Efeitos da exposição ao arsênio, chumbo, mercúrio e cádmio no metabolismo lipídico e glicêmico
Notice bibliographique
Résumé
Contamination by toxic elements, including arsenic (As), lead (Pb), mercury (Hg) and cadmium (Cd), represents a global problem associated with harmful effects on human health, which can cause metabolic changes. However, understanding the impact of exposure to toxic elements on glycemic and lipid profiles remains incomplete. This dissertation consists of two studies: the first is a systematic review and meta-analysis of observational studies (Study 1), and the second, a narrative review (Study 2). Study 1 aimed to answer the following question: “Is exposure to As, Pb, Hg and Cd associated with changes in lipid and glycemic profiles in humans?” The review is registered with PROSPERO (CRD42023393681) and was developed based on the Preferred Reporting Items for Systematic Review and Metaanalysis (PRISMA). Studies involving individuals over 10 years of age were included, containing an exposed group and a group not exposed (or with low exposure) to As, Pb, Hg and Cd, published until March 2024. Fasting blood glucose and lipoprotein low density (LDL-c) were defined as the primary outcomes. Secondary outcomes include glycated hemoglobin (HbA1c), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), and triglycerides (TG). The search, selection, extraction and quality analysis process were carried out independently, by two reviewers. The searches were conducted in the MEDLINE (PubMed), EMBASE, Web of Science, LILACS and Google Scholar databases and analyzes of risk of bias and methodological quality of the included studies were carried out using the modified Newcastle–Ottawa (NOS) and JBI tools. Critical Appraisal Tool. Stata statistical software (Stata Corp., College Station, TX, USA) was used to conduct the meta-analysis. Continuous variables were represented as standardized mean difference (SMD) with 95% confidence intervals (CIs). Heterogeneity between studies was verified by the I² test. The search strategy resulted in 6,020 reported articles, remaining at the end of the selection, 17 studies for narrative synthesis (systematic review) 11 for meta-analysis. Studies report adverse effects on fasting blood glucose concentration, HbA1c, HDL-C and LDL-c in individuals exposed to As. Individuals exposed to Hg showed an increase in TG and TC concentrations. Exposure to Pb was associated with changes in glycemic metabolism and increased concentrations of LDL-c, TC and TG. Finally, exposure to Cd led to an increase in the concentrations of HbA1c, TC, LDL-c and TG, in addition to a reduction in the concentration of HDL-c. Two other studies did not report changes in the components of the glycemic profile in relation to exposure to Cd and Pb. In the meta-analysis, subgroup analysis showed that exposure to As and Cd, as well as concomitant exposure to Pb and Cd, increased concentrations of fasting blood glucose. Exposure to Hg and synergy between Cd and Pb were associated with increased LDL-c and TC. Exposure to Hg was also related to reduced HDL-c concentrations and increased TG. In Study 2, the narrative review aimed to investigate the metabolic aspects of As and mechanisms of action associated with glycemic changes. The search resulted in 466 articles of which only 50 were included in the review. It was observed that the relationship between exposure to As and glycemic changes in humans may be associated with factors such as sex, smoking, body mass index, age, occupation, and genetic factors.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,011 | 0,040 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,005 | 0,009 |
| Bibliométrie | 0,004 | 0,006 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».