Endocrine Abstracts

Background: The role of endocrine disrupting chemicals (EDCs) in the development of the metabolic syndrome and its components gained increasing importance in recent years. The underlying mechanisms appear to be multifactorial and are largely unresolved. Disruption of glucocorticoid and mineralocorticoid hormone action is considered a possible mechanism. This systematic review is the first to summarize epidemiological studies investigating an association between EDC concentrations and altered levels of glucocorticoids, mineralocorticoids, and ACTH.

Methods: Following the PRISMA guidelines, we searched PubMed (n = 2,039) and the Cochrane Library (n = 55) for epidemiological studies published until 1st April 2024 without restrictions on the age, geographic origin and sex of the study population. Various groups of EDCs were evaluated with the prerequisite of direct measurement of the chemical, a metabolite, or biomarker.

Results: We identified 2,094 articles. After removing duplicates and screening, 27 studies were included. Fifteen studies investigated children; five studies examined pregnant women. Studies focused predominantly on glucocorticoids (n = 26) compared to mineralocorticoids (n = 5) and ACTH (n = 2). The most studied EDCs were pesticides (n = 9) and phthalates (n = 8), followed by per- and polyfluoroalkyl substances (PFAS, n = 6), other persistent organic pollutants (POPs, n = 6), and bisphenols (n = 5). All but three studies demonstrated a significant association between the concentration of specific EDCs and hormone levels, although results varied depending on the chemical and its metabolites, and sex and age of the study population.

Conclusion: There is compelling evidence for the impact of specific EDCs on plasma glucocorticoid and mineralocorticoid concentrations in different age groups worldwide. Further research combining EDC concentration, hormone levels and clinical features, complemented by experimental investigations to study cell mechanisms, is needed to gain holistic knowledge of EDCs influence on corticosteroid-related disorders.