1. Association between Exposure to p,p ′-DDT and Its Metabolite p,p ′-DDE with Obesity: Integrated Systematic Review and Meta-Analysis
- Author
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German Cano-Sancho, Michele A. La Merrill, Andrew G. Salmon, Laboratoire d'étude des Résidus et Contaminants dans les Aliments (LABERCA), and Institut National de la Recherche Agronomique (INRA)-Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)
- Subjects
0301 basic medicine ,Insecticides ,medicine.medical_specialty ,Dichlorodiphenyl Dichloroethylene ,[SDV]Life Sciences [q-bio] ,Health, Toxicology and Mutagenesis ,Metabolite ,MEDLINE ,Review ,010501 environmental sciences ,Cardiovascular ,Toxicology ,Medical and Health Sciences ,01 natural sciences ,Oral and gastrointestinal ,DDT ,DDT metabolism ,03 medical and health sciences ,chemistry.chemical_compound ,Environmental health ,medicine ,Humans ,Science Selection ,Obesity ,Metabolic and endocrine ,Nutrition ,Cancer ,0105 earth and related environmental sciences ,2. Zero hunger ,Pollutant ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,Environmental Exposure ,Environmental exposure ,medicine.disease ,3. Good health ,Stroke ,030104 developmental biology ,chemistry ,Meta-analysis ,Environmental Pollutants ,business ,Environmental Sciences - Abstract
Background: The prevalence of obesity is increasing in all countries, becoming a substantial public health concern worldwide. Increasing evidence has associated obesity with persistent pollutants such as the pesticide DDT and its metabolite p,p′-DDE. Objectives: Our objective was to systematically review the literature on the association between exposure to the pesticide DDT and its metabolites and obesity to develop hazard identification conclusions. Methods: We applied a systematic review-based strategy to identify and integrate evidence from epidemiological, in vivo, and in vitro studies. The evidence from prospective epidemiological studies was quantitatively synthesized by meta-analysis. We rated the body of evidence and integrated the streams of evidence to systematically develop hazard identification conclusions. Results: We identified seven epidemiological studies reporting prospective associations between exposure to p,p′-DDE and adiposity assessed by body mass index (BMI) z-score. The results from the meta-analysis revealed positive associations between exposure to p,p′-DDE and BMI z-score (β=0.13 BMI z-score (95% CI: 0.01, 0.25) per log increase of p,p′-DDE). Two studies constituted the primary in vivo evidence. Both studies reported positive associations between exposure to p,p′-DDT and increased adiposity in rodents. We identified 19 in vivo studies and 7 in vitro studies that supported the biological plausibility of the obesogenic effects of p,p′-DDT and p,p′-DDE. Conclusions: We classified p,p′-DDT and p,p′-DDE as “presumed” to be obesogenic for humans, based on a moderate level of primary human evidence, a moderate level of primary in vivo evidence, and a moderate level of supporting evidence from in vivo and in vitro studies. https://doi.org/10.1289/EHP527
- Published
- 2017