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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
BACKGROUND
Diabetes mellitus (DM) is one of the largest global health emergencies of the 21st century. In recent years, its connection with environmental pollutants, such as bisphenol A (BPA), has been demonstrated; consequently, new structurally similar molecules are used to replace BPA in the plastics industry (BPS, BPF and BPAF).
AIM
To carry out a systematic review to allow coherent evaluation of the state of the art. Subsequently, a meta-analysis was performed to unify the existing quantitative data.
METHODS
Firstly, a systematic review was carried out, using the terms “(bisphenol) AND (Diabetes OR Hyperglycemia)”, to maximize the number of results. Subsequently, three authors analyzed the set of articles. Finally, a meta-analysis was performed for each BP, using RevMan software. In addition, funnel plots were developed to study publication bias.
RESULTS
The systematic analysis of the literature revealed 13 recent articles (2017–2023) related to the study paradigm. The qualitative analysis showed interesting data linking diabetes to the three most widely used substitute BPs in the industry: BPS, BPF and BPAF. Finally, the meta-analysis determined a positive relationship with BPS, BPF and BPAF, which was only statistically significant with BPS.
CONCLUSION
There is a need to apply the precautionary principle, regulating the use of new BPs. Therefore, replacing BPA with BPS, BPF or BPAF is unlikely to protect the population from potential health risks, such as DM.
Core tip: The present study analyzed the potential dangers that society faces with the replacement of bisphenol A (BPA) by new BPs. Thus, using PRISMA methodologies, a systematic review and meta-analysis of the relationship between new BPs and diabetes mellitus (DM) in humans was carried out. The results showed a positive relationship between BPS, BPF and BPAF and DM, which was statistically significant only with BPS. Consequently, new BPs could represent a health risk equivalent to that of BPA.
