摘要目的:分析双酚A暴露与儿童青少年肥胖/超重发生的暴露-反应关系。方法:以“bisphenol A” “BPA” “obesity” “weight” “fat”“overweight”“body mass index”“BMI”“waist circumference”“双酚A”“肥胖”“超重”“体质指数”“腰围”为关键词，系统检索PubMed、Web of Science、Scopus、Embase、Cochrane library、中国知网、万方数据服务平台和维普中文科技期刊等数据库截至2021年9月1日发表的双酚A与儿童青少年肥胖/超重关联的文献。使用Stata 15.1软件分析数据，计算合并的 OR（95% CI）值，进行异质性检验、亚组分析、敏感性分析、发表偏倚检验和暴露-反应关系拟合。 结果:共检索1 948篇文献，根据纳入排除标准，纳入9篇英文文献，其中8篇来自美国，1篇来自中国，共涉及6~19岁儿童青少年15 614人次和肥胖/超重人数3 446例。Meta分析结果显示，不同研究的最高剂量组间存在异质性（ I 2=52.1%， P=0.033），经随机效应模型合并数据分析发现，与低剂量组相比，合并的高剂量组尿液双酚A含量与肥胖/超重发生的 OR（95% CI）值为1.56（1.18~1.94），但是尚未发现存在线性或非线性暴露反应关系。敏感性分析表明结果稳定，Egger′s检验（ P=0.263）以及Begg′s检验（ P=0.348）结果均显示纳入文献不存在发表偏倚。 结论:双酚A暴露可增加儿童青少年肥胖/超重发生风险。

abstractsObjective:To explore the relationship between bisphenol A (BPA) exposure and obesity/overweight in children and adolescents through Dose-response Meta analysis.Methods:Articles published up to September 1st 2021 were systematically searched in PubMed, Web of science, Scopus, Embase, Cochrane library, CNKI, Wanfang databases and VIP Chinese Science and Technology Journal by using "bisphenol A" "BPA" "obesity" "weight" "fat""overweight" "body mass index" "BMI" "waist circumference" (both in English and in Chinese) as keywords. Use Stata 15.1 software to calculate the pooled OR (95% CI), perform heterogeneity test, subgroup analysis, sensitivity analysis, publication bias and the exposure-response relationship fitting. Results:A total of 9 English articles were included from 1 948 articles retrieved, including 8 articles from American and 1 article from China. 15 614 children/adolescents and 3 446 obese/overweight cases were further used for Meta-analysis of dose-response relationship. Meta-analysis results showed that there was heterogeneity among the highest dose groups in different studies( I 2=52.1%, P=0.033). The random effect model-analysis found that compared with those in the lowest group, the OR(95% CI) for those in the highest group of urine BPA was 1.56(1.18-1.94)for the risk of obesity/overweight in children and adolescents, but there was no linear or nonlinear dose-response relationship. Sensitivity analyses showed that the results were robust, Egger′s test( P=0.263) and Begg′s test( P=0.348) showed that there was no publication bias. Conclusion:Bisphenol A exposure may increase the risk of obesity/overweight epidemics in children and adolescent.