Disruptores endócrinos ambientais e obesidade: uma revisão de coortes
DOI:
https://doi.org/10.34119/bjhrv7n4-414Keywords:
disruptores endócrinos, obesidade, estudos epidemiológicosAbstract
Objetivo: sintetizar as principais evidências de estudos de coorte nos últimos 10 anos, identificando os principais obesógenos estudados e seus respectivos efeitos observados. Método: Este trabalho é uma revisão sistemática. Foram excluídos estudos in vitro ou com animais, assim como revisões sistemáticas, relatos de caso, editoriais ou estudos cujo objetivo foi a análise de outras comorbidades além da obesidade. Resultados: A principal população avaliada foram crianças e adolescentes em cenário de exposição pré-natal. Foram feitas principalmente análises de medidas séricas e urinárias. O parâmetro de desfecho mais avaliado foi o IMC, contudo, vários estudos, considerando as limitações dessa medida, utilizaram circunferência abdominal, porcentagem de gordura corporal. Cerca de 21 DE foram associados com aumento de IMC, ganho de adiposidade, perfil de adiposidade, aumento da porcentagem de gordura corporal, alteração da relação gordura ginóide/andróide. Aqueles artigos que avaliaram o resultado da exposição combinada a múltiplos DE não encontraram correlação com obesidade. Em 25% dos trabalhos foi encontrada uma correlação inversa entre exposição a DE e aumento de adiposidade, sugerindo diferenças sexo-específicas ainda não muito claras. Conclusão: Nossa revisão reforça a hipótese da correlação positiva de DE com obesidade, mas sugere que estes não são a causa necessária para tal desfecho, uma vez que variáveis como sexo, idade e componentes genéticos também interferem na relação disruptor-desfecho. Adicionalmente, ressaltamos a necessidade de estender os estudos de coorte para outros grupos etários e outras possíveis populações de risco. Também destacamos a importância da busca por biomarcadores de exposição com maior potencial preditivo.
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