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接触世界贸易中心灾难的青少年及匹配对照组中的血清全氟烷基物质与心脏代谢后果

Serum perfluoroalkyl substances and cardiometabolic consequences in adolescents exposed to the World Trade Center disaster and a matched comparison group.

作者信息

Koshy Tony T, Attina Teresa M, Ghassabian Akhgar, Gilbert Joseph, Burdine Lauren K, Marmor Michael, Honda Masato, Chu Dinh Binh, Han Xiaoxia, Shao Yongzhao, Kannan Kurunthachalam, Urbina Elaine M, Trasande Leonardo

机构信息

Pediatrics, New York University School of Medicine, New York, NY, USA.

Pediatrics, New York University School of Medicine, New York, NY, USA; Environmental Medicine, New York University School of Medicine, New York, NY, USA.

出版信息

Environ Int. 2017 Dec;109:128-135. doi: 10.1016/j.envint.2017.08.003. Epub 2017 Sep 8.

Abstract

BACKGROUND

Large amounts of various chemical contaminants, including perfluoroalkyl substances (PFASs), were released at the time of the World Trade Center (WTC) disaster. Thousands of children who lived and/or attended school near the disaster site were exposed to these substances but few studies have examined the possible consequences related to these exposures.

OBJECTIVES

To examine the relationship of PFASs serum levels with cardiometabolic profile in children and adolescents enrolled in the World Trade Center Health Registry (WTCHR) and a matched comparison group.

METHODS

We evaluated WTCHR enrollees who resided in New York City and were born between September 11, 1993 and September 10, 2001, and a matched comparison group consisting of individuals who were ineligible for WTCHR participation upon distance of their home, school or work from the WTC and lack of participation in rescue and recovery activities. Matching was based on date of birth, sex, race, ethnicity, and income. We assessed exposure to PFASs, as measured by serum levels and association with cardiometabolic profile as measured by arterial wall stiffness, body mass index, insulin resistance, fasting total cholesterol, HDL, LDL and triglycerides.

RESULTS

A total of 402 participants completed the study and serum samples were analyzed from 308 participants, 123 in the WTCHR group and 185 in the comparison group. In multivariable regression analysis, after adjusting for relevant confounders, we observed a significant, positive association of perfluorooctanoic acid (PFOA) with triglycerides (beta coefficient=0.14, 95% CI: 0.02, 0.27, 15.1% change), total cholesterol (beta coefficient=0.09, 95% CI: 0.04, 0.14, 9.2% change), and LDL cholesterol (beta coefficient=0.11, 95% CI: 0.03, 0.19, 11.5% change). Perfluorohexanesulfonic acid levels were associated with decreased insulin resistance (beta coefficient=-0.09, 95% CI: -0.18, -0.003, -8.6% change); PFOA and perfluorononanoic acid were associated with increased brachial artery distensibility.

CONCLUSIONS

This research adds to our knowledge of the physical health impacts in a large group of children exposed to the WTC disaster. Abnormal lipid levels in young adults might be an early marker of atherosclerosis and cardiovascular diseases and our findings highlight the importance of conducting longitudinal studies in this population.

摘要

背景

世界贸易中心(WTC)灾难发生时,大量包括全氟烷基物质(PFASs)在内的各种化学污染物被释放。成千上万在灾难现场附近居住和/或上学的儿童接触到了这些物质,但很少有研究探讨这些接触可能产生的后果。

目的

研究世界贸易中心健康登记处(WTCHR)登记的儿童和青少年以及匹配的对照组中PFASs血清水平与心脏代谢状况之间的关系。

方法

我们评估了居住在纽约市、于1993年9月11日至2001年9月10日出生的WTCHR登记者,以及一个匹配的对照组,该对照组由因住所、学校或工作地点距离世贸中心较远且未参与救援和恢复活动而无资格参与WTCHR的个体组成。匹配基于出生日期、性别、种族、民族和收入。我们评估了PFASs的暴露情况,通过血清水平来衡量,并评估其与心脏代谢状况的关联,心脏代谢状况通过动脉壁硬度、体重指数、胰岛素抵抗、空腹总胆固醇、高密度脂蛋白、低密度脂蛋白和甘油三酯来衡量。

结果

共有402名参与者完成了研究,对308名参与者的血清样本进行了分析,其中WTCHR组123名,对照组185名。在多变量回归分析中,在调整了相关混杂因素后,我们观察到全氟辛酸(PFOA)与甘油三酯(β系数 = 0.14,95%可信区间:0.02,0.27,变化15.1%)、总胆固醇(β系数 = 0.09,95%可信区间:0.04,0.14,变化9.2%)和低密度脂蛋白胆固醇(β系数 = 0.11,95%可信区间:0.03,0.19,变化11.5%)之间存在显著的正相关。全氟己烷磺酸水平与胰岛素抵抗降低相关(β系数 = -0.09,95%可信区间:-0.18,-0.003,变化-8.6%);PFOA和全氟壬酸与肱动脉扩张性增加相关。

结论

这项研究增加了我们对一大群暴露于世贸中心灾难的儿童身体健康影响的认识。年轻人血脂异常可能是动脉粥样硬化和心血管疾病的早期标志物,我们的研究结果凸显了对这一人群进行纵向研究的重要性。

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