Dept. Environmental Health, Rollins School of Public Health, Emory University, United States.
Division of Pediatric Gastroenterology, Dept of Pediatrics, Emory School of Medicine and Children's Healthcare of Atlanta, United States.
Environ Res. 2018 Aug;165:317-321. doi: 10.1016/j.envres.2018.05.007. Epub 2018 May 16.
PFOA (perfluoroctanoic acid) is a perfluoroalkyl substance (PFAS). Although use in the US has been phased out, PFOA persists indefinitely in the environment, and is present in the serum of virtually all people in industrialized countries. Approximately 6 million Americans drink water comtaminated with PFOA above EPA-recommended levels. In a previous cohort study (n = 32,000), we found a strong positive exposure-response relation between PFOA serum levels and subsequent ulcerative colitis (UC) in a high-exposed population from the mid-Ohio valley, but no association with Crohn's disease. In the present study we aimed to determine if UC cases had higher levels of PFOA than did controls or Crohn's disease patients.
We measured PFOA and three other PFAS in the serum of 114 UC patients, 60 Crohn's disease patients, and 75 controls, within a year of diagnosis. We conducted regression analyses to assess the association of the PFAS with diagnosis.
The mean age of subjects was 17 years. The mean year of diagnosis was 2007. Mean levels of PFAS were similar to US levels. Mean log PFOA level in UC patients was 38% higher (p = 0.01) than the combined group of Crohn's disease and controls. In contrast, the three other PFASs were significantly higher in controls and Crohn's patients than UC patients. The odds ratio for UC per one unit of log PFOA was 1.60 (95% CI 1.14-2.24), but the trend by quintiles was not monotonic (1, 0.84, 40.98, 33.36, 2.86).
We found higher serum PFOA in UC cases compared to Crohn's disease patients or controls, in contrast to other PFAS. Our research is limited by not knowing if the elevated PFOA preceded UC in this population.
全氟辛酸（PFOA）是一种全氟烷基物质（PFAS）。尽管美国已逐步停止使用，但 PFOA 在环境中会无限期存在，并且在工业化国家几乎所有人的血清中都存在。大约 600 万美国人饮用的水中 PFOA 含量超过了 EPA 推荐的水平。在之前的队列研究（n=32000）中，我们在来自俄亥俄河谷中部的高暴露人群中发现，PFOA 血清水平与随后的溃疡性结肠炎（UC）之间存在很强的正暴露反应关系，但与克罗恩病无关。在本研究中，我们旨在确定 UC 病例的 PFOA 水平是否高于对照组或克罗恩病患者。
我们在诊断后一年内测量了 114 例 UC 患者、60 例克罗恩病患者和 75 名对照者的血清中的 PFOA 和其他三种 PFAS。我们进行了回归分析，以评估 PFAS 与诊断的关联。
受试者的平均年龄为 17 岁。诊断的平均年份是 2007 年。PFAS 的平均水平与美国的水平相似。UC 患者的平均 PFOA 对数水平比对照组和克罗恩病患者的总和高 38%（p=0.01）。相比之下，其他三种 PFAS 在对照组和克罗恩病患者中明显高于 UC 患者。PFOA 每增加一个单位，UC 的比值比为 1.60（95%CI 1.14-2.24），但五分位数的趋势不是单调递增的（1、0.84、40.98、33.36、2.86）。
与其他 PFAS 相比，我们发现 UC 病例的血清 PFOA 水平高于克罗恩病患者或对照组。我们的研究受到限制，因为不知道在该人群中，升高的 PFOA 是否先于 UC。
