Department of Epidemiology and Biostatistics, College of Public Health, East Tennessee State University, Johnson City, TN, United States; Center for Environmental and Respiratory Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.
Center for Environmental and Respiratory Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.
Environ Int. 2015 Sep;82:49-60. doi: 10.1016/j.envint.2015.05.001. Epub 2015 May 23.
In some cross-sectional epidemiologic studies the shape of the association between serum concentrations of perfluoroalkyl acids (PFAAs) and lipids suggests departures from linearity.
We used statistical approaches allowing for non-linearity to determine associations of prenatal exposures of perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) with lipid concentrations.
PFAAs were measured in serum from pregnant women collected in 1991-1992 at enrollment in the Avon Longitudinal Study of Parents and Children and lipids in serum from their daughters at ages 7 (n=111) and 15 (n=88). The associations of PFAAs with lipids were first explored by cubic splines, followed by piecewise linear regressions by tertiles to obtain regression coefficients (β) and their 95% confidence limits (95% CL) (in mg/dL per 1ng/mL).
At age 7, total cholesterol was positively associated with prenatal PFOA concentrations in the lower tertile (β=15.01; 95% CL=2.34, 27.69) but not with PFOA concentrations in the middle (β=-3.63; 95% CL=-17.43, 10.16) and upper (β=-1.58; 95% CL=-4.58, 1.42) tertiles. At age 15, a similar pattern was noted as well. Positive associations between LDL-C and prenatal PFOA concentration in the lower tertile were observed in daughters at ages 7 (β=14.91; 95% CL=3.53, 28.12) and 15 (β=13.93; 95% CL=0.60, 27.26). LDL-C was not associated with PFOA concentrations in the middle or upper tertile at any age. Neither HDL-C nor triglycerides was associated with prenatal PFOA exposure. Non-linear patterns of association of total cholesterol and LDL-C with prenatal PFOS were less consistently noted.
Exposure to low levels of PFOA during prenatal development may alter lipid metabolism later in life. Given the small sample size further replication of the association in large independent cohorts is important.
在一些横断面流行病学研究中，血清中全氟烷基酸（PFAAs）浓度与脂质之间的关联形状表明存在非线性偏离。
我们使用允许非线性的统计方法来确定产前暴露于全氟辛烷磺酸（PFOS）和全氟辛酸（PFOA）与脂质浓度的关联。
在 1991-1992 年招募参加雅芳纵向父母与子女研究的孕妇血清中测量了 PFAAs，在其女儿 7 岁（n=111）和 15 岁（n=88）时测量了血清中的脂质。首先通过三次样条探索 PFAAs 与脂质的关联，然后按 tertiles 进行分段线性回归，以获得回归系数（β）及其 95%置信区间（95%CL）（每 1ng/mL 增加 1mg/dL）。
在 7 岁时，总胆固醇与低 tertile 产前 PFOA 浓度呈正相关（β=15.01；95%CL=2.34，27.69），但与中间（β=-3.63；95%CL=-17.43，10.16）和高 tertile（β=-1.58；95%CL=-4.58，1.42）PFOA 浓度无关。在 15 岁时，也观察到了类似的模式。在 7 岁（β=14.91；95%CL=3.53，28.12）和 15 岁（β=13.93；95%CL=0.60，27.26）的女儿中，LDL-C 与低 tertile 产前 PFOA 浓度之间存在正相关。在任何年龄，LDL-C 均与中间或高 tertile 的 PFOA 浓度无关。HDL-C 和甘油三酯均与产前 PFOA 暴露无关。总胆固醇和 LDL-C 与产前 PFOS 关联的非线性模式则不太一致。
在胎儿发育过程中暴露于低水平的 PFOA 可能会改变生命后期的脂质代谢。鉴于样本量较小，在大型独立队列中进一步复制该关联非常重要。
