1.Research progress on the relationship between early life obesogen exposure and childhood obesity
GAO Lei ; YE Zhen ; WANG Wei ; ZHAO Dong ; XU Peiwei ; ZHANG Ronghua
Journal of Preventive Medicine 2026;38(1):48-54
Childhood obesity has become a global public health issue. Current research indicates that early life obesogen exposure has emerged as a significant risk factor for childhood obesity. While obesogens have been confirmed to influence the development and progression of childhood obesity through mechanisms such as endocrine disruption and epigenetic programming, controversies remain regarding the establishment of causal relationships, assessment of combined exposures, and validation of transgenerational effects in humans. In recent years, novel approaches including multi-omics technologies, exposome-based analysis, and multigenerational cohort studies have integrated dynamic biomarker monitoring with analyses of social-environmental interactions, offering new perspectives and methodologies for constructing a systematic "exposure-mechanism-outcome" research framework. This article reviews literature from PubMed and Web of Science up to August 2025 on the association between early life obesogen exposure and childhood obesity, summarizing evidence on the health effects of early life obesogen exposure, major exposure pathways and internal exposure assessment, interactions and amplifying effects of social and environmental factors, as well as the biological mechanisms underlying obesogen action. It further examines current research frontiers and challenges, aiming to provide a theoretical foundation for early prevention and precision intervention of childhood obesity.
2.Association between plant-based diet and different types of obesity
ZHOU Mengyi ; SU Danting ; HE Mengjie ; XU Peiwei ; HAN Dan ; HUANG Lichun ; ZHANG Ronghua
Journal of Preventive Medicine 2025;37(8):773-778
Objective:
To investigate the association between plant-based diet and different types of obesity, so as to provide references for obesity prevention.
Methods:
Residents aged 35-75 years from 33 counties (cities, districts) in Zhejiang Province were selected as study subjects using a multistage stratified random sampling method between April and December 2024. Demographic information and living behaviors were collected using questionnaire surveys. Height, weight and waist circumference were measured, and body mass index (BMI) was calculated. BMI ≥28.0 kg/m2 was defined as obesity, waist circumference ≥90 cm in males or ≥85 cm in females was defined as central obesity, and individual with obesity who also had central obesity was defined as having compound obesity. Food intake over a 3-day period was collected using the consecutive 3-day 24-hour dietary recall method. The plant diet index (PDI), healthful plant diet index (HPDI), and unhealthful plant diet index (UPDI) were calculated, and categorized into quintiles (Q1-Q5) based on their distribution. Association between the PDI, PDI, UPDI and different types of obesity were analyzed using multivariable logistic regression models.
Results:
A total of 4 882 individuals were surveyed, including 2 233 males (45.74%) and 2 649 females (54.26%). The average age was (55.42±12.14) years. There were 537 individuals of obesity, 1 718 individuals of central obesity, and 500 individuals of compound obesity, with detection rates of 11.00%, 35.19%, and 10.24%, respectively. Multivariable logistic regression analysis showed that, after adjusting for demographic information and living behaviors, compared with Q1 group, HPDI Q5 group showed a 29.6% lower risk of obesity (OR=0.704, 95%CI: 0.525-0.943) and a 32.1% lower risk of compound obesity (OR=0.679, 95%CI: 0.502-0.918). Conversely, the UPDI Q5 group exhibited a 39.5% higher risk of obesity (OR=1.395, 95%CI: 1.032-1.886) and a 39.8% higher risk of compound obesity (OR=1.398, 95%CI: 1.025-1.907). No statistically significant association was found between PDI and obesity, central obesity, and compound obesity (all P>0.05). As HPDI increased, the risks of obesity and compound obesity showed decreasing trends; as UPDI increased, the risks of obesity and compound obesity showed increasing trends (all Ptrend<0.05).
Conclusion
A healthful plant-based diet is associated with reduced risks of obesity and compound obesity, while an unhealthful plant-based diet is associated with increased risks of obesity and compound obesity.
3.USH2A mutation and specific driver mutation subtypes are associated with clinical efficacy of immune checkpoint inhibitors in lung cancer
YANG DEXIN ; FENG YUQIN ; LU HAOHUA ; CHEN KELIE ; XU JINMING ; LI PEIWEI ; WANG TIANRU ; XIA DAJING ; WU YIHUA
Journal of Zhejiang University. Science. B 2023;24(2):143-156,中插1-中插9
This study aimed to identify subtypes of genomic variants associated with the efficacy of immune checkpoint inhibitors (ICIs) by conducting systematic literature search in electronic databases up to May 31, 2021. The main outcomes including overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and durable clinical benefit (DCB) were correlated with tumor genomic features. A total of 1546 lung cancer patients with available genomic variation data were included from 14 studies. The Kirsten rat sarcoma viral oncogene homolog G12C (KRASG12C) mutation combined with tumor protein P53 (TP53) mutation revealed the promising efficacy of ICI therapy in these patients. Furthermore, patients with epidermal growth factor receptor (EGFR) classical activating mutations (including EGFRL858R and EGFRΔ19) exhibited worse outcomes to ICIs in OS (adjusted hazard ratio (HR), 1.40; 95% confidence interval (CI), 1.01?1.95; P=0.0411) and PFS (adjusted HR, 1.98; 95% CI, 1.49?2.63; P<0.0001), while classical activating mutations with EGFRT790M showed no difference compared to classical activating mutations without EGFRT790M in OS (adjusted HR, 0.96; 95% CI, 0.48?1.94; P=0.9157) or PFS (adjusted HR, 0.72; 95% CI, 0.39?1.35; P=0.3050). Of note, for patients harboring the Usher syndrome type-2A (USH2A) missense mutation, correspondingly better outcomes were observed in OS (adjusted HR, 0.52; 95% CI, 0.32?0.82; P=0.0077), PFS (adjusted HR, 0.51; 95% CI, 0.38?0.69; P<0.0001), DCB (adjusted odds ratio (OR), 4.74; 95% CI, 2.75?8.17; P<0.0001), and ORR (adjusted OR, 3.45; 95% CI, 1.88?6.33; P<0.0001). Our findings indicated that, USH2A missense mutations and the KRASG12C mutation combined with TP53 mutation were associated with better efficacy and survival outcomes, but EGFR classical mutations irrespective of combination with EGFRT790M showed the opposite role in the ICI therapy among lung cancer patients. Our findings might guide the selection of precise targets for effective immunotherapy in the clinic.
4.Possible mechanisms of toxic effects of per-and polyfluoroalkyl substances exposure on thyroid
Luyang HE ; Peiwei XU ; Yuan CHEN ; Xiaofeng WANG
Journal of Environmental and Occupational Medicine 2023;40(11):1327-1333
Per- and polyfluoroalkyl substances (PFASs) are persistent organic pollutants (POPs). They are widely used in food packaging, tableware coating, stain resistant furniture, and other industrial production. Humans are exposed to PFASs on a daily basis through drinking water and intaking food, use of consumer products containing PFASs, and occupational exposure during the production of PFASs or related products. A growing body of toxicological studies has shown that PFASs exposure disrupts the thyroid hormone (TH) system and causes hypothyroidism, which is further supported by population epidemiological studies. PFASs can damage thyroid follicular cells and sodium/iodine transporters to impair iodine uptake by thyroid cells. They interfere with the synthesis of thyroglobulin, reduce the activity of thyroid peroxidase, and affect the synthesis and secretion of TH. They interfere with TH transportation and biological effects via TH competitive binding thyroid transporter or thyroid hormone receptor. They suppress TH signaling pathway and deiodinase activity, interfere negative feedback mechanism, and accelerate TH metabolism and excretion. The processes of TH synthesis, transport, degradation, and biological effects may all be affected by PFASs exposure. This paper described possible toxic mechanisms of PFASs on the thyroid from four aspects: TH biosynthesis, transport, action on target cells, and metabolic excretion stage, and summarized the thyroid toxicity associated with PFASs exposure.
5.Safety and effectiveness of bridging therapy in elderly acute stroke patients with posterior circulation large vessel occlusion
Zhiguang LIU ; Zaili LI ; Wenhong ZHI ; Ning HAO ; Xu CAO ; Peiwei CAO
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2023;25(12):1302-1305
Objective To explore the safety and effectiveness of bridging therapy in elderly patients with acute stroke due to posterior circulation large vessel occlusion.Methods A total of 160 eld-erly patients with acute stroke caused by posterior circulation large vessel occlusion admitted to our department were prospectively recruited and randomly divided into bridging group(n=80)and control group(n=80).The bridging group received thrombolysis treatment and then mechan-ical thrombectomy.The control group received mechanical thrombectomy directly.Prognosis and adverse reactions were compared between the two groups.Results The NIHSS score and BATMAN score after treatment were significantly decreased in both groups(P<0.01),and the two scores were obviously lower in the bridging group than the control group(6.54±1.23 vs 7.12± 0.98,2.12±0.34 vs 2.87±0.44,P<0.01).There was no statistical difference in the conversion rate of bleeding after cerebral infarction between the two groups(5.00%vs 3.75%,P>0.05).The number of intraoperative thrombus removal was significantly lower in the bridging group than the control group(2.43±0.33 vs 2.98±0.41,P<0.01).Remarkable difference was observed in the mRS score between the two groups after treatment(P<0.05),with the proportion of mRS score ranging from 0 to 1 larger in the bridging group than the control group(52.50%vs 27.50%,P<0.05).Conclusion Bridging thrombolysis can significantly improve the neurological function in elderly patients with acute stroke due to posterior circulation occlusion.
6.USH2A mutation and specific driver mutation subtypes are associated with clinical efficacy of immune checkpoint inhibitors in lung cancer.
Dexin YANG ; Yuqin FENG ; Haohua LU ; Kelie CHEN ; Jinming XU ; Peiwei LI ; Tianru WANG ; Dajing XIA ; Yihua WU
Journal of Zhejiang University. Science. B 2023;24(2):143-156
This study aimed to identify subtypes of genomic variants associated with the efficacy of immune checkpoint inhibitors (ICIs) by conducting systematic literature search in electronic databases up to May 31, 2021. The main outcomes including overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and durable clinical benefit (DCB) were correlated with tumor genomic features. A total of 1546 lung cancer patients with available genomic variation data were included from 14 studies. The Kirsten rat sarcoma viral oncogene homolog G12C (KRASG12C) mutation combined with tumor protein P53 (TP53) mutation revealed the promising efficacy of ICI therapy in these patients. Furthermore, patients with epidermal growth factor receptor (EGFR) classical activating mutations (including EGFRL858R and EGFRΔ19) exhibited worse outcomes to ICIs in OS (adjusted hazard ratio (HR), 1.40; 95% confidence interval (CI), 1.01‒1.95; P=0.0411) and PFS (adjusted HR, 1.98; 95% CI, 1.49‒2.63; P<0.0001), while classical activating mutations with EGFRT790M showed no difference compared to classical activating mutations without EGFRT790M in OS (adjusted HR, 0.96; 95% CI, 0.48‒1.94; P=0.9157) or PFS (adjusted HR, 0.72; 95% CI, 0.39‒1.35; P=0.3050). Of note, for patients harboring the Usher syndrome type-2A(USH2A) missense mutation, correspondingly better outcomes were observed in OS (adjusted HR, 0.52; 95% CI, 0.32‒0.82; P=0.0077), PFS (adjusted HR, 0.51; 95% CI, 0.38‒0.69; P<0.0001), DCB (adjusted odds ratio (OR), 4.74; 95% CI, 2.75‒8.17; P<0.0001), and ORR (adjusted OR, 3.45; 95% CI, 1.88‒6.33; P<0.0001). Our findings indicated that, USH2A missense mutations and the KRASG12Cmutation combined with TP53 mutation were associated with better efficacy and survival outcomes, but EGFR classical mutations irrespective of combination with EGFRT790M showed the opposite role in the ICI therapy among lung cancer patients. Our findings might guide the selection of precise targets for effective immunotherapy in the clinic.
Humans
;
Carcinoma, Non-Small-Cell Lung/genetics*
;
ErbB Receptors/genetics*
;
Extracellular Matrix Proteins/genetics*
;
Immune Checkpoint Inhibitors/therapeutic use*
;
Lung Neoplasms/genetics*
;
Mutation
;
Protein Kinase Inhibitors/therapeutic use*
;
Proto-Oncogene Proteins p21(ras)/genetics*
;
Treatment Outcome
7.Exposure to and health effects of bisphenols: a review
Yang HU ; Xiaofeng WANG ; Zhijian CHEN ; Peiwei XU ; Xiaoming LOU
Journal of Preventive Medicine 2022;34(8):799-802
Abstract
Bisphenols (BPs), which are mainly used in the production of polycarbonates and epoxy resins, are common endocrine disruptors (EDCs) in natural environments. Human mainly exposes to BPs via ingestion and skin. Previous studies have deteted BPs in human urine, serum, and milk samples, and children and pregnant women have a high level of exposure to to BPs. Based on international and national publications pertaining to BPs since 2009, this review describes the exposure to BPs in human urine, serum, and milk and summarizes neuroendocrine dysfunctions, oxidative stress injury and epigenetics changes caused by BPs, so as to provide insights into reducing the exposure to and health risk of BPs.
8.The exposure levels of phthalic acid esters in population: a review
LIU Jing ; XU Peiwei ; CHEN Zhijian ; SHAO Bin ; SHI Changmiao ; LI Sheng ; WANG Xiaofeng
Journal of Preventive Medicine 2021;33(9):906-909
Phthalic acid esters (PAEs) are commonly used plasticizers and solvents. Human body is exposed and absorbed mainly through diet, skin and air inhalation. The biological samples such as urine, blood, saliva, semen and breast milk generally contain PAEs and their metabolites, but the concentrations of PAEs metabolites vary in different samples. In the general population, the levels of PAEs are higher in children than in adults, and higher in women than in men; the levels of PAEs are higher in the occupational population than in the general population. In this paper, the research of PAEs related human biomonitoring in the general population and occupational population at home and abroad is reviewed, so as to provide the basis for reducing the exposure of PAEs and related health risk.
9.Research progress on environmental concentration levels,population exposure and health risk of triclosan
XIE Huasen ; SONG Yang ; WANG Xiaofeng ; CHEN Zhijian ; XU Peiwei ; LOU Xiaoming
Journal of Preventive Medicine 2021;33(10):1013-1016
Triclosan, widely used in various personal care products, is one of the most common environmental endocrine disruptors in our life. It can be detected from water, soil and dust, and its environmental exposure level increased with consumption. Human body are exposed to triclosan through food and water, but the evidence that triclosan exposure leads to adverse health effects is not sufficient. This paper summarizes the progress of studies related to environmental concentration, population exposure and health risks of triclosan in recent years.
10.Investigation on rural environmental sanitation and summer diarrhea among rural residents in Zhejiang Province
Yuan CHEN ; Lizhi WU ; Peiwei XU ; Weizhong CHEN ; Shengliang HE ; Zhijian CHEN
Journal of Preventive Medicine 2019;31(2):109-112
Objective :
To understand the status of rural environmental sanitation and summer diarrhea among rural residents in Zhejiang Province,and to provide evidence for improvement of rural environmental sanitation and prevention and control of summer diarrhea.
Methods :
The stratified random sampling method was used. Five or six counties each were selected from the east,middle and west of Zhejiang Province;five townships(excluded Chengguan Town)were selected from each selected county;four villages were selected as field survey points from each township;five households were selected from each survey point;one family member(householder or housewife)was selected from each selected household. The information about the environmental sanitation status and prevalence of summer diarrhea were obtained by literature review,interviews,questionnaire suvey,field investigation and laboratory tests. Logistic regression model was used to analyze the influencing factors for occurrence of summer diarrhea among rural residents.
Results :
There were 2 000 households surveyed. In the past two weeks,108 households had families with diarrhea and the prevalence of diarrhea was 5.40%. A total of 1 828 households disposed the household waste in the garbage bins or pools,accounting for 91.40%. There were 1 926 households with organized sewage discharge,accounting for 96.30%. There were 768 households with nymphs found in the kitchen,accounting for 38.40%;404 households with live egg sheaths found,accounting for 20.20%;592 households with cockroach traces found,accounting for 29.60%;564 households with rat traces found,accounting for 28.20%;and 1 206 households with flies found,accounted for 60.30%. There were 1 314 households with disease vectors around the house,accounting for 65.70%. There were 1 944 household with sanitary toilets,accounting for 97.20%. A total of 1 915 households had habits of drinking boiled water,accounting for 96.57%. The results of multivariate logistic regression analysis showed that rat traces found in the kitchen(OR=2.026,95%CI: 1.362-3.013)were a risk factor for summer diarrhea in rural residents,while drinking boiled water(OR=0.272,95%CI: 0.091-0.811)was a protective factor.
Conclusion
The sanitary environment and family health habits of rural residents were related to the prevalence of diarrhea in summer. Paying attention to kitchen hygiene and drinking boiled water could prevent summer diarrhea.


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