全氟烷基物质暴露与成年人甲状腺功能的关系：一项荟萃分析。
Association between perfluoroalkyl substances exposure and thyroid function in adults: A meta-analysis.
机构信息
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University College of Medicine, Seoul, Republic of Korea.
出版信息
PLoS One. 2018 May 10;13(5):e0197244. doi: 10.1371/journal.pone.0197244. eCollection 2018.
OBJECTIVE
Many people are exposed to perfluoroalkyl substances (PFASs) because these substances are widely used as industrial products. Although epidemiological studies suggest that PFASs can disrupt thyroid hormones, the association between PFAS exposure and thyroid function remains inconclusive. Therefore, we performed a comprehensive meta-analysis to investigate the association between PFASs exposure and thyroid hormones.
METHODS
We searched medical literature databases for articles on the association between PFASs-perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and perfluorohexane sulfonic acid (PFHxS)-and thyroid hormone levels in adults. Twelve articles were included in the meta-analysis, and the pooled z values were calculated with correlation or regression coefficients.
RESULTS
The blood PFOS concentration was positively correlated with free T4. The pooled z value was 0.05 (95% confidence interval (CI): 0.03, 0.08). PFOS was negatively correlated with total T4 and total T3 when excluding outlier studies. In a subgroup analysis stratified by mean PFOS concentration, PFOS was observed to be positively associated with free T4 and TSH and negatively associated with total T3 in the intermediate concentration group (8-16 ng/mL). PFOA concentration was negatively correlated with total T4 (z value, -0.06; 95% CI: -0.09, -0.03) after omitting one outlier study. PFHxS also showed a negative correlation with total T4 (z value, -0.04; 95% CI: -0.07, -0.01). A subgroup analysis of pregnant women showed that there was no association between PFASs and thyroid hormones.
CONCLUSIONS
Our meta-analysis suggests that PFASs are negatively associated with total T4, and their effect can be different depending on the PFAS concentration.
目的
许多人接触全氟烷基物质（PFAS），因为这些物质被广泛用作工业产品。尽管流行病学研究表明 PFAS 会干扰甲状腺激素，但 PFAS 暴露与甲状腺功能之间的关系仍不确定。因此，我们进行了一项综合荟萃分析，以调查 PFAS 暴露与甲状腺激素之间的关系。
方法
我们检索了医学文献数据库中关于成年人 PFAS（全氟辛烷磺酸（PFOS）、全氟辛酸（PFOA）和全氟己烷磺酸（PFHxS））与甲状腺激素水平之间关系的文章。有 12 篇文章纳入荟萃分析，用相关或回归系数计算合并 z 值。
结果
血液 PFOS 浓度与游离 T4 呈正相关。合并 z 值为 0.05（95%置信区间（CI）：0.03，0.08）。排除离群值研究后，PFOS 与总 T4 和总 T3 呈负相关。按平均 PFOS 浓度分层的亚组分析中，在中浓度组（8-16ng/ml）中，PFOS 与游离 T4 和 TSH 呈正相关，与总 T3 呈负相关。排除一个离群值研究后，PFOA 浓度与总 T4 呈负相关（z 值，-0.06；95%CI：-0.09，-0.03）。PFHxS 也与总 T4 呈负相关（z 值，-0.04；95%CI：-0.07，-0.01）。对孕妇的亚组分析表明，PFAS 与甲状腺激素之间没有关联。
结论
我们的荟萃分析表明，PFAS 与总 T4 呈负相关，其影响可能因 PFAS 浓度而异。
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