia de cintura (CC) y se obtuvo una R² = 0.144 y una mayor significación: p = 0.001.
    UNASSIGNED: el IID proinflamatorio se relacionó con un mayor dolor, una menor funcionalidad y un puntaje alto del WOMAC, por lo cual la dieta antiinflamatoria podría considerarse como un apoyo para el tratamiento del paciente con OAR.
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  • 文章类型: Journal Article
    食物成分作为药物的作用是健康和肥胖的重要考虑因素。维生素C作为小分子抗氧化剂,但也是参与健康体重和能量代谢的许多过渡金属依赖性酶的辅助因子。维生素C不能由人类制造,主要来自新鲜水果和蔬菜的饮食摄入。在推荐的维生素C每日摄入量中,不同的营养指南之间存在很大差异。维生素C缺乏症是由于摄入含维生素C的食物不足以及氧化和羰基应激的利用增加所致。维生素C缺乏的危险因素包括吸烟,营养不良,肥胖,2型糖尿病,年龄,种族,性别,社会孤立,大手术,和西式饮食。尽管人们普遍认为维生素C缺乏在富裕国家很少见,对大量人群和特定患者群体的调查表明,情况并非如此。肥胖患者通常消耗高度加工,富含能量的食物,含有不足的微量营养素。随着肥胖的增加,为了达到足够的血浆和组织浓度,需要大量的口服维生素C,与体重健康的人相比。这对于控制氧化应激和维持体内平衡和器官功能是重要的。在这篇叙述性评论中,剂量,吸收,分布,排泄,并对维生素C的分解代谢进行了综述,以及肥胖患者维生素C药理学的最新发现。
    The role of food constituents as pharmacological agents is an important consideration in health and obesity. Vitamin C acts as a small molecule antioxidant but is also a co-factor for numerous transition metal-dependent enzymes involved in healthy weight and energy metabolism. Vitamin C cannot be manufactured by humans and is mainly obtained from the dietary intake of fresh fruit and vegetables. There is great variability between different nutritional guidelines in the recommended daily allowance of vitamin C. Vitamin C deficiency results from an inadequate intake of vitamin C-containing foods and also increased utilization by oxidative and carbonyl stress. Risk factors for vitamin C deficiency include cigarette smoking, malnutrition, obesity, type 2 diabetes mellitus, age, race, sex, social isolation, major surgery, and Western-type diets. Despite the common belief that vitamin C deficiency is rare in affluent countries, surveys of large populations and specific patient groups suggest otherwise. Patients with obesity typically consume highly processed, energy-dense foods which contain inadequate micronutrients. As obesity increases, larger amounts of oral vitamin C are required to achieve adequate plasma and tissue concentrations, as compared to persons with a healthy weight. This is important in the control of oxidative stress and the maintenance of homeostasis and organ function. In this narrative review, the dosage, absorption, distribution, excretion, and catabolism of vitamin C are reviewed, together with the latest findings on vitamin C pharmacology in patients with obesity.
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  • 文章类型: Journal Article
    肥胖和环境毒素是乳腺癌的危险因素;然而,关于这些危险因素如何相互作用以促进乳腺癌的知识有限。丙烯酰胺,一种可能的致癌物和致癌物,是导致肥胖的西方饮食中普遍存在的食物中的副产品。丙烯酰胺被细胞色素P4502E1(CYP2E1)代谢为基因毒性环氧化物,缩水甘油胺,并且与患乳腺癌的风险增加有关。为了调查丙烯酰胺和肥胖如何相互作用以增加乳腺癌风险,雌性小鼠饲喂低脂肪(LFD)或高脂肪饮食(HFD)和对照水或补充丙烯酰胺的水,其水平与人类平均每日暴露量相似.虽然HFD显著增强小鼠的体重增加,与相应的对照相比,添加丙烯酰胺并没有显著改变体重.肥胖的乳腺上皮细胞,与所有其他组相比,丙烯酰胺处理的小鼠的DNA链断裂和氧化性DNA损伤增加。体外,缩水甘油胺处理的COMMA-D细胞显示显著增加的DNA链断裂,而丙烯酰胺处理的细胞表现出明显更高水平的细胞内活性氧。CYP2E1的敲除拯救了丙烯酰胺诱导的氧化应激。这些研究表明,通过西方饮食中常见的食物长期接触丙烯酰胺可能会增强DNA损伤和CYP2E1诱导的乳腺上皮细胞氧化应激的产生,可能增加肥胖引起的乳腺癌风险。
    Obesity and environmental toxins are risk factors for breast cancer; however, there is limited knowledge on how these risk factors interact to promote breast cancer. Acrylamide, a probable carcinogen and obesogen, is a by-product in foods prevalent in the obesity-inducing Western diet. Acrylamide is metabolized by cytochrome P450 2E1 (CYP2E1) to the genotoxic epoxide, glycidamide, and is associated with an increased risk for breast cancer. To investigate how acrylamide and obesity interact to increase breast cancer risk, female mice were fed a low-fat (LFD) or high-fat diet (HFD) and control water or water supplemented with acrylamide at levels similar to the average daily exposure in humans. While HFD significantly enhanced weight gain in mice, the addition of acrylamide did not significantly alter body weights compared to respective controls. Mammary epithelial cells from obese, acrylamide-treated mice had increased DNA strand breaks and oxidative DNA damage compared to all other groups. In vitro, glycidamide-treated COMMA-D cells showed significantly increased DNA strand breaks, while acrylamide-treated cells demonstrated significantly higher levels of intracellular reactive oxygen species. The knockdown of CYP2E1 rescued the acrylamide-induced oxidative stress. These studies suggest that long-term acrylamide exposure through foods common in the Western diet may enhance DNA damage and the CYP2E1-induced generation of oxidative stress in mammary epithelial cells, potentially enhancing obesity-induced breast cancer risk.
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  • 文章类型: Journal Article
    肠出血性大肠杆菌(EHEC)是一种主要的食源性病原体,可引起从腹泻到危及生命的并发症的人类疾病。越来越多的证据表明,西方饮食增强小鼠对肠道感染的易感性,但是饮食对EHEC定植的影响和人类肠道微生物群的作用仍然未知。我们的研究旨在研究标准饮食与西方饮食对体外人粘膜白质结肠(M-ARCOL)中EHEC定植的影响以及肠道菌群组成和活动的相关变化。在使用简化的粪便批次实验进行供体选择后,两个M-ARCOL生物反应器接种人粪便样品(n=4),并平行运行,一个接受标准饮食的人,另一种是西方饮食,并感染了EHECO157:H7菌株EDL933。EHEC定植取决于供体和腔内样本中的饮食,但保持在粘膜区室没有消除,为病原体提供了有利的生态位,并可能充当水库。西方饮食也影响了细菌短链脂肪酸和胆汁酸谱,与高丁酸浓度和延长EHEC定殖之间可能存在联系。这项工作展示了复杂的体外模型的应用,以提供对饮食的见解,微生物群,和人体肠道中的病原体相互作用。
    Enterohemorrhagic Escherichia coli (EHEC) is a major food-borne pathogen that causes human disease ranging from diarrhea to life-threatening complications. Accumulating evidence demonstrates that the Western diet enhances the susceptibility to enteric infection in mice, but the effect of diet on EHEC colonization and the role of human gut microbiota remains unknown. Our research aimed to investigate the effects of a Standard versus a Western diet on EHEC colonization in the human in vitro Mucosal ARtificial COLon (M-ARCOL) and the associated changes in the gut microbiota composition and activities. After donor selection using simplified fecal batch experiments, two M-ARCOL bioreactors were inoculated with a human fecal sample (n = 4) and were run in parallel, one receiving a Standard diet, the other a Western diet and infected with EHEC O157:H7 strain EDL933. EHEC colonization was dependent on the donor and diet in the luminal samples, but was maintained in the mucosal compartment without elimination, suggesting a favorable niche for the pathogen, and may act as a reservoir. The Western diet also impacted the bacterial short-chain fatty acid and bile acid profiles, with a possible link between high butyrate concentrations and prolonged EHEC colonization. The work demonstrates the application of a complex in vitro model to provide insights into diet, microbiota, and pathogen interactions in the human gut.
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  • 文章类型: Journal Article
    在评估饮食诱导的氧化应激和炎症时,尿液中的饮食生物标志物仍然难以捉摸。在我们之前的研究中,我们进行了一项随机对照交叉试验,以比较均衡韩国饮食(BKD)与西方饮食的短期(4周)效果,包括2010年美国人饮食指南(2010DGA)和典型的美国饮食(TAD),肥胖韩国成年人的各种代谢指标。在这项工作的基础上,目前的研究集中在这些饮食干预对氧化应激(D-ROM和BAP)和炎症(CRP,TNF-α,IL-6,IL-1β,血清中的MCP-1)生物标志物,和并发的尿液代谢组。每种饮食方案都是在计算机上进行的,并使用ABTS对其抗氧化剂水平进行了实验检查,DPPH,和FRAP测定,以及总黄酮(TFC)和总酚(TPC)含量。我们评估了血清中氧化应激和炎症生物标志物的干预后变化,以及参与者的尿液代谢物谱(n=48,平均年龄:41岁)。与TAD相比,推荐饮食(BKD和2010DGA)的抗氧化剂含量和相关总抗氧化能力(TAC)明显更高(p<0.05)。与ABTS中的TAD相比,推荐饮食中的丁醇提取物(BKD和2010DGA)显示出明显更高的抗氧化活性(p<0.01),DPPH,和FRAP(p<0.05)测定。在总酚和类黄酮含量中观察到一致的结果,反映他们各自的抗氧化活性。干预期之后,血清中的氧化应激和炎症标志物略有变化,然而,BKD和西方饮食组的尿液代谢物谱被明确划分(PC1=5.41%).对于BKD组,干预前和干预后尿液代谢物谱明显分离(PLS2=2.93%).与TAD相比,推荐饮食组的尿液提取物中苯甲酸和酚类衍生物含量较高(VIP>0.7,p<0.05).与BKD相比,在西方饮食组的尿液样品中观察到与氧化应激相关的代谢物更高。尿液代谢组学数据描述了三种饮食干预措施的干预后效果,这证实了它们对代谢指标的影响。
    Dietary biomarkers in urine remain elusive when evaluating diet-induced oxidative stress and inflammation. In our previous study, we conducted a randomized controlled crossover trial to compare the short-term (4-weeks) effects of the balanced Korean diet (BKD) with Western diets, including the 2010 dietary guidelines for Americans (2010 DGA) and typical American diet (TAD), on various metabolic indices in obese Korean adults. Building on this work, the current research focuses on the impact of these dietary interventions on oxidative stress (d-ROMs and BAP) and inflammation (CRP, TNF-α, IL-6, IL-1β, MCP-1) biomarkers in serum, and the concurrent urine metabolomes. Each dietary regimen was in silico and experimentally examined for their antioxidant levels using ABTS, DPPH, and FRAP assays, as well as total flavonoid (TFC) and total phenolic (TPC) contents. We assessed post-intervention variations in oxidative stress and inflammation biomarkers in serum, as well as the urine metabolite profiles for the participants (n = 48, average age: 41 years). Antioxidant contents and associated total antioxidant capacity (TAC) were significantly higher for the recommended diets (BKD and 2010 DGA) compared to TAD (p < 0.05). Butanol extracts from recommended diets (BKD and 2010 DGA) showed significantly higher antioxidant activity compared to TAD in ABTS (p < 0.01), DPPH, and FRAP (p < 0.05) assays. Consistent results were observed in total phenolic and flavonoid contents, mirroring their respective antioxidant activities. Following the intervention period, oxidative stress & inflammation markers in serum varied marginally, however, the urine metabolite profiles were clearly demarcated for the BKD and Western dietary groups (PC1 = 5.41%). For BKD group, the pre- and post-intervention urine metabolite profiles were clearly segregated (PLS2 = 2.93%). Compared to TAD, urine extracts from the recommended dietary group showed higher abundance of benzoic acid & phenolic derivatives (VIP > 0.7, p < 0.05). Metabolites associated with oxidative stress were observed higher in the urine samples from Western dietary groups compared to BKD. Urine metabolomics data delineated the post-intervention effects of three dietary interventions which corroborates the respective findings for their effects on metabolic indices.
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  • 文章类型: Journal Article
    溃疡性结肠炎(UC)是一种自身免疫性疾病,其中免疫系统攻击结肠,导致溃疡发展,结肠功能丧失,和血性腹泻。人类肠道生态系统由近2000种不同的细菌组成,形成以膳食微量营养素为燃料的生物反应器,以产生生物活性化合物,它们被我们的身体吸收并向远处的器官发出信号。研究表明,西方饮食,短链脂肪酸(SCFA)较少,可以改变肠道微生物组组成并引起宿主的表观遗传重编程。此外,由于饮食模式的改变,肠道微生物组的H2S过量产生可以进一步激活UC的促炎信号通路。这篇综述讨论了西方饮食如何影响微生物组的功能并改变宿主的生理稳态和对UC的易感性。这篇文章还涵盖了流行病学,预后,病理生理学,以及目前UC的治疗策略,以及它们与结直肠癌的联系。
    Ulcerative colitis (UC) is an autoimmune disease in which the immune system attacks the colon, leading to ulcer development, loss of colon function, and bloody diarrhea. The human gut ecosystem consists of almost 2000 different species of bacteria, forming a bioreactor fueled by dietary micronutrients to produce bioreactive compounds, which are absorbed by our body and signal to distant organs. Studies have shown that the Western diet, with fewer short-chain fatty acids (SCFAs), can alter the gut microbiome composition and cause the host\'s epigenetic reprogramming. Additionally, overproduction of H2S from the gut microbiome due to changes in diet patterns can further activate pro-inflammatory signaling pathways in UC. This review discusses how the Western diet affects the microbiome\'s function and alters the host\'s physiological homeostasis and susceptibility to UC. This article also covers the epidemiology, prognosis, pathophysiology, and current treatment strategies for UC, and how they are linked to colorectal cancer.
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  • 文章类型: Journal Article
    由于胎儿雄激素的产生/作用受损,母体在人类妊娠中暴露于内分泌干扰化学物质(EDC)被广泛认为是男性生殖健康不良变化的重要原因。然而,支持这一观点的流行病学证据是模棱两可的,除了某些邻苯二甲酸盐,特别是邻苯二甲酸二乙酯己酯(DEHP)。流行病学研究中与不良生殖变化相关的母体邻苯二甲酸盐暴露水平比抑制大鼠胎儿雄激素产生所需的水平低几千倍。使用人类胎儿睾丸组织的直接研究表明,高邻苯二甲酸盐暴露对雄激素产生没有影响。这个难题无法解释,并提出了基本问题。人类DEHP暴露主要是通过与西式(不健康)饮食的消费相关的具有最高暴露的食物。这种饮食也与最常见的EDC暴露增加有关,无论是持久性(氯化或氟化化学品)还是非持久性(邻苯二甲酸酯,双酚)化合物,在脂肪和加工食品中含量最高。因此,与EDC暴露和男性生殖健康障碍相关的流行病学研究被潜在的饮食影响所混淆。反之亦然。年轻成年期的西方饮食/生活方式也与精子数量低有关。在流行病学研究中解开EDC和饮食影响是具有挑战性的。在怀孕期间,西方饮食,EDC暴露,和母亲生活在工业场所附近都与胎儿生长/发育受损有关,由于胎盘功能障碍,这容易导致先天性男性生殖障碍(隐睾,尿道下裂)。虽然后者被认为反映了胎儿雄激素产生受损,胎儿生长障碍(FGI)可能是间接的。由于FGI有许多终身健康后果,受到母亲生活方式的影响,对男性生殖障碍起源的研究应该更多地考虑到这一点。此外,妊娠期药物使用增加对胎儿生长/胎儿睾丸的潜在影响值得更多研究关注。
    Maternal exposure to endocrine-disrupting chemicals (EDCs) in human pregnancy is widely considered as an important cause of adverse changes in male reproductive health due to impaired foetal androgen production/action. However, the epidemiological evidence supporting this view is equivocal, except for certain phthalates, notably diethyl hexyl phthalate (DEHP). Maternal phthalate exposure levels associated with adverse reproductive changes in epidemiological studies are several thousand-fold lower than those needed to suppress foetal androgen production in rats, and direct studies using human foetal testis tissue show no effect of high phthalate exposure on androgen production. This conundrum is unexplained and raises fundamental questions. Human DEHP exposure is predominantly via food with highest exposure associated with consumption of a Western style (unhealthy) diet. This diet is also associated with increased exposure to the most common EDCs, whether persistent (chlorinated or fluorinated chemicals) or non-persistent (phthalates, bisphenols) compounds, which are found at highest levels in fatty and processed foods. Consequently, epidemiological studies associating EDC exposure and male reproductive health disorders are confounded by potential dietary effects, and vice versa. A Western diet/lifestyle in young adulthood is also associated with low sperm counts. Disentangling EDC and dietary effects in epidemiological studies is challenging. In pregnancy, a Western diet, EDC exposure, and maternal living in proximity to industrial sites are all associated with impaired foetal growth/development due to placental dysfunction, which predisposes to congenital male reproductive disorders (cryptorchidism, hypospadias). While the latter are considered to reflect impaired foetal androgen production, effects resulting from foetal growth impairment (FGI) are likely indirect. As FGI has numerous life-long health consequences, and is affected by maternal lifestyle, research into the origins of male reproductive disorders should take more account of this. Additionally, potential effects on foetal growth/foetal testis from the increasing use of medications in pregnancy deserves more research attention.
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