Cláudia Ribeiro1, Vânia Mendes2, Bárbara Peleteiro1, Inês Delgado2, Joana Araújo2, Martine Aggerbeck3, Isabella Annesi-Maesano4, Denis Sarigiannis5, Elisabete Ramos6. 1. EPIUnit - Instituto de Saúde Pública, Universidade Do Porto, Rua das Taipas nº 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade Do Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. 2. EPIUnit - Instituto de Saúde Pública, Universidade Do Porto, Rua das Taipas nº 135, 4050-600, Porto, Portugal. 3. INSERM UMR-S 1124, Toxicologie Pharmacologie et Signalisation Cellulaire, Université Paris Descartes, Sorbonne Paris Cité, UFR des Sciences Fondamentales et Biomédicales, 45 Rue des Saints Pères, 75006, Paris, France. 4. Sorbonne Université and INSERM, Epidemiology of Allergic and Respiratory Diseases Dept (EPAR), Pierre Louis Institute of Epidemiology and Public Health (IPLESP UMRS 1136), Saint-Antoine Medical School, Paris, France. 5. Department of Chemical Engineering, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece. 6. EPIUnit - Instituto de Saúde Pública, Universidade Do Porto, Rua das Taipas nº 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade Do Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. Electronic address: eliramos@med.up.pt.
Abstract
BACKGROUND: Exposure to environmental chemicals has become one of the major concerns in the past decades. Phthalates are a family of synthetic organic chemicals used in the manufacture of plastics, solvents, and personal care products. These compounds are considered as endocrine-disrupting compounds (EDCs) since they may interfere with the endocrine system and disrupt its physiologic function. AIM: The purpose of this work is to synthesize results from published literature on the association between the exposure to phthalates and adiposity in adults and children. METHODS: We searched PubMed from inception up to 01 August 2019, to retrieve original papers reporting data on the association between EDCs and adiposity, using the following search expression: (("Endocrine disruptor" OR Endocrine disruptor[mh] OR phthalate) AND (Obesity OR Overweight OR BMI OR "Body fat" OR Adipose tissue[mh] OR Body size[mh] OR "body size" OR "body weight" OR Anthropometry OR "anthropometric measures")) AND (humans[mh]). The study variables and characteristics were collected during data extraction, namely the study design, sample, exposure, outcome, descriptive and association measures. Study quality was assessed using the STROBE template for observational studies. Although studies examined several adiposity measures, Body Mass Index (BMI) and Waist Circumference (WC) were the most commonly used, therefore, we used the beta coefficients regarding BMI and WC, and odds ratios when BMI outcome was categorical to perform the meta-analysis. Data from the studies were combined using fixed effects meta-analyses to compute summary regression coefficients or odds ratios and corresponding 95% confidence intervals (95% CI). Heterogeneity between studies was assessed by the I2 statistic. RESULTS: In the systematic review we found 29 publications addressing the association between phthalate compounds and adiposity. The vast majority of the included studies reported associations that were not statistically significant. For most of the phthalate compounds there were few studies providing compatible measures and therefore it was not possible to combine the results in a meta-analysis. Both for BMI and WC, the meta-analysis for MiBP, MCPP and MbzP showed negative associations and null association for MBP in children, although none of them was significant. For MEP, positive but not significant associations were found both in children and adults. Conversely, for MEHP a negative association was found also in children and adults although it did not reach statistical significance. Only for MECPP a significant association was found for obesity in adults (OR = 1.67 (95% CI 1.30; 2.16). CONCLUSION: In general, a positive association between phthalates and adiposity measures was found, especially in adults. However, most of the results did not reach statistical significance and the inconsistencies found between studies did not allow to reach a definitive conclusion. Additionally, we cannot exclude a possible effect of publication bias.
BACKGROUND: Exposure to environmental chemicals has become one of the major concerns in the past decades. Phthalates are a family of synthetic organic chemicals used in the manufacture of plastics, solvents, and personal care products. These compounds are considered as endocrine-disrupting compounds (EDCs) since they may interfere with the endocrine system and disrupt its physiologic function. AIM: The purpose of this work is to synthesize results from published literature on the association between the exposure to phthalates and adiposity in adults and children. METHODS: We searched PubMed from inception up to 01 August 2019, to retrieve original papers reporting data on the association between EDCs and adiposity, using the following search expression: (("Endocrine disruptor" OR Endocrine disruptor[mh] OR phthalate) AND (Obesity OR Overweight OR BMI OR "Body fat" OR Adipose tissue[mh] OR Body size[mh] OR "body size" OR "body weight" OR Anthropometry OR "anthropometric measures")) AND (humans[mh]). The study variables and characteristics were collected during data extraction, namely the study design, sample, exposure, outcome, descriptive and association measures. Study quality was assessed using the STROBE template for observational studies. Although studies examined several adiposity measures, Body Mass Index (BMI) and Waist Circumference (WC) were the most commonly used, therefore, we used the beta coefficients regarding BMI and WC, and odds ratios when BMI outcome was categorical to perform the meta-analysis. Data from the studies were combined using fixed effects meta-analyses to compute summary regression coefficients or odds ratios and corresponding 95% confidence intervals (95% CI). Heterogeneity between studies was assessed by the I2 statistic. RESULTS: In the systematic review we found 29 publications addressing the association between phthalate compounds and adiposity. The vast majority of the included studies reported associations that were not statistically significant. For most of the phthalate compounds there were few studies providing compatible measures and therefore it was not possible to combine the results in a meta-analysis. Both for BMI and WC, the meta-analysis for MiBP, MCPP and MbzP showed negative associations and null association for MBP in children, although none of them was significant. For MEP, positive but not significant associations were found both in children and adults. Conversely, for MEHP a negative association was found also in children and adults although it did not reach statistical significance. Only for MECPP a significant association was found for obesity in adults (OR = 1.67 (95% CI 1.30; 2.16). CONCLUSION: In general, a positive association between phthalates and adiposity measures was found, especially in adults. However, most of the results did not reach statistical significance and the inconsistencies found between studies did not allow to reach a definitive conclusion. Additionally, we cannot exclude a possible effect of publication bias.
Authors: Wei-Jie Wang; Chia-Sung Wang; Chi-Kang Wang; An-Ming Yang; Chien-Yu Lin Journal: Int J Environ Res Public Health Date: 2022-06-07 Impact factor: 4.614
Authors: Stefan Scholz; Werner Brack; Beate I Escher; Jörg Hackermüller; Matthias Liess; Martin von Bergen; Lukas Y Wick; Ana C Zenclussen; Rolf Altenburger Journal: Arch Toxicol Date: 2022-08 Impact factor: 6.168
Authors: Carolina C V Silva; Vincent W V Jaddoe; Chalana M Sol; Hanan El Marroun; Maria-Pilar Martinez-Moral; Kurunthachalam Kannan; Leonardo Trasande; Susana Santos Journal: Obesity (Silver Spring) Date: 2021-02 Impact factor: 5.002
Authors: Amelia K Wesselink; Victoria Fruh; Russ Hauser; Jennifer Weuve; Kyla W Taylor; Olivia R Orta; Birgit Claus Henn; Traci N Bethea; Michael D McClean; Paige L Williams; Antonia M Calafat; Donna D Baird; Lauren A Wise Journal: J Expo Sci Environ Epidemiol Date: 2020-09-26 Impact factor: 5.563
Authors: Christina Tsitsimpikou; Nikolaos Georgiadis; Konstantinos Tsarouhas; Panagiotis Kartsidis; Eleni Foufa; Flora Bacopoulou; Athanasios Choursalas; Dimitrios Kouretas; Alexandros K Nikolaidis; Elisabeth A Koulaouzidou Journal: Int J Environ Res Public Health Date: 2021-12-08 Impact factor: 3.390