The associations between prenatal phthalate exposure and childhood glycolipid metabolism and blood pressure: An updated systematic review and a pilot meta-analysis of prospective cohort studies

Hui Gao; Li-Wen Chen; Chen Gong; Shi-Chun Shen; Jia-Ying Zhao; Dou-Dou Xu; Yang Wang; Fang-Biao Tao; Xiao-Chen Fan

doi:10.1016/j.ecoenv.2023.115157

The associations between prenatal phthalate exposure and childhood glycolipid metabolism and blood pressure: An updated systematic review and a pilot meta-analysis of prospective cohort studies

Ecotoxicol Environ Saf. 2023 Jun 20:262:115157. doi: 10.1016/j.ecoenv.2023.115157. Online ahead of print.

Authors

Hui Gao¹, Li-Wen Chen², Chen Gong², Shi-Chun Shen³, Jia-Ying Zhao², Dou-Dou Xu², Yang Wang², Fang-Biao Tao⁴, Xiao-Chen Fan⁵

Affiliations

¹ Department of Pediatrics, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei 230022, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China.
² Department of Pediatrics, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei 230022, Anhui, China.
³ The First Affiliated Hospital of USTC (University of Science and Technology of China), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
⁴ Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei 230032, Anhui, China. Electronic address: taofangbiao@126.com.
⁵ Department of Pediatrics, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei 230022, Anhui, China. Electronic address: xcfan2000@163.com.

PMID: 37348219
DOI: 10.1016/j.ecoenv.2023.115157

Abstract

This is the first pilot meta-analysis on the association of prenatal phthalate exposure with childhood cardiometabolic risks. A systematic literature search was performed in MEDLINE, Web of Science and CNKI (Chinese National Knowledge Infrastructure) until June 5, 2023. A total of seven studies with 5746 children (2646 girls and 3100 boys) were finally included. Four, three and two studies investigated the effects of maternal phthalate exposure on childhood blood pressure (BP), blood lipids and blood glucose profiles, respectively. The pilot meta-analysis suggested that di-2-ethylhexyl phthalate (DEHP) metabolite exposure was associated with a decrease in childhood z-systolic BP (SBP, β = -0.169, 95% CI = -0.338-0.001). Furthermore, the pooled results showed negative relationships of prenatal ∑DEHP exposure with z-SBP (β = -0.109, 95% CI = -0.163 to -0.055) and z-diastolic BP (DBP, β = -0.126, 95% CI = -0.182 to -0.069) in girls. In addition, MEP exposure was associated with z-SBP in girls (β = -0.227, 95% CI = -0.387 to -0.066). The pooled result showed a positive relationship between prenatal ∑DEHP exposure and triglycerides (β = 0.103, 95% CI = 0.028-0.178). The overall results revealed that exposure to ∑DEHP throughout gestation was associated with a decrease in insulin (β = -0.074, 95% CI = -0.144 to -0.004) and glucose (β = -0.129, 95% CI = -0.199 to -0.058) in boys. Interestingly, there was an inverse relationship of prenatal mono- 3 -carboxypropyl phthalate (MCPP) exposure with glucose in pubertal boys (β = -3.749, 95% CIs = -6.758 to -0.741) but not found in postpubertal children. In conclusion, prenatal phthalate exposure interfered with cardiovascular risk in children with gender-specific differences and was influenced by puberty. Overall, prenatal ∑DEHP was negatively associated with systolic blood pressure in girls and with insulin and glucose in boys but increased the level of triglycerides.

Keywords: Birth cohort study; Childhood cardiometabolic risk factors; Prenatal phthalate exposure; Systematic review and meta-analysis.

Publication types

Review