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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
New environmental factors related to diabetes risk in humans: Emerging bisphenols used in synthesis of plastics
Rafael Moreno-Gómez-Toledano, María Delgado-Marín, Alberto Cook-Calvete, Claudia González-Cucharero, Nunzio Alcharani, Beatriz Jiménez-Guirado, Ignacio Hernandez, Rafael Ramirez-Carracedo, Laura Tesoro, Laura Botana, Sandra Sánchez-Esteban, Javier Diez-Mata, Jose Luis Zamorano, Ricardo J. Bosch, Carlos Zaragoza, Marta Saura
Rafael Moreno-Gómez-Toledano, María Delgado-Marín, Alberto Cook-Calvete, Sandra Sánchez-Esteban, Ricardo J. Bosch, Marta Saura, Universidad de Alcalá,Department of Biological Systems/Physiology, Alcalá de Henares 28871, Spain
Rafael Moreno-Gómez-Toledano, Claudia González-Cucharero, Nunzio Alcharani, Beatriz Jiménez-Guirado, Ignacio Hernandez, Rafael Ramirez-Carracedo, Laura Tesoro, Laura Botana, Javier Diez-Mata, Jose Luis Zamorano, Carlos Zaragoza, Cardiology Department, University Hospital Ramón y Cajal, Madrid 28034, Spain
Rafael Moreno-Gómez-Toledano, Claudia González-Cucharero, Nunzio Alcharani, Beatriz Jiménez-Guirado, Ignacio Hernandez, Rafael Ramirez-Carracedo, Laura Tesoro, Laura Botana, Javier Diez-Mata, Carlos Zaragoza, Laboratory of Cardiovascular Pathophysiology, Joint Translational Research Unit, University Francisco de Vitoria School of Medicine, Madrid 28034, Spain
Rafael Moreno-Gómez-Toledano, Claudia González-Cucharero, Nunzio Alcharani, Beatriz Jiménez-Guirado, Ignacio Hernandez, Rafael Ramirez-Carracedo, Laura Tesoro, Laura Botana, Javier Diez-Mata, Jose Luis Zamorano, Carlos Zaragoza, Instituto Ramón y Cajal de Investigación Sanitaria-IRYCIS, Madrid 28034, Spain
Author contributions: Moreno-Gómez-Toledano R contributed to conceptualization; Moreno-Gómez-Toledano R, Delgado-Marín M, Cook-Calvete A contributed to the systematic review; Moreno-Gómez-Toledano R, González-Cucharero C, Alcharani N, Jiménez-Guirado B, Hernández I, Ramírez-Carracedo R, Tesoro L, Botana L, Sánchez-Esteban S, and Díez-Mata J contributed to the qualitative analysis; Moreno-Gómez-Toledano R contributed to data curation, formal analysis, methodology, and writing the original draft; Saura M, Zaragoza C, Bosch RJ, and Zamorano JL contributed to funding acquisition; Moreno-Gómez-Toledano R, Delgado-Marín M, Cook-Calvete A, González-Cucharero C, Alcharani N, Jiménez-Guirado B, Hernández I, Ramírez-Carracedo R, Tesoro L, Botana L, Sánchez-Esteban S, and Díez-Mata J contributed to the investigation; Saura M, Zaragoza C, Bosch RJ, and Zamorano JL contributed to project administration; Moreno-Gómez-Toledano R, Saura M, Zaragoza C, Bosch RJ, and Zamorano JL contributed to writing and editing the review; and all authors have read and agreed to the published version of the manuscript.
Supported by the “Margarita Salas” postdoctoral fellowship from the Universidad de Alcalá; and FPI fellowships from the Universidad de Alcalá.
Conflict-of-interest statement: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Rafael Moreno-Gómez-Toledano, PhD, Assistant Professor, Postdoctoral Fellow, Research Scientist, Universidad de Alcalá, Department of Biological Systems/Physiology, Facultad de Medicina-Campus Universitario-C/ 19, Av. De Madrid, Km 33600, Alcalá de Henares 28871, Spain. r.morenogomeztoledano@gmail.com
Received: March 28, 2023
Peer-review started: March 28, 2023
First decision: May 8, 2023
Revised: May 21, 2023
Accepted: June 5, 2023
Article in press: June 5, 2023
Published online: August 15, 2023
ARTICLE HIGHLIGHTS
Research background
Diabetes mellitus (DM) is one of the largest global health emergencies of the 21st century. The prevalence of DM has increased substantially, from 108 million adults in 1980 to 536 million. In parallel, the consumption of plastic products has increased substantially in recent decades, which implies chronic exposure to monomers, such as bisphenol (BP)A, or its new substitute molecules, BPS, BPF and BPAF.
Research motivation
In recent years, the relationship between BPA and DM has been demonstrated. The new BPA substitute molecules have high structural homology with BPA, as well as similar hormonal activity. Therefore, the study of new BPs is potentially linked to population health.
Research objectives
The present systematic review of the literature allowed a coherent evaluation of the state of the art of the new bisphenols–diabetes paradigm. Subsequently, a meta-analysis was performed to unify the existing quantitative data in human cohorts.
Research methods
Using the PRISMA guidelines as a reference, a systematic review of the literature was carried out. Using the qualitative data, a chronological review was performed, and all quantitative data of interest were identified. Subsequently, a meta-analysis was performed for each BP identified using the RevMan software, and a funnel plot was also performed for risk of bias.
Research results
Qualitative analysis identified 13 recently published articles (2017–2022) that contextualized the new evidence between emerging BPs and DM. The subsequent meta-analysis showed positive results with the three BPs, but only BPS was significant.
Research conclusions
The present study was the first systematic review and meta-analysis of the new BPA substitute molecules and DM. The results support the possible positive relationship between the new BPs and the risk of DM, especially with BPS. Consequently, the substitution of BPA may not improve population health, and government institutions should consider applying the precautionary principle.
Research perspectives
The results support the need to deepen the paradigm, increasing the evidence in basic and translational research, to determine the real risk to which the human population is exposed.
