title: Endocrine-disrupting chemicals, risk of type 2 diabetes, and diabetes-related metabolic traits: A systematic review and meta-analysis.
abstract: BACKGROUND
  Elevated blood or urinary concentrations of endocrine-disrupting chemicals (EDCs) may be related to increased risk of type 2 diabetes (T2D). The aim of the present study was to assess the role of EDCs in affecting risk of T2D and related metabolic traits.
  
  
  METHODS
  MEDLINE was searched for cross-sectional and prospective studies published before 8 March 2014 into the association between EDCs (dioxin, polychlorinated biphenyl [PCB], chlorinated pesticide, bisphenol A [BPA], phthalate) and T2D and related metabolic traits. Three investigators independently extracted information on study design, participant characteristics, EDC types and concentrations, and association measures.
  
  
  RESULTS
  Forty-one cross-sectional and eight prospective studies from ethnically diverse populations were included in the analysis. Serum concentrations of dioxins, PCBs, and chlorinated pesticides were significantly associated with T2D risk; comparing the highest to lowest concentration category, the pooled relative risks (RR) were 1.91 (95% confidence interval [CI] 1.44-2.54) for dioxins, 2.39 (95% CI 1.86-3.08) for total PCBs, and 2.30 (95% CI 1.81-2.93) for chlorinated pesticides. Urinary concentrations of BPA and phthalates were also associated with T2D risk; comparing the highest to lowest concentration categories, the pooled RR were 1.45 (95% CI 1.13-1.87) for BPA and 1.48 (95% CI 0.98-2.25) for phthalates. Further, EDC concentrations were associated with indicators of impaired fasting glucose and insulin resistance.
  
  
  CONCLUSIONS
  Persistent and non-persistent EDCs may affect the risk of T2D. There is an urgent need for further investigation of EDCs, especially non-persistent ones, and T2D risk in large prospective studies.
authors.affiliation: Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA.|Department of Epidemiology, School of Public Health, Providence, Rhode Island, USA.
authors.forename: Yan
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Chou
authors.affiliation: Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA.
authors.forename: Aileen
authors.initials: A
authors.lastname: Baecker
authors.affiliation: Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA.
authors.forename: Nai-Chieh Y
authors.initials: NC
authors.lastname: You
authors.affiliation: Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA.
authors.forename: Yiqing
authors.initials: Y
authors.lastname: Song
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.|Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
authors.forename: Qi
authors.initials: Q
authors.lastname: Sun
authors.affiliation: Department of Epidemiology, School of Public Health, Providence, Rhode Island, USA.|Department of Medicine, Alpert Medical School, Brown University, Providence, Rhode Island, USA.
authors.forename: Simin
authors.initials: S
authors.lastname: Liu
mesh_terms: D001559:Benzhydryl Compounds / Q000097:blood / Q000652:urine; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000139:chemically induced / Q000652:urine*; D004147:Dioxins / Q000097:blood / Q000652:urine; D052244:Endocrine Disruptors / Q000097:blood* / Q000506:poisoning / Q000652:urine*; D006801:Humans; D010636:Phenols / Q000097:blood / Q000652:urine; D010795:Phthalic Acids / Q000097:blood / Q000652:urine; D011078:Polychlorinated Biphenyls / Q000097:blood / Q000652:urine; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D000098826:Bisphenol A Compounds
chemical_list: D001559:Benzhydryl Compounds; D004147:Dioxins; D052244:Endocrine Disruptors; D010636:Phenols; D010795:Phthalic Acids; D011078:Polychlorinated Biphenyls; C032279:phthalic acid; C006780:bisphenol A; D000098826:Bisphenol A Compounds
keywords: bisphenol A; diabetes; endocrine-disrupting chemical; meta-analysis; meta分析; phthalate; 内分泌干扰物; 双酚A; 糖尿病; 邻苯二甲酸盐