early life exposure

生命早期暴露
  • 文章类型: Journal Article
    环境污染物与神经毒性有关,并被认为有助于神经退行性疾病。斑马鱼模型为大规模化学筛选和毒性评估提供了高通量平台,被广泛认为是研究神经退行性疾病的重要动物模型。尽管最近的研究探索了环境污染物在斑马鱼模型中神经退行性疾病中的作用,目前对环境诱导的神经退行性疾病机制的认识相对复杂和重叠。这篇综述主要讨论了利用胚胎斑马鱼作为模型来研究环境污染物相关的神经退行性疾病。我们还回顾了当前适用的方法和重要的生物标志物,以揭示与环境相关的神经退行性疾病的潜在机制。我们发现胚胎斑马鱼是一种强大的工具,为评估由环境相关浓度的神经毒性化合物引发的神经毒性提供了平台。此外,使用可变方法来评估胚胎斑马鱼的神经毒性使研究人员能够深入了解环境污染物和神经退行性疾病之间的复杂相互作用,最终,了解与环境毒物相关的潜在机制。
    Environmental pollutants have been linked to neurotoxicity and are proposed to contribute to neurodegenerative disorders. The zebrafish model provides a high-throughput platform for large-scale chemical screening and toxicity assessment and is widely accepted as an important animal model for the investigation of neurodegenerative disorders. Although recent studies explore the roles of environmental pollutants in neurodegenerative disorders in zebrafish models, current knowledge of the mechanisms of environmentally induced neurodegenerative disorders is relatively complex and overlapping. This review primarily discusses utilizing embryonic zebrafish as the model to investigate environmental pollutants-related neurodegenerative disease. We also review current applicable approaches and important biomarkers to unravel the underlying mechanism of environmentally related neurodegenerative disorders. We found embryonic zebrafish to be a powerful tool that provides a platform for evaluating neurotoxicity triggered by environmentally relevant concentrations of neurotoxic compounds. Additionally, using variable approaches to assess neurotoxicity in the embryonic zebrafish allows researchers to have insights into the complex interaction between environmental pollutants and neurodegenerative disorders and, ultimately, an understanding of the underlying mechanisms related to environmental toxicants.
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  • 文章类型: Journal Article
    早发性结直肠癌(EOCRC)的发病率正在全球增加。这项研究旨在描述发病率的时间趋势,并根据GBD2019在国家一级探索早期生命中的相关风险暴露。
    EOCRC的发生率和归因危险因素的数据来自GBD2019。通过年平均百分比变化(AAPC)评估年龄标准化发病率的时间趋势。早期暴露被表示为选定因素的汇总暴露值(SEV),过去几十年以及0-4、5-9、10-14和15-19岁年龄段的SDI和人均GDP。应用加权线性或非线性回归来评估暴露与EOCRC发生率的生态总体关联。
    在1990年和2019年期间,EOCRC的全球年龄标准化发病率从3.05(3.03,3.07)增加到3.85(3.83,3.86)/100,000。在社会经济水平较高的国家发病率较高,在东亚和加勒比国家大幅增加,尤其是牙买加,沙特阿拉伯和越南。人均GDP,SDI,和缺铁的SEVs,酒精使用,身体质量指数高,早期儿童生长障碍与2019年EOCRC的发病率密切相关。0-4岁、5-9岁、10-14岁和15-19岁的接触也与发病率相关,特别是对于15-19岁的暴露。
    在过去的三十年中,EOCRC的全球发病率增加。区域和国家层面的巨大差异可能与生命早期风险暴露的分布有关。
    UNASSIGNED: The incidence of early-onset colorectal cancer (EOCRC) is increasing globally. This study aims to describe the temporal trends of incidence and explore related risk exposures in early-life at the country level based on the GBD 2019.
    UNASSIGNED: Data on the incidence and attributable risk factors of EOCRC were obtained from the GBD 2019. Temporal trends of age-standardized incidence were evaluated by average annual percentage change (AAPC). Early-life exposures were indicated as summary exposure values (SEV) of selected factors, SDI and GDP per capita in previous decades and at ages 0-4, 5-9, 10-14 and 15-19 years. Weighted linear or non-linear regressions were applied to evaluate the ecological aggregate associations of the exposures with incidences of EOCRC.
    UNASSIGNED: The global age-standardized incidence of EOCRC increased from 3.05 (3.03, 3.07) to 3.85 (3.83, 3.86) per 100,000 during 1990 and 2019. The incidence was higher in countries with high socioeconomic levels, and increased drastically in countries in East Asia and Caribbean, particularly Jamaica, Saudi Arabia and Vietnam. The GDP per capita, SDI, and SEVs of iron deficiency, alcohol use, high body-mass index, and child growth failure in earlier years were more closely related with the incidences of EOCRC in 2019. Exposures at ages 0-4, 5-9, 10-14 and 15-19 years were also associated with the incidences, particularly for the exposures at ages 15-19 years.
    UNASSIGNED: The global incidence of EOCRC increased during past three decades. The large variations at regional and national level may be related with the distribution of risk exposures in early life.
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  • 文章类型: Journal Article
    世界卫生组织(WHO)建议在生命的头6个月进行纯母乳喂养,然后补充食物和持续母乳喂养至少2年。强调其在降低婴儿死亡率和预防各种疾病方面的关键作用。这种观点深入研究了母乳喂养实践之间的复杂关系,早期抗生素暴露,和婴儿肠道微生物组发育,强调它们对儿童健康结果的深远影响。在怀孕和童年期间广泛使用抗生素,破坏微生物组,并且与过敏风险增加有关,肥胖,和神经发育障碍。母乳喂养是更健康的肠道微生物组的重要决定因素,其特征在于更高水平的有益菌如双歧杆菌和更低水平的潜在病原体。尽管人们普遍认识到母乳喂养的好处,医疗保健实践和支持机制方面仍然存在差距,这加剧了母乳喂养家庭面临的挑战。这凸显了对包括母乳喂养行为在内的全面研究的迫切需要,人乳摄入量,以及它们对婴儿健康结果的影响。此外,提高医疗保健提供者和家庭对不必要配方奶粉补充的有害影响的认识可以促进知情决策并提高纯母乳喂养率.此外,供体人乳(DHM)是一种有前途的替代配方,可能减轻抗生素暴露后对婴儿肠道微生物组的破坏。总的来说,优先考虑母乳喂养支持干预措施和弥合研究差距是在全球范围内改善儿童健康结果的重要步骤。
    The World Health Organization (WHO) recommends exclusive breastfeeding for the first 6 months of life followed by complementary foods and sustained breastfeeding for at least 2 years, underscoring its pivotal role in reducing infant mortality and preventing various illnesses. This perspective delves into the intricate relationship between breastfeeding practices, early life antibiotic exposure, and infant gut microbiome development, highlighting their profound influence on child health outcomes. Antibiotics are extensively prescribed during pregnancy and childhood, disrupting the microbiome, and are related to increased risks of allergies, obesity, and neurodevelopmental disorders. Breastfeeding is a significant determinant of a healthier gut microbiome, characterized by higher levels of beneficial bacteria such as Bifidobacterium and lower levels of potential pathogens. Despite widespread recognition of the benefits of breastfeeding, gaps persist in healthcare practices and support mechanisms, exacerbating challenges faced by breastfeeding families. This highlights the pressing need for comprehensive research encompassing breastfeeding behaviors, human milk intake, and their impact on infant health outcomes. Additionally, promoting awareness among healthcare providers and families regarding the detrimental effects of unnecessary formula supplementation could facilitate informed decision-making and bolster exclusive breastfeeding rates. Moreover, donor human milk (DHM) is a promising alternative to formula, potentially mitigating disruptions to the infant gut microbiome after antibiotic exposure. Overall, prioritizing breastfeeding support interventions and bridging research gaps are essential steps towards improving child health outcomes on a global scale.
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  • 文章类型: Journal Article
    抗生素广泛用于畜禽行业,可在动物和环境中积累,导致食物和水消费对人类潜在的健康风险。抗生素毒性研究,特别是它们作为内分泌干扰物对男性生殖系统的影响,仍处于起步阶段。这篇综述强调了抗生素对男性生殖系统的毒性作用,详细介绍了常见的暴露途径以及各种抗生素类别的有害影响和机制。此外,它讨论了食品来源的活性物质对抗生素引起的生殖毒性的保护作用。这篇综述旨在提高人们对男性抗生素生殖毒性的认识,并概述未来研究中必须解决的挑战。
    Antibiotics are extensively utilized in the livestock and poultry industry and can accumulate in animals and the environment, leading to potential health risks for humans via food and water consumption. Research on antibiotic toxicity, particularly their impact as endocrine disruptors on the male reproductive system, is still in its nascent stages. This review highlights the toxic effect of antibiotics on the male reproductive system, detailing the common routes of exposure and the detrimental impact and mechanisms of various antibiotic classes. Additionally, it discusses the protective role of food-derived active substances against the reproductive toxicity induced by antibiotics. This review aims to raise awareness about the reproductive toxicity of antibiotics in males and to outline the challenges that must be addressed in future research.
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  • 文章类型: Journal Article
    有越来越多的证据表明,衰老过程在生命的早期阶段开始,在子宫内,个体的环境起着重要的作用。因此,了解早年生活环境对老年健康的持久影响至关重要。
    在这项研究中,我们进行了一项荟萃分析,以研究中国饥荒(1959-1961)对老年人健康的影响.我们还探索了这些影响的潜在机制。
    早期生活环境之间复杂的相互作用,多个卫生相关部门,健康老龄化需要全面的生命历程方法和战略干预措施,以增强老龄化社会的公共卫生。
    UNASSIGNED: There is mounting evidence indicating that the aging process initiates during early life stages, with in utero the individual\'s environment playing a significant role. Consequently, it is crucial to comprehend the enduring effects of early life circumstances on health in old age.
    UNASSIGNED: In this study, we conducted a meta-analysis to examine the effects of the Chinese Famine (1959-1961) on the health of older adults. We also explored potential mechanisms underlying these effects.
    UNASSIGNED: The complex interplay between early life circumstances, multiple health-related sectors, and healthy aging necessitates a comprehensive life-course approach and strategic interventions to enhance public health in an aging society.
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  • 文章类型: Journal Article
    背景:研究表明,长期接触细颗粒物(PM2.5)会增加神经发育状况的风险,如智力障碍(ID)。很少有研究检查超过24小时(24小时)PM2.5指南的污染峰值对神经发育健康的影响。尽管与监管环境相关。美国目前对24小时PM2.5标准的监管变化的可能性使得对超标的研究变得相关。
    目的:研究24小时PM2.5超标与ID风险之间的关系。
    方法:我们对犹他州的儿童样本进行了回顾性病例对照研究,美国。我们使用广义估计方程根据孕前和怀孕三个月期间24小时PM2.5超标天数来预测ID的几率。超限天数的定义是根据当前的世界卫生组织(WHO)[≥15μg/m3]和当前的美国环境保护署(EPA)[≥35μg/m3]24小时指南。
    结果:PM2.5超标与孕前和孕早期的ID风险相关,而不是第二和孕晚期。在先入为主的时期,每天超过15μg/m3或35μg/m3与ID的几率增加1.023(CI:1.011-1.040)或1.042(CI:1.026-1.059,p<0.001)相关,分别。在头三个月,每天超过15μg/m3或35μg/m3与ID的几率增加1.032(CI:1.017-1.047)或1.059(CI:1.030-1.088)相关,分别。
    美国24小时PM2.5标准的潜在监管运动使得明确研究超标的研究高度相关。然而,很少有研究检查超过24小时指南对任何空气污染物的健康影响。这项研究通过检查智力残疾的几率与超过当前24小时PM2.5指南的天数之间的关联,填补了文献中的重要空白。由世界卫生组织和美国环境保护署建立,在产前期间。我们发现两组准则的超标,在孕前和孕早期,与ID风险相关。
    BACKGROUND: Research demonstrates that chronic exposure to fine particulates (PM2.5) increases risks of neurodevelopmental conditions, such as intellectual disability (ID). Few studies have examined neurodevelopmental health impacts of pollution spikes exceeding 24-h (24-h) PM2.5 guidelines, despite relevance to the regulatory landscape. The current potential for regulatory changes to 24-h PM2.5 standards in the United States makes research on exceedances relevant.
    OBJECTIVE: To examine associations between 24-h PM2.5 exceedances and the risk of ID.
    METHODS: We conducted a retrospective case-control study of a sample of children in Utah, USA. We used generalized estimating equations to predict odds of ID based on the number of 24-h PM2.5 exceedance days during the preconception period and three trimesters of pregnancy. Exceedance days are defined as per current World Health Organization (WHO) [≥15 μg/m3] and current US Environmental Protection Agency (EPA) [≥35 μg/m3] 24-h guidelines.
    RESULTS: PM2.5 exceedances are associated with ID risk during the preconception and first trimester periods and not the second and third trimesters. During the preconception period, each day exceeding 15 μg/m3 or 35 μg/m3 was associated with a 1.023 (CI: 1.011-1.040) or 1.042 (CI: 1.026-1.059, p < 0.001) increase in odds of ID, respectively. During the first trimester, each day exceeding 15 μg/m3 or 35 μg/m3 was associated with a 1.032 (CI: 1.017-1.047) or 1.059 (CI: 1.030-1.088) increase in odds of ID, respectively.
    UNASSIGNED: Potential regulatory movement on the US 24-h PM2.5 standard makes research that explicitly studies exceedances highly relevant. Yet few studies examine health effects of exceeding 24-h guidelines for any air pollutants. This study fills important gaps in the literature by examining associations between odds of intellectual disability and the count of days exceeding current 24-h PM2.5 guidelines, as established by the World Health Organization and US Environmental Protection Agency, during the prenatal period. We find that exceedances of both sets of guidelines, during the preconception and first trimester periods, are associated with ID risk.
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  • 文章类型: Journal Article
    霉菌毒素是对人类健康产生不利影响的有毒化学物质。这里,我们评估了霉菌毒素暴露对尼日利亚新生儿和婴儿(NIs)早期肠道微生物群纵向发育的影响.基于液相色谱串联质谱的人体生物监测测定法用于定量NI消耗的母乳中的真菌毒素(n=68),他们的大便(n=82),和尿液样本(n=15),从分娩后1-18个月纵向收集。通过粪便样品的16SrRNA基因扩增子测序来表征微生物群落组成,并与霉菌毒素暴露模式相关。伏马菌素B1(FB1),在6至18个月之间的粪便样品中,经常对FB2和交替种单甲基醚(AME)进行定量。黄曲霉毒素M1(AFM1),AME,和citrinin在低浓度的母乳样品中进行定量。在尿液样品中以相对较高的浓度定量AFM1,FB1和曲霉毒素A。克雷伯菌和大肠杆菌/志贺氏菌在生命早期的粪便样本中占主导地位(第1个月),而双歧杆菌在3和6个月之间占优势。粪便中的总霉菌毒素水平与NIs\'肠道微生物组组成显着相关(PERMANOVA,p<0.05)。然而,在特定微生物群和某些霉菌毒素的检测之间没有观察到显著的相关性.尽管是一小群人,这项研究表明,真菌毒素可能会影响生命早期肠道微生物组的组成。
    Mycotoxins are toxic chemicals that adversely affect human health. Here, we assessed the influence of mycotoxin exposure on the longitudinal development of early life intestinal microbiota of Nigerian neonates and infants (NIs). Human biomonitoring assays based on liquid chromatography tandem mass spectrometry were applied to quantify mycotoxins in breast milk (n = 68) consumed by the NIs, their stool (n = 82), and urine samples (n = 15), which were collected longitudinally from month 1-18 postdelivery. Microbial community composition was characterized by 16S rRNA gene amplicon sequencing of stool samples and was correlated to mycotoxin exposure patterns. Fumonisin B1 (FB1), FB2, and alternariol monomethyl ether (AME) were frequently quantified in stool samples between months 6 and 18. Aflatoxin M1 (AFM1), AME, and citrinin were quantified in breast milk samples at low concentrations. AFM1, FB1, and ochratoxin A were quantified in urine samples at relatively high concentrations. Klebsiella and Escherichia/Shigella were dominant in very early life stool samples (month 1), whereas Bifidobacterium was dominant between months 3 and 6. The total mycotoxin levels in stool were significantly associated with NIs\' gut microbiome composition (PERMANOVA, p < 0.05). However, no significant correlation was observed between specific microbiota and the detection of certain mycotoxins. Albeit a small cohort, this study demonstrates that mycotoxins may influence early life gut microbiome composition.
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  • 文章类型: Journal Article
    目的:这项研究的目的是比较事件人群的差异,合并症,以及新诊断的早发性(T2DM)和晚发性T2DM患者之间的降糖药物处方,为临床实践提供现实世界的证据。
    方法:本研究基于上海医院链接数据库(SHLD)。本研究包括2013年至2021年的匿名电子病历(EHR)数据。新诊断的T2DM患者被定义为在过去三年中没有相关诊断记录或降糖药物处方的患者。早发性T2DM定义为在T2DM首次就诊时年龄为18-40岁的患者,代表1980年代以后出生的患者。晚发性T2DM被定义为65-80岁的人群,代表出生在相对不发达时期的人群。
    结果:本研究共纳入35457例新诊断的早发性T2DM患者和149108例新诊断的晚发性T2DM患者。与晚发型T2DM患者相比,更多的早发型T2DM患者在首次就诊时出现血脂异常(9.5%V.S.7.7%,P<0.01),尽管他们的年龄差异显着。早发型T2DM患者更有可能使用二甲双胍,DDP-4i,TZD,SGLT2-i,GLP-1RA在他们第一次访问医院。
    结论:早发性T2DM和晚发性T2DM患者的特征不同。与晚发型T2DM患者相比,早发型T2DM患者更容易出现血脂异常,并有新型的器官保护药物.
    UNASSIGNED: The aim of this study was to compare the differences in incident population, comorbidities, and glucose-lowering drug prescriptions between newly diagnosed patients with early-onset type 2 diabetes mellitus (T2DM) and those with late-onset T2DM to provide real-world evidence for clinical practice.
    UNASSIGNED: This study was based on the Shanghai Hospital Link Database (SHLD). Anonymized electronic medical record (EHR) data from 2013 to 2021 were included in this study. Newly diagnosed patients with T2DM were defined as those without related diagnostic records or glucose-lowering medicine prescriptions in the past 3 years. Early-onset T2DM was defined as patients who were aged 18-40 years old at the first visit for T2DM to represent those who were born after the 1980s. And late-onset T2DM was defined as those aged 65-80 years old to represent those who were born in a relatively undeveloped period. Descriptive statistical analyses were performed to describe their incidence number, glucose-lowering drug prescriptions, and comorbidities at the first visit to the hospital between two T2DM groups.
    UNASSIGNED: There were a total of 35,457 newly diagnosed patients with early-onset T2DM and 149,108 newly diagnosed patients with late-onset T2DM included in this study. Patients with late-onset T2DM constituted the majority and their number increased by 2.5% on average by years, while the number of patients with early-onset T2DM remained stable each year. Compared with late-onset T2DM patients, more early-onset T2DM patients had dyslipidemia at the first visit to hospitals (9.5% vs 7.7%, P < 0.01) despite their significant age differences. Patients with early-onset T2DM were more likely to use metformin (74.8% vs 46.5, P < 0.01), dipeptidyl peptidase-4 inhibitors (DDP-4i) (16.7% vs 11.2%, P < 0.01), thiazolidinediones (TZD) (14.9% vs 8.4%, P < 0.01), sodium glucose cotransporter 2 inhibitors (SGLT2-i) (0.8% vs 0.3%, P < 0.01), and glucagon-like peptide 1 receptor agonists (GLP-1 RA) (3.7% vs 0.5%, P < 0.01) at their first visit to the hospital.
    UNASSIGNED: Different characteristics were observed between patients with early-onset T2DM and those with late-onset T2DM. Compared with patients with late-onset T2DM, those with early-onset T2DM were more prone to dyslipidemia and had novel organ-protective drugs prescribed.
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  • 文章类型: Journal Article
    早期呼吸道合胞病毒(RSV)感染(eRSV)是儿童严重肺部疾病的主要原因之一。eRSV与以后发生哮喘和肺功能受损的风险较高相关。镉(Cd)是一种有毒金属,广泛存在于环境和食品中。我们最近表明,eRSV重新编程代谢并增强肺中的Cd毒性,我们的转录-代谢组研究显示,S-棕榈酰转移酶的表达与Cd刺激的肺部炎症和纤维化信号之间有很强的关联.关于eRSV重新编程代谢并增强肺部Cd毒性的机制的信息有限。在目前的研究中,我们使用小鼠模型来检查蛋白质S-棕榈酰化(Pr-S-帕尔)在低剂量Cd升高的肺代谢破坏和eRSV后炎症中的作用。随后用饮用水中的Cd(3.3mgCdCl2/L)处理暴露于eRSV的小鼠6周(RSV+Cd)。使用棕榈酰转移酶抑制剂研究了Pr-S-帕尔的作用,2-溴棕榈酸酯(BP,10µM)。炎症标志物分析表明,细胞因子,RSV+Cd组趋化因子和炎症细胞最高,和BP降低炎症标志物。肺代谢组学分析显示,包括苯丙氨酸、酪氨酸和色氨酸,磷脂酰肌醇和鞘脂在治疗过程中发生了变化。BP拮抗RSVCd对鞘脂和糖胺聚糖代谢的代谢破坏,与BP对炎症标志物的影响一致。这项研究表明,Cd暴露后的eRSV对随后的炎症反应和肺代谢有显著影响,这是由Pr-S-帕尔介导的,并保证未来对治疗目标的研究。
    Early-life respiratory syncytial virus (RSV) infection (eRSV) is one of the leading causes of serious pulmonary disease in children. eRSV is associated with higher risk of developing asthma and compromised lung function later in life. Cadmium (Cd) is a toxic metal, widely present in the environment and in food. We recently showed that eRSV re-programs metabolism and potentiates Cd toxicity in the lung, and our transcriptome-metabolome-wide study showed strong associations between S-palmitoyl transferase expression and Cd-stimulated lung inflammation and fibrosis signaling. Limited information is available on the mechanism by which eRSV re-programs metabolism and potentiates Cd toxicity in the lung. In the current study, we used a mouse model to examine the role of protein S-palmitoylation (Pr-S-Pal) in low dose Cd-elevated lung metabolic disruption and inflammation following eRSV. Mice exposed to eRSV were later treated with Cd (3.3 mg CdCl2/L) in drinking water for 6 weeks (RSV+Cd). The role of Pr-S-Pal was studied using a palmitoyl transferase inhibitor, 2-bromopalmitate (BP, 10 µM). Inflammatory marker analysis showed that cytokines, chemokines and inflammatory cells were highest in the RSV+Cd group, and BP decreased inflammatory markers. Lung metabolomics analysis showed that pathways including phenylalanine, tyrosine and tryptophan, phosphatidylinositol and sphingolipid were altered across treatments. BP antagonized metabolic disruption of sphingolipid and glycosaminoglycan metabolism by RSV+Cd, consistent with BP effect on inflammatory markers. This study shows that Cd exposure following eRSV has a significant impact on subsequent inflammatory response and lung metabolism, which is mediated by Pr-S-Pal, and warrants future research for a therapeutic target.
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  • 文章类型: Meta-Analysis
    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。
    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.
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