Endocrine Disruptors, Diabetic Retinopathy Treatment, Childhood Obesity and Cancer

In new research this week, an exhaustive review of 25 years of literature finds that endocrine disrupting chemicals can interfere with fetal development as well as wreak havoc on a pregnant person. A study adds evidence that cholesterol-lowering drugs called fenofibrates can slow the progression of a form of diabetic eye disease. And lastly, researchers in Sweden examined the link between being overweight as a child and the risk of developing obesity-related cancer as an adult.

Endocrine disruptors affect both mother and baby-to-be

Experts have long known that endocrine disruptors are harmful chemical compounds that can alter hormones, interfere with the body’s endocrine system, and lead to a wide variety of health problems.

Now, an extensive review of 25 years of literature on endocrine disruptors shows that exposure to these environmental chemicals during pregnancy can affect the health and development of a fetus as well as a pregnant person.

“Women need to be more aware of endocrine disruptors, especially during pregnancy,” said Isabelle Plante, PhD, lead author of the study and researcher in environmental toxicology at Quebec’s National Institute of Scientific Research. She is also co-director of the Intersectorial Center for Endocrine Disruptors Analysis. “During pregnancy it’s not only the woman who is affected; it’s her baby, too.”

Pregnancy is a complicated process during which a wide range of development and programming occurs. If disrupted, changes can be irreversible, Dr. Plante said.

While in utero, the placenta is sensitive to environmental contaminants, the review showed. If endocriners alter the ability of the placenta to function properly, it can lead to short-, medium-, and long-term health problems including diabetes, obesity, cancer, and other chronic diseases, according to the report.

The Canadian researchers looked at 12 of the most common endocrine disruptors including bisphenol A, which is found in food-grade plastics, and phthalates, which are used to soften plastics and are also found in many cosmetics. The researchers focused on chemicals that have been shown to affect the reproductive system, metabolism, and mammary gland development during pregnancy.

The review was published in an April special issue of the journal Environmental Research.

Found in numerous consumer products including makeup, food packaging, cleaning products, and children’s toys, endocrine disruptors can be hard to avoid, Dr. Plante said.

“Be aware of what’s present in the products you buy. Look to see if they’re listed. Avoid them or find alternativesshe said.

Cholesterol-lowering fenofibrate drugs slow diabetic eye disease

Researchers studying how cholesterol-lowering fenofibrates affect the course of diabetic retinopathy, an eye complication of diabetes, found that the drugs can slow the progression of this disease.

The study, which was published in JAMA Ophthalmologyfound that fenofibrates can slow the development of proliferative diabetic retinopathy.

Diabetes causes vision loss through two main mechanisms, said Brian L. VanderBeek, MD, of the Scheie Eye Institute in Philadelphia. Diabetic macular edema (DME) occurs when there is swelling in the center part of the retina called the macula. Proliferative diabetic retinopathy (PDR) occurs through new blood vessel growth.

The study found that fenofibrates were associated with a protective effect for PDR but not DME.

Related: Statins May Prevent Diabetic Neuropathy in People With Diabetes

While further research is needed, if fenofibrates are beneficial for the management of diabetic cholesterol eye disease it would be an exciting new application of the drugs, which are commonly prescribed to reduce levels. Currently, fenofibrates are not widely used to manage diabetic eye disease.

“Fenofibrate is known to reduce blood levels of triglycerides and increase HDL levels. Some of its effects may be due to these primary effects, but there is also evidence that fenofibrate impacts other pathways which could impact the progression of diabetic retinopathy,” Dr. VanderBeek said.

Currently, there is a large ongoing clinical trial focused on the use of fenofibrates in diabetic retinopathy patients. “The hope is that the results of this clinical trial will convince more physicians of the beneficial effects of fenofibrates,” Dr. VanderBeek said.

Childhood obesity is a risk factor for obesity-related adult cancer

The link between a high body mass index in adulthood and the risk of developing an obesity-related cancer is well known, but now researchers have made a significant discovery: Excess weight in childhood also brings an elevated risk of obesity-related cancer as an adult .

The new study from the University of Gothenburg was published in the journal Cancer Communications. It is the first to detail the risk of high BMI during childhood and puberty.

Being overweight or obese is associated with 13 types of cancer, including cancer of the blood, colon, gallbladder, liver, mouth, pancreas, skin, and thyroid. The study found that men who had a high BMI as children had an elevated risk of obesity-related cancer later in life, even if their weight was in the normal range in young adulthood. Data was based on 36,565 Swedish men born in 1945–61.

Scientists analyzed the BMI of participants at age 8 and again at 20, then followed them for 40 years, which was crucial to the study because most obesity-related cancer occurs in upper middle age. More than 90% of new cases of obesity-related cancers occur in men and women who are 50 or older.

The study found that boys who were overweight at age 8 had a markedly increased risk of obesity-related cancer and death in adulthood, especially if they remained overweight at 20 compared to their normal-weight peers. However, participants whose BMI was recorded at normal by the age of 20 also experienced an increased risk of cancer, the study found.

“Alarmingly, a near 40% excess relative risk remained even for the group of boys who were overweight at age 8 but had a normal weight at age 20, compared to the group with normal weight at both ages,” said the study’s lead author Jimmy Celind, a pediatrician and researcher at Sahlgrenska Academy’s Institute of Medicine at the University of Gothenburg, in a release accompanying the study.

Childhood obesity is a severe health problem worldwide. In the United States 19% of people 2 to 19 are obese, which is nearly 1 in 5 kids.

“Preventive measures against obesity-related cancer should start early in childhood,” Celind said.

“Our findings suggest that weight control during childhood could prevent obesity-related adult cancer in men,” he said.

  • Environmental Research (1 April 2022). “Killing two birds with one stone: Pregnancy is a sensitive window for endocrine effects on both the mother and the fetus.” https://www.sciencedirect.com/science/article/pii/S0013935121017369
  • Institut National de la Recherche Scientifique press release (April 28, 2022). “Mother and child vulnerable to endocrine disruptor exposure.” https://inrs.ca/en/news/mother-and-child-vulnerable-to-endocrine-disruptor-exposure/
  • JAMA Ophthalmology (April 7, 2022). “Use of Fenofibrate in the Management of Diabetic Retinopathy—Large Population Analyses.” https://jamanetwork.com/journals/jamaophthalmology/article-abstract/2790666
  • NIH Medline Plus, “Fenofibrate.” Page last revised 11/15/19. Accessed May 5, 2022. https://medlineplus.gov/druginfo/meds/a601052.html
  • Cancer Communications (08 April 2022). “Childhood overweight and risk of obesity-related adult cancer in men.” https://onlinelibrary.wiley.com/doi/10.1002/cac2.12286
  • University of Gothenburg press release (2 May 2022). “Remaining increase in cancer risk after high childhood BMI.” https://www.gu.se/en/news/remaining-increase-in-cancer-risk-after-high-childhood-bmi

Freelance writer

Melissa Erickson has more than 30 years of experience as a journalist, including reporting for a group of weekly newspapers in the Chicago suburbs and contributing to the news service for GateHouse Media Inc. and Gannett Co.

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