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The association between environmental exposures to chlordanes, adiposity and diabetes-related features: a systematic review and meta-analysis.
Mendes, V, Ribeiro, C, Delgado, I, Peleteiro, B, Aggerbeck, M, Distel, E, Annesi-Maesano, I, Sarigiannis, D, Ramos, E
Scientific reports. 2021;11(1):14546
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Chlordane is a synthetic organochlorine pesticide used for several decades in agriculture, but also in housing for pest control. Chlordane compounds are endocrine disrupting chemicals (EDCs), which means that they may affect the natural function of hormones by blocking, mimicking, displacing, or acting to subvert their roles. The aim of this study was to investigate whether exposure to chlordane compounds increases the risk of adiposity and diabetes in humans. This study is a systematic review and meta-analysis of 31 publications. Results demonstrate that there is no association between chlordane compounds and adiposity. However, there are higher odds of having diabetes-related features with increasing levels of all the chlordane compounds evaluated. Authors conclude that an international agreement on methods to measure both exposure and outcome variables and to conduct epidemiological studies could increase the knowledge on how adverse effects of exposure to various stressors (exposome) can influence human health.
Abstract
Chlordane compounds (CHLs) are components of technical chlordane listed in the Stockholm convention on persistent organic pollutants identified as endocrine disrupting chemicals (EDCs) and may interfere with hormone biosynthesis, metabolism or action resulting in an unbalanced hormonal function. There is increasing scientific evidence showing EDCs as risk factors in the pathogenesis and development of obesity and obesity-related metabolic syndromes such as type 2 diabetes, but there is no systematized information on the effect of CHLs in humans. Our aim is to identify the epidemiological data on the association between CHLs with adiposity and diabetes using a systematic approach to identify the available data and summarizing the results through meta-analysis. We searched PubMed and Web of Science from inception up to 15 February 2021, to retrieve original data on the association between chlordanes, and adiposity or diabetes. For adiposity, regression coefficients and Pearson or Spearman correlation coefficients were extracted and converted into standardized regression coefficients. Data were combined using fixed effects meta-analyses to compute summary regression coefficients and corresponding 95% confidence intervals (95% CI). For the association between chlordanes and diabetes, Odds ratios (ORs) were extracted and the DerSimonian and Laird method was used to compute summary estimates and respective 95% CI. For both, adjusted estimates were preferred, whenever available. Among 31 eligible studies, mostly using a cross-sectional approach, the meta-analysis for adiposity was possible only for oxychlordane and transchlordane, none of them were significantly associated with adiposity [(β = 0.04, 95% CI 0.00; 0.07, I2 = 89.7%)] and (β = 0.02, 95% CI - 0.01; 0.06), respectively. For diabetes, the estimates were positive for all compounds but statistically significant for oxychlordane [OR = 1.96 (95% CI 1.19; 3.23)]; for trans-nonachlor [OR = 2.43 (95% CI 1.64; 3.62)] and for heptachlor epoxide [OR = 1.88 (95% CI 1.42; 2.49)]. Our results support that among adults, the odds of having diabetes significantly increase with increasing levels of chlordanes. The data did not allow to reach a clear conclusion regarding the association with adiposity.
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Impact of Diabetes Mellitus on Lower Urinary Tract Symptoms in Benign Prostatic Hyperplasia Patients: A Meta-Analysis.
Xin, C, Fan, H, Xie, J, Hu, J, Sun, X, Liu, Q
Frontiers in endocrinology. 2021;12:741748
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Benign prostatic hyperplasia (BPH) is a disease that causes lower urinary tract symptoms (LUTS). Age, sex hormones, diet, diabetes, obesity, and genetic factors are closely related to the occurrence of BPH. The aim of this study was to investigate the impact of diabetes mellitus on LUTS in BPH patients. This study is a systematic review and meta-analysis of eighteen articles consisting of 1685 cases and 4653 controls. Results show that the International Prostate Symptom Score of the diabetic BPH group was significantly higher than that of the non-diabetic BPH group, indicating that diabetes mellitus may aggravate the LUTS of BPH patients. Authors conclude that LUTS in BPH patients is increased in patients with diabetes mellitus compared with controls.
Abstract
BACKGROUND Benign prostatic hyperplasia (BPH) is a disease that causes lower urinary tract symptoms (LUTS), which are the most common urological problem in approximately one-third of the male population aged over 50 years. Some studies have suggested that diabetes may be a risk factor for the development of BPH. However, whether diabetes aggravates the LUTS of BPH patients is still controversial. AIM: To investigate the impact of diabetes mellitus on LUTS in BPH patients. METHODS A literature search was conducted using Web of Science, Embase, PubMed, and China National Knowledge Infrastructure literature databases. This meta-analysis was registered in PROSPERO (registration number: CRD 42020200794). Fixed- or random-effects models were used for analysis according to heterogeneity. The results of the systematic analysis are presented as weighted mean difference (WMD) with the corresponding 95% confidence intervals (CI). RESULTS In total, 1308 studies were retrieved from databases and 18 articles comprising 1685 cases and 4653 controls were selected for meta-analysis. The results of the meta-analysis showed that the International Prostate Symptom Score (IPSS) value and prostate volume of BPH patients with diabetes was significantly higher than that of BPH patients without diabetes. CONCLUSIONS This systematic review is the first to evaluate the impact of diabetes mellitus on LUTS in BPH patients. The results of our meta-analysis support the hypothesis that LUTS in BPH patients is increased in patients with diabetes mellitus compared with controls, which suggests that physicians should pay more attention to BPH patients with diabetes mellitus. SYSTEMATIC REVIEW REGISTRATION PROSPERO [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=200794], identifier CRD 42020200794.
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A Systematic Review of Organic Versus Conventional Food Consumption: Is There a Measurable Benefit on Human Health?
Vigar, V, Myers, S, Oliver, C, Arellano, J, Robinson, S, Leifert, C
Nutrients. 2019;12(1)
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The demand for organic products has risen rapidly over the last decades. The reasons why consumers may favour organic over conventional products are varied. They may be for personal health and wellbeing, environmental considerations, animal welfare or perceived higher nutritional profile - which is true for some, but not all components. While the long-term safety of pesticide consumption through conventional food production has been questioned, organic foods clearly show lower levels of toxic metabolites, like heavy metals and synthetic fertilizer and pesticide residues. This systematic review aimed to assess the current evidence of organic diet consumption and human health compared to conventionally produced foods. Included were 35 papers on clinical trials and observational studies. The clinical trials studied pesticide and phytochemical excretion, antioxidant capacity, body composition, lipids and inflammatory markers. The observational studies were focused on fertility, foetal and childhood development, pregnancy, lactation and levels of pesticides in children and adults, as well as nutritional biomarkers and cancer risk in adults. An increased intake of organic produce in long-term studies appeared to reduce the incidence of infertility, birth defects, allergies, middle ear infection, pre-eclampsia, metabolic syndrome, high BMI, and non-Hodgkin lymphoma. Organic intake was also linked to reduced urinary levels of organophosphorus pesticides and herbicides. Yet, the author highlighted that organic consumers are more likely to be health conscious, physically active, eat a more plant-based diet, have higher education levels and income, and therefore are not representative of the general population. They also argue that the possible benefits from an organic diet may be partially due to the quality and composition of the diet rather than a direct effect of organic food consumption. Whereby a growing number of findings demonstrate the health benefits of organic food consumption, according to the authors, the current evidence does not yield a solid and definitive answer.
Abstract
The current review aims to systematically assess the evidence related to human health outcomes when an organic diet is consumed in comparison to its conventional counterpart. Relevant databases were searched for articles published to January 2019. Clinical trials and observational research studies were included where they provided comparative results on direct or indirect health outcomes. Thirty-five papers met the criteria for inclusion in the review. Few clinical trials assessed direct improvements in health outcomes associated with organic food consumption; most assessed either differences in pesticide exposure or other indirect measures. Significant positive outcomes were seen in longitudinal studies where increased organic intake was associated with reduced incidence of infertility, birth defects, allergic sensitisation, otitis media, pre-eclampsia, metabolic syndrome, high BMI, and non-Hodgkin lymphoma. The current evidence base does not allow a definitive statement on the health benefits of organic dietary intake. However, a growing number of important findings are being reported from observational research linking demonstrable health benefits with organic food consumption. Future clinical research should focus on using long-term whole-diet substitution with certified organic interventions as this approach is more likely to determine whether or not true measurable health benefits exist.