Exposure Science and the exposome in relation to metabolic syndrome: a systematic review within the context of environmental health

This systematic review assessed the role of the exposome in the development of metabolic syndrome (MetS) and its components, including obesity, hypertension, dyslipidemia, and hyperglycemia. A systematic literature search was conducted on 27 June 2024, following PRISMA guidelines across PubMed, Web of Science, Scopus, and Google Scholar, identifying studies on exposome approaches to MetS. Out of 164 initial records, 10 studies met the inclusion criteria and were analyzed. The results highlight complex interactions between environmental pollutants, lifestyle factors, and MetS. Exposure to organochlorine pesticides and per- and polyfluoroalkyl substances was consistently linked to metabolic disturbances, including insulin resistance and lipid abnormalities. Pollutants such as 2,5-dichlorophenol (2,5-DCP) and polycyclic aromatic hydrocarbons were associated with reduced HDL cholesterol and disruptions in lipid metabolism. Minimal influence of gut microbiota on the association between PFHxS exposure and MetS was reported. Additionally, cumulative chemical exposures, particularly to 2-phenanthrene (2-PHEN), were linked to an elevated risk of MetS. This study highlights the complex, multifactorial nature of MetS, stressing the significant influence of environmental exposures in conjunction with demographic and lifestyle factors. Environmental exposures frequently interact synergistically, with the combined effects of chemicals increasing the risk of MetS.