Asociación de la exposición a contaminantes atmosféricos y el síndrome metabólico en adultos: una revisión sistemática y un metaanálisis

Background: The metabolic syndrome is a precursor pathophysiological state of cardiovascular diseases or accidents with a high global prevalence. Its etiology is not completely clear, but recent studies have suggested that environmental pollutants may increase the risk of metabolic syndrome. We deci...

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Autores:
Goethe Flórez, Dilson David
Tipo de recurso:
Fecha de publicación:
2021
Institución:
Corporación Universidad de la Costa
Repositorio:
REDICUC - Repositorio CUC
Idioma:
spa
OAI Identifier:
oai:repositorio.cuc.edu.co:11323/8961
Acceso en línea:
https://hdl.handle.net/11323/8961
https://repositorio.cuc.edu.co/
Palabra clave:
Air pollution
Blood pressure
Waist circumference
Fasting sugar levels
Contaminación atmosférica
Presión arterial
Circunferencia de la cintura
Niveles de azúcar en ayunas
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openAccess
License
Attribution-NonCommercial-ShareAlike 4.0 International
id RCUC2_b418abee8658f29792f906c39c98a38d
oai_identifier_str oai:repositorio.cuc.edu.co:11323/8961
network_acronym_str RCUC2
network_name_str REDICUC - Repositorio CUC
repository_id_str
dc.title.spa.fl_str_mv Asociación de la exposición a contaminantes atmosféricos y el síndrome metabólico en adultos: una revisión sistemática y un metaanálisis
title Asociación de la exposición a contaminantes atmosféricos y el síndrome metabólico en adultos: una revisión sistemática y un metaanálisis
spellingShingle Asociación de la exposición a contaminantes atmosféricos y el síndrome metabólico en adultos: una revisión sistemática y un metaanálisis
Air pollution
Blood pressure
Waist circumference
Fasting sugar levels
Contaminación atmosférica
Presión arterial
Circunferencia de la cintura
Niveles de azúcar en ayunas
title_short Asociación de la exposición a contaminantes atmosféricos y el síndrome metabólico en adultos: una revisión sistemática y un metaanálisis
title_full Asociación de la exposición a contaminantes atmosféricos y el síndrome metabólico en adultos: una revisión sistemática y un metaanálisis
title_fullStr Asociación de la exposición a contaminantes atmosféricos y el síndrome metabólico en adultos: una revisión sistemática y un metaanálisis
title_full_unstemmed Asociación de la exposición a contaminantes atmosféricos y el síndrome metabólico en adultos: una revisión sistemática y un metaanálisis
title_sort Asociación de la exposición a contaminantes atmosféricos y el síndrome metabólico en adultos: una revisión sistemática y un metaanálisis
dc.creator.fl_str_mv Goethe Flórez, Dilson David
dc.contributor.advisor.spa.fl_str_mv Schnorr, Carlos Eduardo
Martinello, Katia
dc.contributor.author.spa.fl_str_mv Goethe Flórez, Dilson David
dc.subject.spa.fl_str_mv Air pollution
Blood pressure
Waist circumference
Fasting sugar levels
Contaminación atmosférica
Presión arterial
Circunferencia de la cintura
Niveles de azúcar en ayunas
topic Air pollution
Blood pressure
Waist circumference
Fasting sugar levels
Contaminación atmosférica
Presión arterial
Circunferencia de la cintura
Niveles de azúcar en ayunas
description Background: The metabolic syndrome is a precursor pathophysiological state of cardiovascular diseases or accidents with a high global prevalence. Its etiology is not completely clear, but recent studies have suggested that environmental pollutants may increase the risk of metabolic syndrome. We decided to conduct a systematic review to assess the risk among people with exposure to air pollution and parameters of metabolic syndrome. Methods: Potential studies were identified in the literature from reliable databases such as PubMed and ISI Web of Science until July 2021. The methodological quality of the studies was evaluated according to the New-Castle Ottawa rating, for the meta-analysis it was used a random effects mathematical model in RevMan software (version 5.2). Results: In total, 3479 studies were identified, only 9 studies met the inclusion and exclusion criteria. The studies totaled 16.409.475 participants between men and women with an average age of 52.5 years. The meta-analysis revealed an increased risk of metabolic syndrome, due to exposures to MP2.5 (RR 1.03; CI 1.01-1.05) and MP10 (RR 1.04; CI 1.00-1.09). Regarding NO2 (RR 1.02; CI 0.93 - 1.11) and O3 (RR 1.04; CI 0.96 -1.12), there was no statistically significant association with the metabolic syndrome. Conclusions: The results of this review suggest that adults exposed to long-term air pollutants are at increased risk of MetS, specifically exposure to MP2.5 and MP10.
publishDate 2021
dc.date.accessioned.none.fl_str_mv 2021-12-15T19:21:13Z
dc.date.available.none.fl_str_mv 2021-12-15T19:21:13Z
dc.date.issued.none.fl_str_mv 2021
dc.type.spa.fl_str_mv Trabajo de grado - Maestría
dc.type.content.spa.fl_str_mv Text
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/masterThesis
dc.type.redcol.spa.fl_str_mv http://purl.org/redcol/resource_type/TM
dc.type.version.spa.fl_str_mv info:eu-repo/semantics/acceptedVersion
status_str acceptedVersion
dc.identifier.uri.spa.fl_str_mv https://hdl.handle.net/11323/8961
dc.identifier.instname.spa.fl_str_mv Corporación Universidad de la Costa
dc.identifier.reponame.spa.fl_str_mv REDICUC - Repositorio CUC
dc.identifier.repourl.spa.fl_str_mv https://repositorio.cuc.edu.co/
url https://hdl.handle.net/11323/8961
https://repositorio.cuc.edu.co/
identifier_str_mv Corporación Universidad de la Costa
REDICUC - Repositorio CUC
dc.language.iso.none.fl_str_mv spa
language spa
dc.relation.references.spa.fl_str_mv Alberti, K. G. M. M., Eckel, R. H., Grundy, S. M., Zimmet, P. Z., Cleeman, J. I., Donato, K. A., Fruchart, J., James, W. P. T., Loria, C. M., & Sidney, C. (2009). The online version of this article, along with updated information and services, is located on the World Wide Web at: https://doi.org/10.1161/CIRCULATIONAHA.109.192644
American Association for Cancer Research. (2021). La contaminación del aire puede estar asociada con muchos tipos de cáncer. 35–37.
An, R., Ji, M., Yan, H., & Guan, C. (2018). Impact of ambient air pollution on obesity: A systematic review. International Journal of Obesity, 42(6), 1112–1126. https://doi.org/10.1038/s41366-018-0089-y
Ansari-moghaddam, A., Adineh, H. A., Zareban, I., & Farmanfarma, K. H. K. (2019). Prevalence of metabolic syndrome and population attributable risk for cardiovascular, stroke , and coronary heart diseases as well as myocardial infarction and all-cause mortality in middle-east : Systematic review & meta- analysis. 14(March), 1–8. https://doi.org/10.1016/j.obmed.2019.100086
Arias, M. (2015). Lectura crítica en pequeñas dosis.
Balakrishnan, K., Brauer, M., Chen, G., & Chow, J. (2015). To Humans Outdoor Air Pollution. In IARC monographs (Vol. 109).
Ballestri, S., Zona, S., Targher, G., Romagnoli, D., Baldelli, E., Nascimbeni, F., Roverato, A., Guaraldi, G., & Lonardo, A. (2016). Nonalcoholic fatty liver disease is associated with an almost twofold increased risk of incident type 2 diabetes and metabolic syndrome. Evidence from a systematic review and meta-analysis. Journal of Gastroenterology and Hepatology (Australia), 31(5), 936–944. https://doi.org/10.1111/jgh.13264
Berglund, B., Brunekreef, B., Knöppe, H., Lindvall, T., Maroni, M., Mølhave, L., & Skov, P. (1992). Effects of Indoor Air Pollution on Human Health. Indoor Air, 2(1), 2–25. https://doi.org/10.1111/j.1600-0668.1992.02-21.x
Bhandari, R., Kelley, G. A., Hartley, T. A., & Rockett, I. R. H. (2014). Metabolic Syndrome Is Associated with Increased Breast Cancer Risk: A Systematic Review with Meta-Analysis. International Journal of Breast Cancer, 2014, 1–13. https://doi.org/10.1155/2014/189384
Booth, F. W., Roberts, C. K., & Laye, M. J. (2012). Lack of exercise is a major cause of chronic diseases. Comprehensive Physiology, 2(2), 1143–1211. https://doi.org/10.1002/cphy.c110025
Brook, R. D., Sun, Z., Brook, J. R., Zhao, X., Ruan, Y., Yan, J., Mukherjee, B., Rao, X., Duan, F., Sun, L., Liang, R., Lian, H., Zhang, S., Fang, Q., Gu, D., Sun, Q., Fan, Z., & Rajagopalan, S. (2016). Extreme Air Pollution Conditions Adversely Affect Blood Pressure and Insulin Resistance: The Air Pollution and Cardiometabolic Disease Study. Hypertension, 67(1), 77–85. https://doi.org/10.1161/HYPERTENSIONAHA.115.06237
Bryce, A., Alegría, E., San Martin-San Martin, M. G., & Alfonso Bryce-Moncloa, C. (2017). Obesidad y riesgo de enfermedad cardiovascular Cardiovascular risk and obesity. Fac Med, 78(2), 202–206. http://dx.doi.org/10.15381/anales.v78i2.13218
Cai, Y., Zhang, B., Ke, W., Feng, B., Lin, H., Xiao, J., Zeng, W., Li, X., Tao, J., Yang, Z., Ma, W., & Liu, T. (2016). Associations of Short-Term and Long-Term Exposure to Ambient Air Pollutants With Hypertension: A Systematic Review and Meta-Analysis. Hypertension, 68(1), 62–70. https://doi.org/10.1161/HYPERTENSIONAHA.116.07218
Carll, A. P., Crespo, S. M., Filho, M. S., Zati, D. H., Coull, B. A., Diaz, E. A., Raimundo, R. D., Jaeger, T. N. G., Ricci-vitor, A. L., Papapostolou, V., Lawrence, J. E., Garner, D. M., Perry, B. S., Harkema, J. R., & Godleski, J. J. (2017). Inhaled ambient-level traffic-derived particulates decrease cardiac vagal influence and baroreflexes and increase arrhythmia in a rat model of metabolic syndrome. 1–15. https://doi.org/10.1186/s12989-017-0196-2
Chassan B, H., Neela, G., Aaron, C., Francine, L., Ole, R., Jonathan M, S., Paolo, V., Francesco, F., Paulo, S., Yirifuji, T., & Dana, L. (2014). Outdoor Particulate Matter Exposure and Lung Cancer: A Systematic Review. 906(9).
Chen, J. C., & Schwartz, J. (2008). Metabolic syndrome and inflammatory responses to long-term particulate air pollutants. Environmental Health Perspectives, 116(5), 612– 617. https://doi.org/10.1289/ehp.10565
Chen, L., Zhou, Y., Li, S., Williams, G., Kan, H., Marks, G. B., Morawska, L., Abramson, M. J., Chen, S., Yao, T., Qin, T., Wu, S., & Guo, Y. (2016). Air pollution and fasting blood glucose: A longitudinal study in China. Science of the Total Environment, 541(2), 750–755. https://doi.org/10.1016/j.scitotenv.2015.09.132
Choi, Y. J., Kim, S. H., Kang, S. H., Kim, S. Y., Kim, O. J., Yoon, C. H., Lee, H. Y., Youn, T. J., Chae, I. H., & Kim, C. H. (2019). Short-term effects of air pollution on blood pressure. Scientific Reports, 9(1), 1–8. https://doi.org/10.1038/s41598-019-56413-y Clementi, E. A., Talusan, A., Vaidyanathan, S., Veerappan, A., Mikhail, M., Ostrofsky, D.,
Crowley, G., Kim, J. S., Kwon, S., & Nolan, A. (2019). Metabolic syndrome and air pollution: A narrative review of their cardiopulmonary effects. Toxics, 7(1), 1–13https://doi.org/10.3390/toxics7010006
Clifton, P. (2019). Metabolic syndrome—role of dietary fat type and quantity. Nutrients, 11(7). https://doi.org/10.3390/nu11071438
Colbeck, I. (1995). Particle Emission from Outdoor and Indoor Sources. Handbook of Environmental Chemistry, 4, 1–33. https://doi.org/10.1007/978-3-540-49145-3-1
Curto, A., Ranzani, O., Milà, C., Sanchez, M., Marshall, J. D., Kulkarni, B., Bhogadi, S., Kinra, S., Wellenius, G. A., & Tonne, C. (2019). Lack of association between particulate air pollution and blood glucose levels and diabetic status in peri-urban India. Environment International, 131(February), 105033. https://doi.org/10.1016/j.envint.2019.105033
D. Koman, P., & Peter, M. (2017). Ozone Exposure, Cardiopulmonary Health, and Obesity: A Substantive Review. Physiology & Behavior, 176(3), 139–148. https://doi.org/10.1021/acs.chemrestox.7b00077.Ozone
da Silva, A. A., do Carmo, J. M., Li, X., Wang, Z., Mouton, A. J., & Hall, J. E. (2020). Role of Hyperinsulinemia and Insulin Resistance in Hypertension: Metabolic Syndrome Revisited. The Canadian Journal of Cardiology, 36(5), 671–682. https://doi.org/10.1016/j.cjca.2020.02.066
Dabass, A., Talbott, E. O., Rager, J. R., Marsh, G. M., Venkat, A., Holguin, F., & Sharma, R. K. (2018a). Systemic in fl ammatory markers associated with cardiovascular disease and acute and chronic exposure to fi ne particulate matter air pollution (MP 2. 5) among US NHANES adults with metabolic syndrome. Environmental Research, 161(July 2017), 485–491. https://doi.org/10.1016/j.envres.2017.11.042
Dabass, A., Talbott, E. O., Rager, J. R., Marsh, G. M., Venkat, A., Holguin, F., & Sharma, R. K. (2018b). Systemic inflammatory markers associated with cardiovascular disease and acute and chronic exposure to fine particulate matter air pollution (MP2.5) among US NHANES adults with metabolic syndrome. Environmental Research, 161(October 2017), 485–491. https://doi.org/10.1016/j.envres.2017.11.042
Departamento Nacional de Planeación. (2017). Los costos en la salud asociados a la degradación ambiental en Colombia ascienden a $20,7 billones. 1–6. https://www.dnp.gov.co/Paginas/Los-costos-en-la-salud-asociados-a-la-degradaciónambiental-en-Colombia-ascienden-a-$20,7-billones-.aspx
Despre, J., Lemieux, I., Bergeron, J., Pibarot, P., Mathieu, P., Larose, E., Bertrand, O. F., & Poirier, P. (2008). Abdominal Obesity and the Metabolic Syndrome: Contribution to Global Cardiometabolic Risk. 1039–1049. https://doi.org/10.1161/ATVBAHA.107.159228
Díaz, V. (2009). Metodología de la investigación científica y bioestadística. 2021.
Dominici, F., Greenstone, M., & Sunstein, C. R. (2014). Particulate matter matters. In Science (Vol. 344, Issue 6181). https://doi.org/10.1126/science.1247348
Dommermuth, R., & Ewing, K. (2018). Metabolic Syndrome: Systems Thinking in Heart Disease. Primary Care - Clinics in Office Practice, 45(1), 109–129. https://doi.org/10.1016/j.pop.2017.10.003
Dong, G. H., Qian, Z. M., Xaverius, P. K., Trevathan, E., Maalouf, S., Parker, J., Yang, L., Liu, M. M., Wang, D., Ren, W. H., Ma, W., Wang, J., Zelicoff, A., Fu, Q., & Simckes, M. (2013). Association between long-term air pollution and increased blood pressure and hypertension in China. Hypertension, 61(3), 578–584. https://doi.org/10.1161/HYPERTENSIONAHA.111.00003
Edginton, S., Sullivan, D. E. O., King, W., & Lougheed, M. D. (2019). Effect of outdoor particulate air pollution on FEV 1 in healthy adults: a systematic review and meta analysis. 583–591. https://doi.org/10.1136/oemed-2018-105420
Eze, I. C., Schaffner, E., Foraster, M., Imboden, M., von Eckardstein, A., Gerbase, M. W., Rothe, T., Rochat, T., Künzli, N., Schindler, C., & Probst-Hensch, N. (2015). LongTerm Exposure to Ambient Air Pollution and Metabolic Syndrome in Adults. PLOS ONE, 10(6), e0130337. https://doi.org/10.1371/journal.pone.0130337
Fajardo-Gutiérrez, A. (2017). Medición en epidemiología: prevalencia, incidencia, riesgo, medidas de impacto. Revista Alergia México, 64(1), 109. https://doi.org/10.29262/ram.v64i1.252
Falcon-Rodriguez, C. I., Osornio-Vargas, A. R., Sada-Ovalle, I., & Segura-Medina, P. (2016a). Aeroparticles, composition, and lung diseases. Frontiers in Immunology, 7(JAN). https://doi.org/10.3389/fimmu.2016.00003
Falcon-Rodriguez, C. I., Osornio-Vargas, A. R., Sada-Ovalle, I., & Segura-Medina, P. (2016b). Aeroparticles, composition, and lung diseases. Frontiers in Immunology, 7(JAN). https://doi.org/10.3389/fimmu.2016.00003
Fernandez Chinguel, J. E., Zafra Tanaka, J. H., Goicochea Lugo, S., Peralta, C. I., & Taype Rondan, A. (2019). Aspectos básicos sobre la lectura de revisiones sistemáticas y la interpretación de meta-análisis. Acta Medica Peruana, 36(2), 157–169. https://doi.org/10.35663/amp.2019.362.818
Ferreira, I., Urrutia, G., & Coello, P. A. (2019). Revisiones sistemáticas y metaanálisis: Bases conceptuales e interpretación. Revista Española de Cardiología, 64(8), 688–696. https://doi.org/10.1016/j.recesp.2011.03.029
Gaio, V., Roquette, R., Dias, C. M., & Nunes, B. (2019). Ambient air pollution and lipid profile: Systematic review and meta-analysis. Environmental Pollution, 254. https://doi.org/10.1016/j.envpol.2019.113036
Ghafuri, S., Ghaderi, E., Fahami, Y., & Rajabnia, M. (2019). Diabetes & Metabolic Syndrome : Clinical Research & Reviews Epidemiologic study of type 2 diabetes mellitus and metabolic syndrome in rural population of kurdistan province , Iran , in 2011 e 2017. 13. https://doi.org/10.1016/j.dsx.2019.03.037
Glass, G. V. (1976). Primary, Secondary, and Meta-Analysis of Research’. 5(10), 3–8. Han, T. S., & Lean, M. E. J. (2006). Metabolic syndrome. Medicine, 34(12), 536–542. https://doi.org/10.1053/j.mpmed.2006.09.012
Hanson, R. L., Imperatore, G., Bennett, P. H., & Knowler, W. C. (2002). Components of the “metabolic syndrome” and incidence of type 2 diabetes. Diabetes, 51(10), 3120– 3127. https://doi.org/10.2337/diabetes.51.10.3120
Hayes, R. B., Lim, C., Zhang, Y., Cromar, K., Shao, Y., Reynolds, H. R., Silverman, D. T., Jones, R. R., Park, Y., Jerrett, M., Ahn, J., & Thurston, G. D. (2020). MP2.5 air pollution and cause-specific cardiovascular disease mortality. International Journal of Epidemiology, 49(1), 25–35. https://doi.org/10.1093/ije/dyz114
Higgins, J., & Green, S. (2011). Manual Cochrane de revisiones sistemáticas de intervenciones (Julian PT Higgins y Sally Green (ed.)).
Holme, J. A., Brinchmann, B. C., Refsnes, M., Låg, M., & Øvrevik, J. (2019). Potential role of polycyclic aromatic hydrocarbons as mediators of cardiovascular effects from combustion particles. 1–18.
Hotamisligil, G. S. (2006). https://doi.org/10.1038/nature05485. Nature, 444(7121), 860– 867. https://doi.org/10.1038/nature05485
Hou, J., Liu, X., Tu, R., Dong, X., Zhai, Z., Mao, Z., Huo, W., Chen, G., Xiang, H., Guo, Y., Li, S., & Wang, C. (2020). Long-term exposure to ambient air pollution attenuated the association of physical activity with metabolic syndrome in rural Chinese adults: A cross-sectional study. Environment International, 136(August 2019), 105459. https://doi.org/10.1016/j.envint.2020.105459
Huang, M., Chen, J., Yang, Y., Yuan, H., Huang, Z., & Lu, Y. (2021). Effects of ambient air pollution on blood pressure among children and adolescents: A systematic review and meta-analysis. Journal of the American Heart Association, 10(10). https://doi.org/10.1161/JAHA.120.017734
Huang, S., Zhang, X., Huang, J., Lu, X., Liu, F., & Gu, D. (2020). Ambient air pollution and body weight status in adults: A systematic review and meta-analysis. Environmental Pollution, 265, 114999. https://doi.org/10.1016/j.envpol.2020.114999
Hutcheson, R., & Rocic, P. (2012). The Metabolic Syndrome, Oxidative Stress, Environment, and Cardiovascular Disease : The Great Exploration. 2012. https://doi.org/10.1155/2012/271028
Hwang, S. E., Kwon, H., Jeong, S. M., Kim, H. J., & Park, J. H. (2019). Ambient air pollution exposure and obesity-related traits in Korean adults. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 12, 1365–1377. https://doi.org/10.2147/DMSO.S208115
Impellizzeri, F. M., & Mario Bizzini, P. (2012). SYSTEMATIC REVIEW AND METAANALYSIS: A PRIMER. Urology, 135(C), 152. https://doi.org/10.1016/j.urology.2019.09.037
Instituto Nacional de Salud. (2018). Carga de enfermedad ambiental en Colombia. Informe Técnico Especial 10, 177. https://www.ins.gov.co/Direcciones/ONS/Informes/10 Carga de enfermedad ambiental en Colombia.pdf
International Diabetes Federation. (n.d.). The metabolic Syndrome.
International Diabetes Federation. (2019). IDF Diabetes Atlas, 9th edn. Brussels, Belgium. In Atlas de la Diabetes de la FID. http://www.idf.org/sites/default/files/Atlas-poster2014_ES.pdf
Jaganathan, S., Jaacks, L. M., Magsumbol, M., Walia, G. K., Sieber, N. L., Shivasankar, R., Dhillon, P. K., Hameed, S. S., Schwartz, J., & Prabhakaran, D. (2019). Association of long-term exposure to fine particulate matter and cardio-metabolic diseases in lowand middle-income countries: A systematic review. International Journal of Environmental Research and Public Health, 16(14), 1–18. https://doi.org/10.3390/ijerph16142541
Kamioka, H. (2019). Preferred reporting items for systematic review and meta-analysis protocols (prisma-p) 2015 statement. Japanese Pharmacology and Therapeutics, 47(8), 1177–1185.
Kim, S. Y., Kim, J. K., Park, S. H., Kim, B. G., Jang, A. S., Oh, S. H., Lee, J. H., Suh, M. W., & Park, M. K. (2018). Effects of inhaled particulate matter on the central nervous system in mice. NeuroToxicology, 67, 169–177. https://doi.org/10.1016/j.neuro.2018.06.001
Kitchenham, B. (2004). Procedures for Performing Systematic Reviews.
Lanktree, M. B., & Hegele, R. A. (2017). Metabolic Syndrome. In Genomic and Precision Medicine: Primary Care: Third Edition. Elsevier Inc. https://doi.org/10.1016/B978-0- 12-800685-6.00015-1
Lee, S., Park, H., Kim, S., Lee, E. K., Lee, J., Hong, Y. S., & Ha, E. (2019a). Fine particulate matter and incidence of metabolic syndrome in non-CVD patients: A nationwide population-based cohort study. International Journal of Hygiene and Environmental Health, 222(3), 533–540. https://doi.org/10.1016/j.ijheh.2019.01.010
Lee, S., Park, H., Kim, S., Lee, E. K., Lee, J., Hong, Y. S., & Ha, E. (2019b). Fine particulate matter and incidence of metabolic syndrome in non-CVD patients: A nationwide population-based cohort study. International Journal of Hygiene and Environmental Health, 222(3), 533–540. https://doi.org/10.1016/j.ijheh.2019.01.010
Litvinova, L., Atochin, D. N., Fattakhov, N., Vasilenko, M., Zatolokin, P., & Kirienkova, E. (2015). Nitric oxide and mitochondria in metabolic syndrome. Frontiers in Physiology, 6(FEB), 1–10. https://doi.org/10.3389/fphys.2015.00020
Lo, C. K., Mertz, D., & Loeb, M. (2014). Newcastle-Ottawa Scale: comparing reviewers ’ to authors ’ assessments. BMC Medical Research Methodology, 14(1), 1–5. https://doi.org/10.1186/1471-2288-14-45
Lu, S., Hao, X., Liu, D., Wang, Q., Zhang, W., Liu, P., Zhang, R., Yu, S., Pan, R., Wu, M., Yonemochi, S., & Wang, Q. (2015). Mineralogical characterization of ambient fine/ultrafine particles emitted from Xuanwei C1 coal combustion. Atmospheric Research. https://doi.org/10.1016/j.atmosres.2015.09.020
M., I. (2016). Assessment of the environmental and genetic factors influencing prevalence of metabolic syndrome in Saudi Arabia. Saudi Medical Journal, 37(1), 12–20. https://doi.org/10.15537/smj.2016.1.12675
Ma, R., Zhang, Y., Sun, Z., Xu, D., & Li, T. (2020). Effects of ambient particulate matter on fasting blood glucose: A systematic review and meta-analysis. Environmental Pollution, 258, 113589. https://doi.org/10.1016/j.envpol.2019.113589
Manisalidis, I., Stavropoulou, E., Stavropoulos, A., & Bezirtzoglou, E. (2020). Environmental and Health Impacts of Air Pollution: A Review. In Frontiers in Public Health (Vol. 8). https://doi.org/10.3389/fpubh.2020.00014
Manterola, C., & Otzen, T. (2015). Valoración Clínica del Riesgo, Interpretación y Utilidad Práctica Clinical Risk Assessment, Interpretation and Practical Utility. Int. J. Morphol, 33(3), 842–849. https://scielo.conicyt.cl/pdf/ijmorphol/v33n3/art06.pdf
Martínez-González, M. Á., Alonso, Á., & Fidalgo, J. L. (2008). What is hazard ratio? Concepts in survival analysis. Medicina Clinica, 131(2), 65–72. https://doi.org/10.1157/13123495
Matthiessen, C., Lucht, S., Hennig, F., Ohlwein, S., & Jakobs, H. (2018). Long-term exposure to airborne particulate matter and NO 2 and prevalent and incident metabolic syndrome – Results from the Heinz Nixdorf Recall Study. 116(2), 74–82. https://doi.org/10.1016/j.envint.2018.02.035
Matthiessen, C., Lucht, S., Hennig, F., Ohlwein, S., Jakobs, H., Jöckel, K. H., Moebus, S., & Hoffmann, B. (2018). Long-term exposure to airborne particulate matter and NO2 and prevalent and incident metabolic syndrome – Results from the Heinz Nixdorf Recall Study. Environment International, 116(2), 74–82. https://doi.org/10.1016/j.envint.2018.02.035
Mauro, R. Di, Cantarella, G., Bernardini, R., Rosa, M. Di, Barbagallo, I., Distefano, A., Longhitano, L., Vicario, N., Nicolosi, D., Lazzarino, G., Tibullo, D., Gulino, M. E., Spampinato, M., Avola, R., & Volti, G. L. (2019). The biochemical and pharmacological properties of ozone: The smell of protection in acute and chronic diseases. International Journal of Molecular Sciences, 20(3). https://doi.org/10.3390/ijms20030634
Merletti, F., Solkolne, C., & Vineis, P. (2011). Epidemiología y Estadística. Enciclopedia de Salud y Seguridad En El Trabajo, 20.1-20.40.
Mirón, J., & Alonso, M. (2008). Medidas de frecuencia, asociacion e impacto en investigacion aplicada. Medicina y Seguridad Del Trabajo, 211, 93–102. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0465-546X2008000200011
Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., & Petticrew, M. (2016). Revista Española de Nutrición Humana y Dietética d. December. https://doi.org/10.1186/2046-4053-4-1
Moreno-Ríos, A. L., Tejeda-Benítez, L. P., & Bustillo-Lecompte, C. F. (2021). Sources, characteristics, toxicity, and control of ultrafine particles: An overview. Geoscience Frontiers, 101147. https://doi.org/10.1016/j.gsf.2021.101147
Morgan, R. L., Whaley, P., Thayer, K. A., & Schünemann, H. J. (2018). Identifying the PECO: A framework for formulating good questions to explore the association of environmental and other exposures with health outcomes. Environment International. https://doi.org/10.1016/j.envint.2018.07.015
Mottillo, S., Bs, C., Filion, K. B., Genest, J., Joseph, L., Pilote, L., Poirier, P., Rinfret, S., Ms, C., Schiffrin, E. L., & Eisenberg, M. J. (2010). The Metabolic Syndrome and Cardiovascular Risk A Systematic Review and Meta-Analysis. JAC, 56(14), 1113– 1132. https://doi.org/10.1016/j.jacc.2010.05.034
Myte, R., Gylling, B., Häggström, J., Häggström, C., Zingmark, C., Löfgren Burström, A., Palmqvist, R., & Van Guelpen, B. (2019). Metabolic factors and the risk of colorectal cancer by KRAS and BRAF mutation status. International Journal of Cancer, 145(2), 327–337. https://doi.org/10.1002/ijc.32104
Negida, A. (2017). Chapter (14 ) Introduction to Systematic Review and Meta-analysis. August.
Neira, M., & Prüss-Ustün, A. (2016). Preventing disease through healthy environments: A global assessment of the environmental burden of disease. Toxicology Letters, 259, S1. https://doi.org/10.1016/j.toxlet.2016.07.028
Ning, J., Zhang, Y., Hu, H., Hu, W., Li, L., Pang, Y., Ma, S., Niu, Y., & Zhang, R. (2021). Association between ambient particulate matter exposure and metabolic syndrome risk: A systematic review and meta-analysis. Science of the Total Environment, 782, 146855. https://doi.org/10.1016/j.scitotenv.2021.146855
Ohlwein, S., Kappeler, R., Kutlar Joss, M., Künzli, N., & Hoffmann, B. (2019). Health effects of ultrafine particles: a systematic literature review update of epidemiological evidence. International Journal of Public Health, 64(4), 547–559. https://doi.org/10.1007/s00038-019-01202-7
Organizacion Panamericana de Salud. (2021). Evaluación de riesgo. 1–4. https://www.paho.org/hq/index.php?option=com_content&view=article&id=5720:201 1-risk-assessment-dva&Itemid=4113&lang=es
Palacios, E. K. M. (2019). La contaminación del aire, un problema de todos. 67(2), 189– 191.
Park, S. K., Auchincloss, A. H., O’Neill, M. S., Prineas, R., Correa, J. C., Keeler, J., Graham Barr, R., Kaufman, J. D., & Diez Roux, A. V. (2010). Particulate air pollution, metabolic syndrome, and heart rate variability: The multi-ethnic study of atherosclerosis (MESA). Environmental Health Perspectives, 118(10), 1406–1411. https://doi.org/10.1289/ehp.0901778
Peralta, C. I., & Taype-rondan, A. (2019). Aspectos básicos sobre la lectura de revisiones sistemáticas y la interpretación de metaanálisis. Acta Médica Peruana, 36(2), 157– 169.
Pérez-Torres, I., Manzano-Pech, L., Rubio-Ruíz, M. E., Soto, M. E., & Guarner-Lans, V. (2020). Nitrosative stress and its association with cardiometabolic disorders. Molecules, 25(11). https://doi.org/10.3390/molecules25112555
Piecha, R., Svačina, Š., Malý, M., Vrbík, K., Lacinová, Z., Haluzík, M., Pavloušková, J.,Vavrouš, A., Matějková, D., Müllerová, D., Mráz, M., & Matoulek, M. (2016). Urine levels of phthalate metabolites and bisphenol a in relation to main metabolic syndrome components: Dyslipidemia, hypertension and type 2 diabetes a pilot study. Central European Journal of Public Health, 24(4), 297–301. https://doi.org/10.21101/cejph.a4704
Preker, A. S., Adeyi, O. O., Lapetra, M. G., Simon, D. C., & Keuffel, E. (2016). Health Care Expenditures Associated With Pollution: Exploratory Methods and Findings. Annals of Global Health, 82(5), 711–721. https://doi.org/10.1016/j.aogh.2016.12.003
PROSPERO. (2011). International prospective register of systematic reviews Registering a review on PROSPERO What does registration on PROSPERO involve? Inclusion criteria When to register your review PROSPERO International prospective register of systematic reviews Regist. 1–12.
Raaschou-Nielsen, O., Beelen, R., Wang, M., Hoek, G., Andersen, Z. J., Hoffmann, B., Stafoggia, M., Samoli, E., Weinmayr, G., Dimakopoulou, K., Nieuwenhuijsen, M., Xun, W. W., Fischer, P., Eriksen, K. T., Sørensen, M., Tjønneland, A., Ricceri, F., de Hoogh, K., Key, T., … Vineis, P. (2016). Particulate matter air pollution components and risk for lung cancer. Environment International, 87(July 2015), 66–73. https://doi.org/10.1016/j.envint.2015.11.007
Rajkumar, S., Young, B. N., Clark, M. L., Benka-Coker, M. L., Bachand, A. M., Brook, R. D., Nelson, T. L., Volckens, J., Reynolds, S. J., L’Orange, C., Good, N., Koehler, K., Africano, S., Osorto Pinel, A. B., & Peel, J. L. (2019). Household air pollution from biomass-burning cookstoves and metabolic syndrome, blood lipid concentrations, and waist circumference in Honduran women: A cross-sectional study. Environmental Research, 170(October 2018), 46–55. https://doi.org/10.1016/j.envres.2018.12.010
Raviv, N. V., Sakhuja, S., Schlachter, M., & Akinyemiju, T. (2017). Metabolic syndrome and in-hospital outcomes among pancreatic cancer patients. Diabetes and Metabolic Syndrome: Clinical Research and Reviews, 11, S643–S650. https://doi.org/10.1016/j.dsx.2017.04.019
Regufe, V. M. G., Pinto, C. M. C. B., & Perez, P. M. V. H. C. (2020). Metabolic syndrome in type 2 diabetic patients: a review of current evidence. Porto Biomedical Journal, 5(6), e101. https://doi.org/10.1097/j.pbj.0000000000000101
Sackett, D. L. (1996). On some clinically useful measures of the effects of treatment. Evidence-Based Nursing, 4(2), 36–39. https://doi.org/10.1136/ebn.4.2.36
Sanidas, E., Papadopoulos, D. P., Grassos, H., Velliou, M., Tsioufis, K., Barbetseas, J., & Papademetriou, V. (2017). Air pollution and arterial hypertension. A new risk factor is in the air. Journal of the American Society of Hypertension, 11(11), 709–715. https://doi.org/10.1016/j.jash.2017.09.008
Saxena, P., & Sonwani, S. (2019). Criteria Air Pollutants and their Impact on Environmental Health. In Criteria Air Pollutants and their Impact on Environmental Health. https://doi.org/10.1007/978-981-13-9992-3
Schultz, W. M., Sperling, L., Esmaeeli, A., Mahlof, E. N., Varghese, T., Sandesara, P. B., Dhindsa, D. S., Ricketts, J. C., Kelli, H. M., Heinl, R. E., Allard-Ratick, M. P., Millard, A. J., & Eapen, D. J. (2016). Comprehensive Cardiovascular Risk Reduction and Cardiac Rehabilitation in Diabetes and the Metabolic Syndrome. Canadian Journal of Cardiology, 32(10), S349–S357. https://doi.org/10.1016/j.cjca.2016.07.507
Shah, A. S. V., Lee, K. K., McAllister, D. A., Hunter, A., Nair, H., Whiteley, W., Langrish, J. P., Newby, D. E., & Mills, N. L. (2015). Short term exposure to air pollution and stroke: Systematic review and meta-analysis. In BMJ (Online) (Vol. 350).https://doi.org/10.1136/BMJ.h1295
Shamy, M., Alghamdi, M., Khoder, M., Mohorjy, A., Alkhatim, A., Alkhalaf, A., Brocato, J., Chen, L., Thurston, G., Lim, C., & Costa, M. (2017). Association between Exposure to Ambient Air Particulates and Metabolic Syndrome Components in a Saudi Arabian Population. International Journal of Environmental Research and Public Health, 15(1), 27. https://doi.org/10.3390/ijerph15010027
Shim, Y. H., Ock, J. W., Kim, Y. J., Kim, Y., Kim, S. Y., & Kang, D. (2019). Association between Heavy Metals, Bisphenol A, volatile organic compounds and phthalates and metabolic syndrome. International Journal of Environmental Research and Public Health, 16(4). https://doi.org/10.3390/ijerph16040671
Tocabens, B. E. (2011). Definiciones acerca del riesgo y sus implicaciones. Revista Cubana de Higiene y Epidemiologia, 49(3), 470–481.
Tsai, D. H., Amyai, N., Marques-Vidal, P., Wang, J. L., Riediker, M., Mooser, V., Paccaud, F., Waeber, G., Vollenweider, P., & Bochud, M. (2012). Effects of particulate matter on inflammatory markers in the general adult population. Particle and Fibre Toxicology, 9, 1–9. https://doi.org/10.1186/1743-8977-9-24
Tuomisto, J. (2019). Dioxins and dioxin-like compounds: toxicity in humans and animals, sources, and behaviour in the environment. WikiJournal of Medicine, 6(1), 8. https://doi.org/10.15347/wjm/2019.008
Vallero, D. (2014). The Science of Air Pollution. In Fundamentals of Air Pollution. https://doi.org/10.1016/b978-0-12-401733-7.00003-7
Voss, S., Schneider, A., Huth, C., Wolf, K., Markevych, I., Schwettmann, L., Rathmann, W., Peters, A., & Breitner, S. (2021). ENVINT-D-20-01309: Long-term exposure to air pollution, road traffic noise, residential greenness, and prevalent and incident metabolic syndrome: Results from the population-based KORA F4/FF4 cohort in Augsburg, Germany. Environment International, 147(November 2020), 106364. https://doi.org/10.1016/j.envint.2020.106364
Wallwork, R. S., Colicino, E., Zhong, J., Kloog, I., Coull, B. A., Vokonas, P., Schwartz, J. D., & Baccarelli, A. A. (2017). Ambient fine particulate matter, outdoor temperature, and risk of met. American Journal of Epidemiology, 185(1), 30–39. https://doi.org/10.1093/aje/kww157
Wang, L., Liu, C., Meng, X., Niu, Y., Lin, Z., Liu, Y., Liu, J., Qi, J., You, J., Tse, L. A., Chen, J., Zhou, M., Chen, R., Yin, P., & Kan, H. (2018). Associations between shortterm exposure to ambient sulfur dioxide and increased cause-specific mortality in 272 Chinese cities. Environment International, 117(January), 33–39. https://doi.org/10.1016/j.envint.2018.04.019
Wei, Y., Zhang, J., Li, Z., Gow, A., Chung, K. F., Hu, M., Sun, Z., Zeng, L., Zhu, T., Jia, G., Li, X., Duarte, M., & Tang, X. (2016). Chronic exposure to air pollution particles increases the risk of obesity and metabolic syndrome: Findings from a natural experiment in Beijing. FASEB Journal, 30(6), 2115–2122. https://doi.org/10.1096/fj.201500142
Wennberg, M., Gustafsson, P. E., Wennberg, P., & Hammarström, A. (2016). Irregular eating of meals in adolescence and the metabolic syndrome in adulthood: Results from a 27-year prospective cohort. Public Health Nutrition, 19(4), 667–673. https://doi.org/10.1017/S1368980015001445
WHO. (2014). Burden of disease from household air pollution for 2012. Summary of results. World Health Organization, 35(February), 2012–2014. http://www.who.int/phe/health_topics/outdoorair/databases/FINAL_HAP_AAP_BoD_24March2014.pdf
Wong, E. M., Walby, W. F., Wilson, D. W., Tablin, F., & Schelegle, E. S. (2018). Ultrafine Particulate Matter Combined With Ozone Exacerbates Lung Injury in Mature Adult Rats With Cardiovascular Disease. Toxicological Sciences, 163(1), 140–151. https://doi.org/10.1093/toxsci/kfy018
Wu, L., Jin, L., Shi, T., Zhang, B., Zhou, Y., Zhou, T., Bao, W., Xiang, H., Zuo, Y., Li, G., Wang, C., Duan, Y., Peng, Z., Huang, X., Zhang, H., Xu, T., Li, Y., Pan, X., Xia, Y., … Liu, Y. (2017). Association between ambient particulate matter exposure and semen quality in Wuhan, China. Environment International, 98, 219–228. https://doi.org/10.1016/j.envint.2016.11.013
Xie, Xiaoxu, Wang, Y., Yang, Y., Xu, J., Zhang, Y., Tang, W., Guo, T., Wang, Q., Shen, H., Zhang, Y., Yan, D., Peng, Z., Chen, Y., He, Y., & Ma, X. (2018). Long-term exposure to fine particulate matter and tachycardia and heart rate: Results from 10 million reproductive-age adults in China. Environmental Pollution, 242, 1371–1378. https://doi.org/10.1016/j.envpol.2018.08.022
Xie, Xiaoyun, Li, W., Zhang, Y., Kan, H., & Ying, Z. (2019). Metabolomics analysis of a mouse model for chronic exposure to. 247. https://doi.org/10.1016/j.envpol.2019.01.118
Yang, B., Min, Z., Li, S., Fan, S., Chen, G., Syberg, K. M., Xian, H., Wang, S., Ma, H., Chen, D., & Yang, M. (2018). Long-term exposure to ambient air pollution ( including MP 1 ) and metabolic syndrome : The 33 Communities Chinese Health Study ( 33CCHS ). Environmental Research, 164(February), 204–211. https://doi.org/10.1016/j.envres.2018.02.029
Yang, B. Y., Fan, S., Thiering, E., Seissler, J., Nowak, D., Dong, G. H., & Heinrich, J. (2020a). Ambient air pollution and diabetes: A systematic review and meta-analysis. Environmental Research, 180(October 2019), 108817. https://doi.org/10.1016/j.envres.2019.108817
Yang, B. Y., Fan, S., Thiering, E., Seissler, J., Nowak, D., Dong, G. H., & Heinrich, J. (2020b). Ambient air pollution and diabetes: A systematic review and meta-analysis. Environmental Research, 180(June 2019), 108817. https://doi.org/10.1016/j.envres.2019.108817
Yang, B. Y., Qian, Z. (Min), Li, S., Fan, S., Chen, G., Syberg, K. M., Xian, H., Wang, S. Q., Ma, H., Chen, D. H., Yang, M., Liu, K. K., Zeng, X. W., Hu, L. W., Guo, Y., & Dong, G. H. (2018). Long-term exposure to ambient air pollution (including MP 1 ) and metabolic syndrome: The 33 Communities Chinese Health Study (33CCHS). Environmental Research, 164(February), 204–211. https://doi.org/10.1016/j.envres.2018.02.029
Yang, B. Y., Qian, Z., Howard, S. W., Vaughn, M. G., Fan, S. J., Liu, K. K., & Dong, G. H. (2018). Global association between ambient air pollution and blood pressure: A systematic review and meta-analysis. Environmental Pollution, 235, 576–588. https://doi.org/10.1016/j.envpol.2018.01.001
Ye, D., Klein, M., Chang, H. H., Sarnat, J. A., Mulholland, J. A., Edgerton, E. S., Winquist, A., Tolbert, P. E., & Sarnat, S. E. (2017). Estimating Acute Cardiorespiratory Effects of Ambient Volatile Organic Compounds. In Epidemiology (Vol. 28, Issue 2, pp. 197– 206). https://doi.org/10.1097/EDE.0000000000000607
Yin, P., Guo, J., Wang, L., Fan, W., Lu, F., Guo, M., Moreno, S. B. R., Wang, Y., Wang, H., Zhou, M., & Dong, Z. (2020). Higher Risk of Cardiovascular Disease Associated with Smaller Size-Fractioned Particulate Matter. Environmental Science and Technology Letters, 7(2), 95–101. https://doi.org/10.1021/acs.estlett.9b00735
Yoo, S., Oh, S., Park, J., Cho, S. Y., Cho, M. C., Son, H., & Jeong, H. (2019). Effects of metabolic syndrome on the prevalence of prostate cancer: historical cohort study using the national health insurance service database. Journal of Cancer Research and Clinical Oncology, 145(3), 775–780. https://doi.org/10.1007/s00432-019-02842-1
Yu, Y., Paul, K., Arah, O. A., Mayeda, E. R., Wu, J., Lee, E., Shih, I. F., Su, J., Jerrett, M., Haan, M., & Ritz, B. (2020). Air pollution, noise exposure, and metabolic syndrome – A cohort study in elderly Mexican-Americans in Sacramento area. Environment International, 134(October 2019). https://doi.org/10.1016/j.envint.2019.105269
Yuan, S., Wang, J., Jiang, Q., He, Z., Huang, Y., Li, Z., Cai, L., & Cao, S. (2019a). Longterm exposure to MP 2. 5 and stroke : A systematic review and meta- analysis of cohort studies. Environmental Research, 177(13), 108587. https://doi.org/10.1016/j.envres.2019.108587
Yuan, S., Wang, J., Jiang, Q., He, Z., Huang, Y., Li, Z., Cai, L., & Cao, S. (2019b). Longterm exposure to MP2.5 and stroke: A systematic review and meta-analysis of cohort studies. Environmental Research, 177(13), 108587. https://doi.org/10.1016/j.envres.2019.108587
Zhang, Y., Hu, H., Shi, Y., Yang, X., Cao, L., Wu, J., Asweto, C. O., Feng, L., Duan, J., & Sun, Z. (2017). Science of the Total Environment H NMR-based metabolomics study on repeat dose toxicity of fi ne particulate matter in rats after intratracheal instillation. 589, 212–221. https://doi.org/10.1016/j.scitotenv.2017.02.149
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spelling Schnorr, Carlos EduardoMartinello, KatiaGoethe Flórez, Dilson David2021-12-15T19:21:13Z2021-12-15T19:21:13Z2021https://hdl.handle.net/11323/8961Corporación Universidad de la CostaREDICUC - Repositorio CUChttps://repositorio.cuc.edu.co/Background: The metabolic syndrome is a precursor pathophysiological state of cardiovascular diseases or accidents with a high global prevalence. Its etiology is not completely clear, but recent studies have suggested that environmental pollutants may increase the risk of metabolic syndrome. We decided to conduct a systematic review to assess the risk among people with exposure to air pollution and parameters of metabolic syndrome. Methods: Potential studies were identified in the literature from reliable databases such as PubMed and ISI Web of Science until July 2021. The methodological quality of the studies was evaluated according to the New-Castle Ottawa rating, for the meta-analysis it was used a random effects mathematical model in RevMan software (version 5.2). Results: In total, 3479 studies were identified, only 9 studies met the inclusion and exclusion criteria. The studies totaled 16.409.475 participants between men and women with an average age of 52.5 years. The meta-analysis revealed an increased risk of metabolic syndrome, due to exposures to MP2.5 (RR 1.03; CI 1.01-1.05) and MP10 (RR 1.04; CI 1.00-1.09). Regarding NO2 (RR 1.02; CI 0.93 - 1.11) and O3 (RR 1.04; CI 0.96 -1.12), there was no statistically significant association with the metabolic syndrome. Conclusions: The results of this review suggest that adults exposed to long-term air pollutants are at increased risk of MetS, specifically exposure to MP2.5 and MP10.Antecedentes: El síndrome metabólico es un estado fisiopatológico precursor de enfermedades o accidentes cardiovasculares con una alta prevalencia global. Su etiología no está completamente clara, pero estudios recientes han sugerido que los contaminantes ambientales pueden aumentar el riesgo de síndrome metabólico. Así que se decidió realizar una revisión sistemática para evaluar el riesgo entre las personas con exposición a la contaminación del aire y parámetros de síndrome metabólico. Se identificaron estudios potenciales en la literatura a partir de bases de datos confiables como PubMed y ISI Web of Science hasta Julio del 2021. Se evaluó la calidad metodológica según la calificación de New-Castle Ottawa, para el metaanálisis se empleó un modelo matemático de efectos aleatorios en el software Rev Man. En total, 3479 estudios fueron identificados, solamente 9 estudios cumplieron los criterios de inclusión y exclusión. Los estudios totalizaron 16.409.475 participantes entre hombresy mujeres con edad promedio de 52.5 años. El metaanálisis reveló incremento del riesgo de síndrome metabólico, por las exposiciones a MP2.5 (RR 1.03; IC 1.01-1.05) y MP10 (RR 1.04; IC1.00-1.09). En lo que refiere a NO2 (RR 1.02; IC 0.93 – 1.11) y O3 (RR 1.04; IC 0.96 -1.12) no evidencio asociación estadísticamente significativa con el síndrome metabólico. Los resultados de esta revisión sugieren que los adultos expuestos a contaminantes del aire a largo plazo presentan un mayor riesgo de MetS, en específicos la exposición a MP2.5 yMP10.Goethe Flórez, Dilson Davidapplication/pdfspaCorporación Universidad de la CostaMaestría de Investigación en Desarrollo Sostenible MIDESAttribution-NonCommercial-ShareAlike 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-sa/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Air pollutionBlood pressureWaist circumferenceFasting sugar levelsContaminación atmosféricaPresión arterialCircunferencia de la cinturaNiveles de azúcar en ayunasAsociación de la exposición a contaminantes atmosféricos y el síndrome metabólico en adultos: una revisión sistemática y un metaanálisisTrabajo de grado - MaestríaTextinfo:eu-repo/semantics/masterThesishttp://purl.org/redcol/resource_type/TMinfo:eu-repo/semantics/acceptedVersionAlberti, K. G. M. M., Eckel, R. H., Grundy, S. M., Zimmet, P. Z., Cleeman, J. I., Donato, K. A., Fruchart, J., James, W. P. T., Loria, C. M., & Sidney, C. (2009). The online version of this article, along with updated information and services, is located on the World Wide Web at: https://doi.org/10.1161/CIRCULATIONAHA.109.192644American Association for Cancer Research. (2021). La contaminación del aire puede estar asociada con muchos tipos de cáncer. 35–37.An, R., Ji, M., Yan, H., & Guan, C. (2018). Impact of ambient air pollution on obesity: A systematic review. International Journal of Obesity, 42(6), 1112–1126. https://doi.org/10.1038/s41366-018-0089-yAnsari-moghaddam, A., Adineh, H. A., Zareban, I., & Farmanfarma, K. H. K. (2019). Prevalence of metabolic syndrome and population attributable risk for cardiovascular, stroke , and coronary heart diseases as well as myocardial infarction and all-cause mortality in middle-east : Systematic review & meta- analysis. 14(March), 1–8. https://doi.org/10.1016/j.obmed.2019.100086Arias, M. (2015). Lectura crítica en pequeñas dosis.Balakrishnan, K., Brauer, M., Chen, G., & Chow, J. (2015). To Humans Outdoor Air Pollution. In IARC monographs (Vol. 109).Ballestri, S., Zona, S., Targher, G., Romagnoli, D., Baldelli, E., Nascimbeni, F., Roverato, A., Guaraldi, G., & Lonardo, A. (2016). Nonalcoholic fatty liver disease is associated with an almost twofold increased risk of incident type 2 diabetes and metabolic syndrome. Evidence from a systematic review and meta-analysis. Journal of Gastroenterology and Hepatology (Australia), 31(5), 936–944. https://doi.org/10.1111/jgh.13264Berglund, B., Brunekreef, B., Knöppe, H., Lindvall, T., Maroni, M., Mølhave, L., & Skov, P. (1992). Effects of Indoor Air Pollution on Human Health. Indoor Air, 2(1), 2–25. https://doi.org/10.1111/j.1600-0668.1992.02-21.xBhandari, R., Kelley, G. A., Hartley, T. A., & Rockett, I. R. H. (2014). Metabolic Syndrome Is Associated with Increased Breast Cancer Risk: A Systematic Review with Meta-Analysis. International Journal of Breast Cancer, 2014, 1–13. https://doi.org/10.1155/2014/189384Booth, F. W., Roberts, C. K., & Laye, M. J. (2012). Lack of exercise is a major cause of chronic diseases. Comprehensive Physiology, 2(2), 1143–1211. https://doi.org/10.1002/cphy.c110025Brook, R. D., Sun, Z., Brook, J. R., Zhao, X., Ruan, Y., Yan, J., Mukherjee, B., Rao, X., Duan, F., Sun, L., Liang, R., Lian, H., Zhang, S., Fang, Q., Gu, D., Sun, Q., Fan, Z., & Rajagopalan, S. (2016). Extreme Air Pollution Conditions Adversely Affect Blood Pressure and Insulin Resistance: The Air Pollution and Cardiometabolic Disease Study. Hypertension, 67(1), 77–85. https://doi.org/10.1161/HYPERTENSIONAHA.115.06237Bryce, A., Alegría, E., San Martin-San Martin, M. G., & Alfonso Bryce-Moncloa, C. (2017). Obesidad y riesgo de enfermedad cardiovascular Cardiovascular risk and obesity. Fac Med, 78(2), 202–206. http://dx.doi.org/10.15381/anales.v78i2.13218Cai, Y., Zhang, B., Ke, W., Feng, B., Lin, H., Xiao, J., Zeng, W., Li, X., Tao, J., Yang, Z., Ma, W., & Liu, T. (2016). Associations of Short-Term and Long-Term Exposure to Ambient Air Pollutants With Hypertension: A Systematic Review and Meta-Analysis. Hypertension, 68(1), 62–70. https://doi.org/10.1161/HYPERTENSIONAHA.116.07218Carll, A. P., Crespo, S. M., Filho, M. S., Zati, D. H., Coull, B. A., Diaz, E. A., Raimundo, R. D., Jaeger, T. N. G., Ricci-vitor, A. L., Papapostolou, V., Lawrence, J. E., Garner, D. M., Perry, B. S., Harkema, J. R., & Godleski, J. J. (2017). Inhaled ambient-level traffic-derived particulates decrease cardiac vagal influence and baroreflexes and increase arrhythmia in a rat model of metabolic syndrome. 1–15. https://doi.org/10.1186/s12989-017-0196-2Chassan B, H., Neela, G., Aaron, C., Francine, L., Ole, R., Jonathan M, S., Paolo, V., Francesco, F., Paulo, S., Yirifuji, T., & Dana, L. (2014). Outdoor Particulate Matter Exposure and Lung Cancer: A Systematic Review. 906(9).Chen, J. C., & Schwartz, J. (2008). Metabolic syndrome and inflammatory responses to long-term particulate air pollutants. Environmental Health Perspectives, 116(5), 612– 617. https://doi.org/10.1289/ehp.10565Chen, L., Zhou, Y., Li, S., Williams, G., Kan, H., Marks, G. B., Morawska, L., Abramson, M. J., Chen, S., Yao, T., Qin, T., Wu, S., & Guo, Y. (2016). Air pollution and fasting blood glucose: A longitudinal study in China. Science of the Total Environment, 541(2), 750–755. https://doi.org/10.1016/j.scitotenv.2015.09.132Choi, Y. J., Kim, S. H., Kang, S. H., Kim, S. Y., Kim, O. J., Yoon, C. H., Lee, H. Y., Youn, T. J., Chae, I. H., & Kim, C. H. (2019). Short-term effects of air pollution on blood pressure. Scientific Reports, 9(1), 1–8. https://doi.org/10.1038/s41598-019-56413-y Clementi, E. A., Talusan, A., Vaidyanathan, S., Veerappan, A., Mikhail, M., Ostrofsky, D.,Crowley, G., Kim, J. S., Kwon, S., & Nolan, A. (2019). Metabolic syndrome and air pollution: A narrative review of their cardiopulmonary effects. Toxics, 7(1), 1–13https://doi.org/10.3390/toxics7010006Clifton, P. (2019). Metabolic syndrome—role of dietary fat type and quantity. Nutrients, 11(7). https://doi.org/10.3390/nu11071438Colbeck, I. (1995). Particle Emission from Outdoor and Indoor Sources. Handbook of Environmental Chemistry, 4, 1–33. https://doi.org/10.1007/978-3-540-49145-3-1Curto, A., Ranzani, O., Milà, C., Sanchez, M., Marshall, J. D., Kulkarni, B., Bhogadi, S., Kinra, S., Wellenius, G. A., & Tonne, C. (2019). Lack of association between particulate air pollution and blood glucose levels and diabetic status in peri-urban India. Environment International, 131(February), 105033. https://doi.org/10.1016/j.envint.2019.105033D. Koman, P., & Peter, M. (2017). Ozone Exposure, Cardiopulmonary Health, and Obesity: A Substantive Review. Physiology & Behavior, 176(3), 139–148. https://doi.org/10.1021/acs.chemrestox.7b00077.Ozoneda Silva, A. A., do Carmo, J. M., Li, X., Wang, Z., Mouton, A. J., & Hall, J. E. (2020). Role of Hyperinsulinemia and Insulin Resistance in Hypertension: Metabolic Syndrome Revisited. The Canadian Journal of Cardiology, 36(5), 671–682. https://doi.org/10.1016/j.cjca.2020.02.066Dabass, A., Talbott, E. O., Rager, J. R., Marsh, G. M., Venkat, A., Holguin, F., & Sharma, R. K. (2018a). Systemic in fl ammatory markers associated with cardiovascular disease and acute and chronic exposure to fi ne particulate matter air pollution (MP 2. 5) among US NHANES adults with metabolic syndrome. Environmental Research, 161(July 2017), 485–491. https://doi.org/10.1016/j.envres.2017.11.042Dabass, A., Talbott, E. O., Rager, J. R., Marsh, G. M., Venkat, A., Holguin, F., & Sharma, R. K. (2018b). Systemic inflammatory markers associated with cardiovascular disease and acute and chronic exposure to fine particulate matter air pollution (MP2.5) among US NHANES adults with metabolic syndrome. Environmental Research, 161(October 2017), 485–491. https://doi.org/10.1016/j.envres.2017.11.042Departamento Nacional de Planeación. (2017). Los costos en la salud asociados a la degradación ambiental en Colombia ascienden a $20,7 billones. 1–6. https://www.dnp.gov.co/Paginas/Los-costos-en-la-salud-asociados-a-la-degradaciónambiental-en-Colombia-ascienden-a-$20,7-billones-.aspxDespre, J., Lemieux, I., Bergeron, J., Pibarot, P., Mathieu, P., Larose, E., Bertrand, O. F., & Poirier, P. (2008). Abdominal Obesity and the Metabolic Syndrome: Contribution to Global Cardiometabolic Risk. 1039–1049. https://doi.org/10.1161/ATVBAHA.107.159228Díaz, V. (2009). Metodología de la investigación científica y bioestadística. 2021.Dominici, F., Greenstone, M., & Sunstein, C. R. (2014). Particulate matter matters. In Science (Vol. 344, Issue 6181). https://doi.org/10.1126/science.1247348Dommermuth, R., & Ewing, K. (2018). Metabolic Syndrome: Systems Thinking in Heart Disease. Primary Care - Clinics in Office Practice, 45(1), 109–129. https://doi.org/10.1016/j.pop.2017.10.003Dong, G. H., Qian, Z. M., Xaverius, P. K., Trevathan, E., Maalouf, S., Parker, J., Yang, L., Liu, M. M., Wang, D., Ren, W. H., Ma, W., Wang, J., Zelicoff, A., Fu, Q., & Simckes, M. (2013). Association between long-term air pollution and increased blood pressure and hypertension in China. Hypertension, 61(3), 578–584. https://doi.org/10.1161/HYPERTENSIONAHA.111.00003Edginton, S., Sullivan, D. E. O., King, W., & Lougheed, M. D. (2019). Effect of outdoor particulate air pollution on FEV 1 in healthy adults: a systematic review and meta analysis. 583–591. https://doi.org/10.1136/oemed-2018-105420Eze, I. C., Schaffner, E., Foraster, M., Imboden, M., von Eckardstein, A., Gerbase, M. W., Rothe, T., Rochat, T., Künzli, N., Schindler, C., & Probst-Hensch, N. (2015). LongTerm Exposure to Ambient Air Pollution and Metabolic Syndrome in Adults. PLOS ONE, 10(6), e0130337. https://doi.org/10.1371/journal.pone.0130337Fajardo-Gutiérrez, A. (2017). Medición en epidemiología: prevalencia, incidencia, riesgo, medidas de impacto. Revista Alergia México, 64(1), 109. https://doi.org/10.29262/ram.v64i1.252Falcon-Rodriguez, C. I., Osornio-Vargas, A. R., Sada-Ovalle, I., & Segura-Medina, P. (2016a). Aeroparticles, composition, and lung diseases. Frontiers in Immunology, 7(JAN). https://doi.org/10.3389/fimmu.2016.00003Falcon-Rodriguez, C. I., Osornio-Vargas, A. R., Sada-Ovalle, I., & Segura-Medina, P. (2016b). Aeroparticles, composition, and lung diseases. Frontiers in Immunology, 7(JAN). https://doi.org/10.3389/fimmu.2016.00003Fernandez Chinguel, J. E., Zafra Tanaka, J. H., Goicochea Lugo, S., Peralta, C. I., & Taype Rondan, A. (2019). Aspectos básicos sobre la lectura de revisiones sistemáticas y la interpretación de meta-análisis. Acta Medica Peruana, 36(2), 157–169. https://doi.org/10.35663/amp.2019.362.818Ferreira, I., Urrutia, G., & Coello, P. A. (2019). Revisiones sistemáticas y metaanálisis: Bases conceptuales e interpretación. Revista Española de Cardiología, 64(8), 688–696. https://doi.org/10.1016/j.recesp.2011.03.029Gaio, V., Roquette, R., Dias, C. M., & Nunes, B. (2019). Ambient air pollution and lipid profile: Systematic review and meta-analysis. Environmental Pollution, 254. https://doi.org/10.1016/j.envpol.2019.113036Ghafuri, S., Ghaderi, E., Fahami, Y., & Rajabnia, M. (2019). Diabetes & Metabolic Syndrome : Clinical Research & Reviews Epidemiologic study of type 2 diabetes mellitus and metabolic syndrome in rural population of kurdistan province , Iran , in 2011 e 2017. 13. https://doi.org/10.1016/j.dsx.2019.03.037Glass, G. V. (1976). Primary, Secondary, and Meta-Analysis of Research’. 5(10), 3–8. Han, T. S., & Lean, M. E. J. (2006). Metabolic syndrome. Medicine, 34(12), 536–542. https://doi.org/10.1053/j.mpmed.2006.09.012Hanson, R. L., Imperatore, G., Bennett, P. H., & Knowler, W. C. (2002). Components of the “metabolic syndrome” and incidence of type 2 diabetes. Diabetes, 51(10), 3120– 3127. https://doi.org/10.2337/diabetes.51.10.3120Hayes, R. B., Lim, C., Zhang, Y., Cromar, K., Shao, Y., Reynolds, H. R., Silverman, D. T., Jones, R. R., Park, Y., Jerrett, M., Ahn, J., & Thurston, G. D. (2020). MP2.5 air pollution and cause-specific cardiovascular disease mortality. International Journal of Epidemiology, 49(1), 25–35. https://doi.org/10.1093/ije/dyz114Higgins, J., & Green, S. (2011). Manual Cochrane de revisiones sistemáticas de intervenciones (Julian PT Higgins y Sally Green (ed.)).Holme, J. A., Brinchmann, B. C., Refsnes, M., Låg, M., & Øvrevik, J. (2019). Potential role of polycyclic aromatic hydrocarbons as mediators of cardiovascular effects from combustion particles. 1–18.Hotamisligil, G. S. (2006). https://doi.org/10.1038/nature05485. Nature, 444(7121), 860– 867. https://doi.org/10.1038/nature05485Hou, J., Liu, X., Tu, R., Dong, X., Zhai, Z., Mao, Z., Huo, W., Chen, G., Xiang, H., Guo, Y., Li, S., & Wang, C. (2020). Long-term exposure to ambient air pollution attenuated the association of physical activity with metabolic syndrome in rural Chinese adults: A cross-sectional study. Environment International, 136(August 2019), 105459. https://doi.org/10.1016/j.envint.2020.105459Huang, M., Chen, J., Yang, Y., Yuan, H., Huang, Z., & Lu, Y. (2021). Effects of ambient air pollution on blood pressure among children and adolescents: A systematic review and meta-analysis. Journal of the American Heart Association, 10(10). https://doi.org/10.1161/JAHA.120.017734Huang, S., Zhang, X., Huang, J., Lu, X., Liu, F., & Gu, D. (2020). Ambient air pollution and body weight status in adults: A systematic review and meta-analysis. Environmental Pollution, 265, 114999. https://doi.org/10.1016/j.envpol.2020.114999Hutcheson, R., & Rocic, P. (2012). The Metabolic Syndrome, Oxidative Stress, Environment, and Cardiovascular Disease : The Great Exploration. 2012. https://doi.org/10.1155/2012/271028Hwang, S. E., Kwon, H., Jeong, S. M., Kim, H. J., & Park, J. H. (2019). Ambient air pollution exposure and obesity-related traits in Korean adults. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 12, 1365–1377. https://doi.org/10.2147/DMSO.S208115Impellizzeri, F. M., & Mario Bizzini, P. (2012). SYSTEMATIC REVIEW AND METAANALYSIS: A PRIMER. Urology, 135(C), 152. https://doi.org/10.1016/j.urology.2019.09.037Instituto Nacional de Salud. (2018). Carga de enfermedad ambiental en Colombia. Informe Técnico Especial 10, 177. https://www.ins.gov.co/Direcciones/ONS/Informes/10 Carga de enfermedad ambiental en Colombia.pdfInternational Diabetes Federation. (n.d.). The metabolic Syndrome.International Diabetes Federation. (2019). IDF Diabetes Atlas, 9th edn. Brussels, Belgium. In Atlas de la Diabetes de la FID. http://www.idf.org/sites/default/files/Atlas-poster2014_ES.pdfJaganathan, S., Jaacks, L. M., Magsumbol, M., Walia, G. K., Sieber, N. L., Shivasankar, R., Dhillon, P. K., Hameed, S. S., Schwartz, J., & Prabhakaran, D. (2019). Association of long-term exposure to fine particulate matter and cardio-metabolic diseases in lowand middle-income countries: A systematic review. International Journal of Environmental Research and Public Health, 16(14), 1–18. https://doi.org/10.3390/ijerph16142541Kamioka, H. (2019). Preferred reporting items for systematic review and meta-analysis protocols (prisma-p) 2015 statement. Japanese Pharmacology and Therapeutics, 47(8), 1177–1185.Kim, S. Y., Kim, J. K., Park, S. H., Kim, B. G., Jang, A. S., Oh, S. H., Lee, J. H., Suh, M. W., & Park, M. K. (2018). Effects of inhaled particulate matter on the central nervous system in mice. NeuroToxicology, 67, 169–177. https://doi.org/10.1016/j.neuro.2018.06.001Kitchenham, B. (2004). Procedures for Performing Systematic Reviews.Lanktree, M. B., & Hegele, R. A. (2017). Metabolic Syndrome. In Genomic and Precision Medicine: Primary Care: Third Edition. Elsevier Inc. https://doi.org/10.1016/B978-0- 12-800685-6.00015-1Lee, S., Park, H., Kim, S., Lee, E. K., Lee, J., Hong, Y. S., & Ha, E. (2019a). Fine particulate matter and incidence of metabolic syndrome in non-CVD patients: A nationwide population-based cohort study. International Journal of Hygiene and Environmental Health, 222(3), 533–540. https://doi.org/10.1016/j.ijheh.2019.01.010Lee, S., Park, H., Kim, S., Lee, E. K., Lee, J., Hong, Y. S., & Ha, E. (2019b). Fine particulate matter and incidence of metabolic syndrome in non-CVD patients: A nationwide population-based cohort study. International Journal of Hygiene and Environmental Health, 222(3), 533–540. https://doi.org/10.1016/j.ijheh.2019.01.010Litvinova, L., Atochin, D. N., Fattakhov, N., Vasilenko, M., Zatolokin, P., & Kirienkova, E. (2015). Nitric oxide and mitochondria in metabolic syndrome. Frontiers in Physiology, 6(FEB), 1–10. https://doi.org/10.3389/fphys.2015.00020Lo, C. K., Mertz, D., & Loeb, M. (2014). Newcastle-Ottawa Scale: comparing reviewers ’ to authors ’ assessments. BMC Medical Research Methodology, 14(1), 1–5. https://doi.org/10.1186/1471-2288-14-45Lu, S., Hao, X., Liu, D., Wang, Q., Zhang, W., Liu, P., Zhang, R., Yu, S., Pan, R., Wu, M., Yonemochi, S., & Wang, Q. (2015). Mineralogical characterization of ambient fine/ultrafine particles emitted from Xuanwei C1 coal combustion. Atmospheric Research. https://doi.org/10.1016/j.atmosres.2015.09.020M., I. (2016). Assessment of the environmental and genetic factors influencing prevalence of metabolic syndrome in Saudi Arabia. Saudi Medical Journal, 37(1), 12–20. https://doi.org/10.15537/smj.2016.1.12675Ma, R., Zhang, Y., Sun, Z., Xu, D., & Li, T. (2020). Effects of ambient particulate matter on fasting blood glucose: A systematic review and meta-analysis. Environmental Pollution, 258, 113589. https://doi.org/10.1016/j.envpol.2019.113589Manisalidis, I., Stavropoulou, E., Stavropoulos, A., & Bezirtzoglou, E. (2020). Environmental and Health Impacts of Air Pollution: A Review. In Frontiers in Public Health (Vol. 8). https://doi.org/10.3389/fpubh.2020.00014Manterola, C., & Otzen, T. (2015). Valoración Clínica del Riesgo, Interpretación y Utilidad Práctica Clinical Risk Assessment, Interpretation and Practical Utility. Int. J. Morphol, 33(3), 842–849. https://scielo.conicyt.cl/pdf/ijmorphol/v33n3/art06.pdfMartínez-González, M. Á., Alonso, Á., & Fidalgo, J. L. (2008). What is hazard ratio? Concepts in survival analysis. Medicina Clinica, 131(2), 65–72. https://doi.org/10.1157/13123495Matthiessen, C., Lucht, S., Hennig, F., Ohlwein, S., & Jakobs, H. (2018). Long-term exposure to airborne particulate matter and NO 2 and prevalent and incident metabolic syndrome – Results from the Heinz Nixdorf Recall Study. 116(2), 74–82. https://doi.org/10.1016/j.envint.2018.02.035Matthiessen, C., Lucht, S., Hennig, F., Ohlwein, S., Jakobs, H., Jöckel, K. H., Moebus, S., & Hoffmann, B. (2018). Long-term exposure to airborne particulate matter and NO2 and prevalent and incident metabolic syndrome – Results from the Heinz Nixdorf Recall Study. Environment International, 116(2), 74–82. https://doi.org/10.1016/j.envint.2018.02.035Mauro, R. Di, Cantarella, G., Bernardini, R., Rosa, M. Di, Barbagallo, I., Distefano, A., Longhitano, L., Vicario, N., Nicolosi, D., Lazzarino, G., Tibullo, D., Gulino, M. E., Spampinato, M., Avola, R., & Volti, G. L. (2019). The biochemical and pharmacological properties of ozone: The smell of protection in acute and chronic diseases. International Journal of Molecular Sciences, 20(3). https://doi.org/10.3390/ijms20030634Merletti, F., Solkolne, C., & Vineis, P. (2011). Epidemiología y Estadística. Enciclopedia de Salud y Seguridad En El Trabajo, 20.1-20.40.Mirón, J., & Alonso, M. (2008). Medidas de frecuencia, asociacion e impacto en investigacion aplicada. Medicina y Seguridad Del Trabajo, 211, 93–102. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0465-546X2008000200011Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., & Petticrew, M. (2016). Revista Española de Nutrición Humana y Dietética d. December. https://doi.org/10.1186/2046-4053-4-1Moreno-Ríos, A. L., Tejeda-Benítez, L. P., & Bustillo-Lecompte, C. F. (2021). Sources, characteristics, toxicity, and control of ultrafine particles: An overview. Geoscience Frontiers, 101147. https://doi.org/10.1016/j.gsf.2021.101147Morgan, R. L., Whaley, P., Thayer, K. A., & Schünemann, H. J. (2018). Identifying the PECO: A framework for formulating good questions to explore the association of environmental and other exposures with health outcomes. Environment International. https://doi.org/10.1016/j.envint.2018.07.015Mottillo, S., Bs, C., Filion, K. B., Genest, J., Joseph, L., Pilote, L., Poirier, P., Rinfret, S., Ms, C., Schiffrin, E. L., & Eisenberg, M. J. (2010). The Metabolic Syndrome and Cardiovascular Risk A Systematic Review and Meta-Analysis. JAC, 56(14), 1113– 1132. https://doi.org/10.1016/j.jacc.2010.05.034Myte, R., Gylling, B., Häggström, J., Häggström, C., Zingmark, C., Löfgren Burström, A., Palmqvist, R., & Van Guelpen, B. (2019). Metabolic factors and the risk of colorectal cancer by KRAS and BRAF mutation status. International Journal of Cancer, 145(2), 327–337. https://doi.org/10.1002/ijc.32104Negida, A. (2017). Chapter (14 ) Introduction to Systematic Review and Meta-analysis. August.Neira, M., & Prüss-Ustün, A. (2016). Preventing disease through healthy environments: A global assessment of the environmental burden of disease. Toxicology Letters, 259, S1. https://doi.org/10.1016/j.toxlet.2016.07.028Ning, J., Zhang, Y., Hu, H., Hu, W., Li, L., Pang, Y., Ma, S., Niu, Y., & Zhang, R. (2021). Association between ambient particulate matter exposure and metabolic syndrome risk: A systematic review and meta-analysis. Science of the Total Environment, 782, 146855. https://doi.org/10.1016/j.scitotenv.2021.146855Ohlwein, S., Kappeler, R., Kutlar Joss, M., Künzli, N., & Hoffmann, B. (2019). Health effects of ultrafine particles: a systematic literature review update of epidemiological evidence. International Journal of Public Health, 64(4), 547–559. https://doi.org/10.1007/s00038-019-01202-7Organizacion Panamericana de Salud. (2021). Evaluación de riesgo. 1–4. https://www.paho.org/hq/index.php?option=com_content&view=article&id=5720:201 1-risk-assessment-dva&Itemid=4113&lang=esPalacios, E. K. M. (2019). La contaminación del aire, un problema de todos. 67(2), 189– 191.Park, S. K., Auchincloss, A. H., O’Neill, M. S., Prineas, R., Correa, J. C., Keeler, J., Graham Barr, R., Kaufman, J. D., & Diez Roux, A. V. (2010). Particulate air pollution, metabolic syndrome, and heart rate variability: The multi-ethnic study of atherosclerosis (MESA). Environmental Health Perspectives, 118(10), 1406–1411. https://doi.org/10.1289/ehp.0901778Peralta, C. I., & Taype-rondan, A. (2019). Aspectos básicos sobre la lectura de revisiones sistemáticas y la interpretación de metaanálisis. Acta Médica Peruana, 36(2), 157– 169.Pérez-Torres, I., Manzano-Pech, L., Rubio-Ruíz, M. E., Soto, M. E., & Guarner-Lans, V. (2020). Nitrosative stress and its association with cardiometabolic disorders. Molecules, 25(11). https://doi.org/10.3390/molecules25112555Piecha, R., Svačina, Š., Malý, M., Vrbík, K., Lacinová, Z., Haluzík, M., Pavloušková, J.,Vavrouš, A., Matějková, D., Müllerová, D., Mráz, M., & Matoulek, M. (2016). Urine levels of phthalate metabolites and bisphenol a in relation to main metabolic syndrome components: Dyslipidemia, hypertension and type 2 diabetes a pilot study. Central European Journal of Public Health, 24(4), 297–301. https://doi.org/10.21101/cejph.a4704Preker, A. S., Adeyi, O. O., Lapetra, M. G., Simon, D. C., & Keuffel, E. (2016). Health Care Expenditures Associated With Pollution: Exploratory Methods and Findings. Annals of Global Health, 82(5), 711–721. https://doi.org/10.1016/j.aogh.2016.12.003PROSPERO. (2011). International prospective register of systematic reviews Registering a review on PROSPERO What does registration on PROSPERO involve? Inclusion criteria When to register your review PROSPERO International prospective register of systematic reviews Regist. 1–12.Raaschou-Nielsen, O., Beelen, R., Wang, M., Hoek, G., Andersen, Z. J., Hoffmann, B., Stafoggia, M., Samoli, E., Weinmayr, G., Dimakopoulou, K., Nieuwenhuijsen, M., Xun, W. W., Fischer, P., Eriksen, K. T., Sørensen, M., Tjønneland, A., Ricceri, F., de Hoogh, K., Key, T., … Vineis, P. (2016). Particulate matter air pollution components and risk for lung cancer. Environment International, 87(July 2015), 66–73. https://doi.org/10.1016/j.envint.2015.11.007Rajkumar, S., Young, B. N., Clark, M. L., Benka-Coker, M. L., Bachand, A. M., Brook, R. D., Nelson, T. L., Volckens, J., Reynolds, S. J., L’Orange, C., Good, N., Koehler, K., Africano, S., Osorto Pinel, A. B., & Peel, J. L. (2019). Household air pollution from biomass-burning cookstoves and metabolic syndrome, blood lipid concentrations, and waist circumference in Honduran women: A cross-sectional study. Environmental Research, 170(October 2018), 46–55. https://doi.org/10.1016/j.envres.2018.12.010Raviv, N. V., Sakhuja, S., Schlachter, M., & Akinyemiju, T. (2017). Metabolic syndrome and in-hospital outcomes among pancreatic cancer patients. Diabetes and Metabolic Syndrome: Clinical Research and Reviews, 11, S643–S650. https://doi.org/10.1016/j.dsx.2017.04.019Regufe, V. M. G., Pinto, C. M. C. B., & Perez, P. M. V. H. C. (2020). Metabolic syndrome in type 2 diabetic patients: a review of current evidence. Porto Biomedical Journal, 5(6), e101. https://doi.org/10.1097/j.pbj.0000000000000101Sackett, D. L. (1996). On some clinically useful measures of the effects of treatment. Evidence-Based Nursing, 4(2), 36–39. https://doi.org/10.1136/ebn.4.2.36Sanidas, E., Papadopoulos, D. P., Grassos, H., Velliou, M., Tsioufis, K., Barbetseas, J., & Papademetriou, V. (2017). Air pollution and arterial hypertension. A new risk factor is in the air. Journal of the American Society of Hypertension, 11(11), 709–715. https://doi.org/10.1016/j.jash.2017.09.008Saxena, P., & Sonwani, S. (2019). Criteria Air Pollutants and their Impact on Environmental Health. In Criteria Air Pollutants and their Impact on Environmental Health. https://doi.org/10.1007/978-981-13-9992-3Schultz, W. M., Sperling, L., Esmaeeli, A., Mahlof, E. N., Varghese, T., Sandesara, P. B., Dhindsa, D. S., Ricketts, J. C., Kelli, H. M., Heinl, R. E., Allard-Ratick, M. P., Millard, A. J., & Eapen, D. J. (2016). Comprehensive Cardiovascular Risk Reduction and Cardiac Rehabilitation in Diabetes and the Metabolic Syndrome. Canadian Journal of Cardiology, 32(10), S349–S357. https://doi.org/10.1016/j.cjca.2016.07.507Shah, A. S. V., Lee, K. K., McAllister, D. A., Hunter, A., Nair, H., Whiteley, W., Langrish, J. P., Newby, D. E., & Mills, N. L. (2015). Short term exposure to air pollution and stroke: Systematic review and meta-analysis. In BMJ (Online) (Vol. 350).https://doi.org/10.1136/BMJ.h1295Shamy, M., Alghamdi, M., Khoder, M., Mohorjy, A., Alkhatim, A., Alkhalaf, A., Brocato, J., Chen, L., Thurston, G., Lim, C., & Costa, M. (2017). Association between Exposure to Ambient Air Particulates and Metabolic Syndrome Components in a Saudi Arabian Population. International Journal of Environmental Research and Public Health, 15(1), 27. https://doi.org/10.3390/ijerph15010027Shim, Y. H., Ock, J. W., Kim, Y. J., Kim, Y., Kim, S. Y., & Kang, D. (2019). Association between Heavy Metals, Bisphenol A, volatile organic compounds and phthalates and metabolic syndrome. International Journal of Environmental Research and Public Health, 16(4). https://doi.org/10.3390/ijerph16040671Tocabens, B. E. (2011). Definiciones acerca del riesgo y sus implicaciones. Revista Cubana de Higiene y Epidemiologia, 49(3), 470–481.Tsai, D. H., Amyai, N., Marques-Vidal, P., Wang, J. L., Riediker, M., Mooser, V., Paccaud, F., Waeber, G., Vollenweider, P., & Bochud, M. (2012). Effects of particulate matter on inflammatory markers in the general adult population. Particle and Fibre Toxicology, 9, 1–9. https://doi.org/10.1186/1743-8977-9-24Tuomisto, J. (2019). Dioxins and dioxin-like compounds: toxicity in humans and animals, sources, and behaviour in the environment. WikiJournal of Medicine, 6(1), 8. https://doi.org/10.15347/wjm/2019.008Vallero, D. (2014). The Science of Air Pollution. In Fundamentals of Air Pollution. https://doi.org/10.1016/b978-0-12-401733-7.00003-7Voss, S., Schneider, A., Huth, C., Wolf, K., Markevych, I., Schwettmann, L., Rathmann, W., Peters, A., & Breitner, S. (2021). ENVINT-D-20-01309: Long-term exposure to air pollution, road traffic noise, residential greenness, and prevalent and incident metabolic syndrome: Results from the population-based KORA F4/FF4 cohort in Augsburg, Germany. Environment International, 147(November 2020), 106364. https://doi.org/10.1016/j.envint.2020.106364Wallwork, R. S., Colicino, E., Zhong, J., Kloog, I., Coull, B. A., Vokonas, P., Schwartz, J. D., & Baccarelli, A. A. (2017). Ambient fine particulate matter, outdoor temperature, and risk of met. American Journal of Epidemiology, 185(1), 30–39. https://doi.org/10.1093/aje/kww157Wang, L., Liu, C., Meng, X., Niu, Y., Lin, Z., Liu, Y., Liu, J., Qi, J., You, J., Tse, L. A., Chen, J., Zhou, M., Chen, R., Yin, P., & Kan, H. (2018). Associations between shortterm exposure to ambient sulfur dioxide and increased cause-specific mortality in 272 Chinese cities. Environment International, 117(January), 33–39. https://doi.org/10.1016/j.envint.2018.04.019Wei, Y., Zhang, J., Li, Z., Gow, A., Chung, K. F., Hu, M., Sun, Z., Zeng, L., Zhu, T., Jia, G., Li, X., Duarte, M., & Tang, X. (2016). Chronic exposure to air pollution particles increases the risk of obesity and metabolic syndrome: Findings from a natural experiment in Beijing. FASEB Journal, 30(6), 2115–2122. https://doi.org/10.1096/fj.201500142Wennberg, M., Gustafsson, P. E., Wennberg, P., & Hammarström, A. (2016). Irregular eating of meals in adolescence and the metabolic syndrome in adulthood: Results from a 27-year prospective cohort. Public Health Nutrition, 19(4), 667–673. https://doi.org/10.1017/S1368980015001445WHO. (2014). Burden of disease from household air pollution for 2012. Summary of results. World Health Organization, 35(February), 2012–2014. http://www.who.int/phe/health_topics/outdoorair/databases/FINAL_HAP_AAP_BoD_24March2014.pdfWong, E. M., Walby, W. F., Wilson, D. W., Tablin, F., & Schelegle, E. S. (2018). Ultrafine Particulate Matter Combined With Ozone Exacerbates Lung Injury in Mature Adult Rats With Cardiovascular Disease. Toxicological Sciences, 163(1), 140–151. https://doi.org/10.1093/toxsci/kfy018Wu, L., Jin, L., Shi, T., Zhang, B., Zhou, Y., Zhou, T., Bao, W., Xiang, H., Zuo, Y., Li, G., Wang, C., Duan, Y., Peng, Z., Huang, X., Zhang, H., Xu, T., Li, Y., Pan, X., Xia, Y., … Liu, Y. (2017). Association between ambient particulate matter exposure and semen quality in Wuhan, China. Environment International, 98, 219–228. https://doi.org/10.1016/j.envint.2016.11.013Xie, Xiaoxu, Wang, Y., Yang, Y., Xu, J., Zhang, Y., Tang, W., Guo, T., Wang, Q., Shen, H., Zhang, Y., Yan, D., Peng, Z., Chen, Y., He, Y., & Ma, X. (2018). Long-term exposure to fine particulate matter and tachycardia and heart rate: Results from 10 million reproductive-age adults in China. Environmental Pollution, 242, 1371–1378. https://doi.org/10.1016/j.envpol.2018.08.022Xie, Xiaoyun, Li, W., Zhang, Y., Kan, H., & Ying, Z. (2019). Metabolomics analysis of a mouse model for chronic exposure to. 247. https://doi.org/10.1016/j.envpol.2019.01.118Yang, B., Min, Z., Li, S., Fan, S., Chen, G., Syberg, K. M., Xian, H., Wang, S., Ma, H., Chen, D., & Yang, M. (2018). Long-term exposure to ambient air pollution ( including MP 1 ) and metabolic syndrome : The 33 Communities Chinese Health Study ( 33CCHS ). Environmental Research, 164(February), 204–211. https://doi.org/10.1016/j.envres.2018.02.029Yang, B. Y., Fan, S., Thiering, E., Seissler, J., Nowak, D., Dong, G. H., & Heinrich, J. (2020a). Ambient air pollution and diabetes: A systematic review and meta-analysis. Environmental Research, 180(October 2019), 108817. https://doi.org/10.1016/j.envres.2019.108817Yang, B. Y., Fan, S., Thiering, E., Seissler, J., Nowak, D., Dong, G. H., & Heinrich, J. (2020b). Ambient air pollution and diabetes: A systematic review and meta-analysis. Environmental Research, 180(June 2019), 108817. https://doi.org/10.1016/j.envres.2019.108817Yang, B. Y., Qian, Z. (Min), Li, S., Fan, S., Chen, G., Syberg, K. M., Xian, H., Wang, S. Q., Ma, H., Chen, D. H., Yang, M., Liu, K. K., Zeng, X. W., Hu, L. W., Guo, Y., & Dong, G. H. (2018). Long-term exposure to ambient air pollution (including MP 1 ) and metabolic syndrome: The 33 Communities Chinese Health Study (33CCHS). Environmental Research, 164(February), 204–211. https://doi.org/10.1016/j.envres.2018.02.029Yang, B. Y., Qian, Z., Howard, S. W., Vaughn, M. G., Fan, S. J., Liu, K. K., & Dong, G. H. (2018). Global association between ambient air pollution and blood pressure: A systematic review and meta-analysis. Environmental Pollution, 235, 576–588. https://doi.org/10.1016/j.envpol.2018.01.001Ye, D., Klein, M., Chang, H. H., Sarnat, J. A., Mulholland, J. A., Edgerton, E. S., Winquist, A., Tolbert, P. E., & Sarnat, S. E. (2017). Estimating Acute Cardiorespiratory Effects of Ambient Volatile Organic Compounds. In Epidemiology (Vol. 28, Issue 2, pp. 197– 206). https://doi.org/10.1097/EDE.0000000000000607Yin, P., Guo, J., Wang, L., Fan, W., Lu, F., Guo, M., Moreno, S. B. R., Wang, Y., Wang, H., Zhou, M., & Dong, Z. (2020). Higher Risk of Cardiovascular Disease Associated with Smaller Size-Fractioned Particulate Matter. Environmental Science and Technology Letters, 7(2), 95–101. https://doi.org/10.1021/acs.estlett.9b00735Yoo, S., Oh, S., Park, J., Cho, S. Y., Cho, M. C., Son, H., & Jeong, H. (2019). Effects of metabolic syndrome on the prevalence of prostate cancer: historical cohort study using the national health insurance service database. Journal of Cancer Research and Clinical Oncology, 145(3), 775–780. https://doi.org/10.1007/s00432-019-02842-1Yu, Y., Paul, K., Arah, O. A., Mayeda, E. R., Wu, J., Lee, E., Shih, I. F., Su, J., Jerrett, M., Haan, M., & Ritz, B. (2020). Air pollution, noise exposure, and metabolic syndrome – A cohort study in elderly Mexican-Americans in Sacramento area. Environment International, 134(October 2019). https://doi.org/10.1016/j.envint.2019.105269Yuan, S., Wang, J., Jiang, Q., He, Z., Huang, Y., Li, Z., Cai, L., & Cao, S. (2019a). Longterm exposure to MP 2. 5 and stroke : A systematic review and meta- analysis of cohort studies. Environmental Research, 177(13), 108587. https://doi.org/10.1016/j.envres.2019.108587Yuan, S., Wang, J., Jiang, Q., He, Z., Huang, Y., Li, Z., Cai, L., & Cao, S. (2019b). Longterm exposure to MP2.5 and stroke: A systematic review and meta-analysis of cohort studies. Environmental Research, 177(13), 108587. https://doi.org/10.1016/j.envres.2019.108587Zhang, Y., Hu, H., Shi, Y., Yang, X., Cao, L., Wu, J., Asweto, C. O., Feng, L., Duan, J., & Sun, Z. (2017). Science of the Total Environment H NMR-based metabolomics study on repeat dose toxicity of fi ne particulate matter in rats after intratracheal instillation. 589, 212–221. https://doi.org/10.1016/j.scitotenv.2017.02.149PublicationORIGINALAsociación de la exposición a contaminantes atmosféricos y el síndrome metabólico en adultos. una revisión sistemática y un metaanálisis.pdfAsociación de la exposición a contaminantes atmosféricos y el síndrome metabólico en adultos. una revisión sistemática y un metaanálisis.pdfapplication/pdf1564731https://repositorio.cuc.edu.co/bitstreams/c3fb949a-bfed-4133-b0af-f45233011b05/downloade06fa345926ee433246be89ee1dba682MD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-81031https://repositorio.cuc.edu.co/bitstreams/e51d67b9-7737-4761-ba1a-1e62efeb6434/download934f4ca17e109e0a05eaeaba504d7ce4MD52LICENSElicense.txtlicense.txttext/plain; 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