134953 20260217205529.0 doi 10.1016/j.envpol.2024.124044 sideral 138500 ART-2024-138500 eng Mérida, Diana María Phthalate exposure and subclinical carotid atherosclerosis: A systematic review and meta-analysis 2024 Access copy available to the general public Unrestricted Phthalates may be associated with an increased risk of cardiometabolic diseases by interfering with glucose and lipid metabolism and by promoting adipogenesis. This study aimed to perform a systematic review and meta-analysis of the association between phthalate exposure and subclinical carotid atherosclerosis, using surrogate markers such as carotid intima-media thickness (IMT) and carotid plaques. The literature search was performed using four databases (Web of Science, Medline, PubMed, and Scopus), and this systematic review includes all available observational studies until July 6th, 2023. The Joanna Briggs Institute critical appraisal tool was used to assess the risk of bias. Meta-analyses were performed, and random effects models were used. Six high-quality cross-sectional studies and 2570 participants aged 12 to 70 were included. Six phthalate metabolites showed significant associations with subclinical carotid atherosclerosis. Exposure to MBzP, ΣDEHP, and MnBP was associated with increased carotid IMT. Exposure to MEP was associated with a higher prevalence of carotid plaques, and MiBP was associated with a lower prevalence. Mixed results were observed for MMP in older adults. The meta-analyses showed a high degree of heterogeneity, and the results are based on single studies. This study accurately describes the evidence of this association to date, suggesting that phthalates are associated with increased carotid IMT and a higher prevalence of carotid plaques. Further research is needed to elucidate this association, as phthalates are still used in the manufacture of everyday products, humans continue to be exposed to them, and atherosclerosis is a public health concern. info:eu-repo/grantAgreement/ES/ISCIII/PI20/144 info:eu-repo/semantics/openAccess by-nc-nd https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es 7.3 2024 ENVIRONMENTAL SCIENCES 47 / 376 = 0.125 2024 Q1 T1 2.205 2024 Health, Toxicology and Mutagenesis 2024 Q1 Toxicology 2024 Q1 Pollution 2024 Q1 Medicine (miscellaneous) 2024 Q1 16.0 2024 info:eu-repo/semantics/review info:eu-repo/semantics/publishedVersion Acosta-Reyes, Jorge Bayán-Bravo, Ana Moreno-Franco, Belén Universidad de Zaragoza (orcid)0000-0003-0604-5042 Laclaustra, Martín Universidad de Zaragoza (orcid)0000-0003-3963-0846 Guallar-Castillón, Pilar 1007 610 Universidad de Zaragoza Dpto. Medicina, Psiqu. y Derm. Area Medicina 1011 615 Universidad de Zaragoza Dpto. Microb.Ped.Radio.Sal.Pú. Área Medic.Prevent.Salud Públ. 350 (2024), 124044 [11 pp.] Environ. pollut. Environmental Pollution 0269-7491 1521214 http://zaguan.unizar.es/record/134953/files/texto_completo.pdf Versión publicada 2481181 http://zaguan.unizar.es/record/134953/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:134953 articulos driver 2026-02-17-20:31:46 ARTICLE