Department of Community Medicine, West Virginia University School of Medicine, Morgantown, WV, USA.
Clin Epidemiol. 2011;3:251-8. doi: 10.2147/CLEP.S21677. Epub 2011 Sep 30.
Perfluoroalkyl chemicals, including perfluorooctanoic acid and perfluorooctane sulfonate, are man-made chemicals that have been detected in the blood of over 98% of the US population. Serum uric acid is a novel biomarker, even mild elevations of which has been implicated in the development of hypertension, diabetes mellitus, cardiovascular disease, and chronic kidney disease. We examined the relationship of serum perfluoroalkyl chemicals, including perfluorooctanoic acid and perfluorooctane sulfonate, and elevated uric acid levels in a representative sample of US adults.
We examined 3883 participants from the 1999-2000 and 2003-2006 National Health and Nutritional Examination Surveys, a representative, multiethnic population-based survey of noninstitutionalized US adults. Serum perfluorooctanoic acid and perfluorooctane sulfonate were analyzed as quartiles. The main outcome was hyperuricemia.
We found that serum levels of perfluoroalkyl chemicals, including perfluorooctanoic acid and perfluorooctane sulfonate, were positively associated with hyperuricemia. This association appeared to be independent of confounders such as age, gender, race-ethnicity, body mass index, diabetes, hypertension, and serum cholesterol. Compared with subjects in quartile 1 (referent), the multivariate odds ratio for hyperuricemia among subjects in quartile 4 was 1.97 (95% confidence interval 1.44-2.70, P < 0.0001) for perfluorooctanoic acid and 1.48% (95% confidence interval 0.99-2.22, P = 0.0433) for perfluorooctane sulfonate. This observed association persisted in subgroup analysis by gender and body mass index.
Our results demonstrate that elevated levels of perfluoroalkyl chemicals are associated with hyperuricemia even at low perfluoroalkyl chemical exposure levels as seen in the US general population.
全氟烷基化学品，包括全氟辛酸和全氟辛烷磺酸，是人为合成的化学物质，在美国超过 98%的人口的血液中都有检测到。血清尿酸是一种新型生物标志物，即使是轻度升高，也与高血压、糖尿病、心血管疾病和慢性肾病的发展有关。我们研究了全氟烷基化学物质（包括全氟辛酸和全氟辛烷磺酸）与美国成年人代表性样本中尿酸水平升高之间的关系。
我们检查了来自 1999-2000 年和 2003-2006 年全国健康和营养调查的 3883 名参与者，这是一项针对非机构化美国成年人的代表性、多种族的基于人群的调查。血清全氟辛酸和全氟辛烷磺酸按四分位数进行分析。主要结局是高尿酸血症。
我们发现，全氟烷基化学物质（包括全氟辛酸和全氟辛烷磺酸）的血清水平与高尿酸血症呈正相关。这种关联似乎独立于年龄、性别、种族-民族、体重指数、糖尿病、高血压和血清胆固醇等混杂因素。与四分位数 1（参照）的受试者相比，四分位数 4 中尿酸升高的受试者的多变量优势比为 1.97（95%置信区间 1.44-2.70，P<0.0001）全氟辛酸和 1.48%（95%置信区间 0.99-2.22，P=0.0433）全氟辛烷磺酸。按性别和体重指数进行亚组分析时，观察到的这种相关性仍然存在。
我们的研究结果表明，即使在美国一般人群中观察到的低全氟烷基化学物质暴露水平，升高的全氟烷基化学物质水平也与高尿酸血症有关。
