Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China.
Center for Environmental Protection, Anyuan, 342100, China.
Ecotoxicol Environ Saf. 2020 Jun 15;196:110589. doi: 10.1016/j.ecoenv.2020.110589. Epub 2020 Apr 8.
The nonlinear associations of serum perfluoroalkyl acids (PFAAs) with hypertension and blood pressure have not been addressed. Cross-sectional data from 6967 adults (age ≥ 20 years) from the 2003-2012 National Health and Nutrition Examination Survey (NHANES) were analyzed. Hypertension was defined as an average systolic blood pressure above 140 mmHg, an average diastolic blood pressure above 90 mmHg or self-reported use of prescribed medicine for diagnosed hypertension. After multivariable adjustment, compared with the lowest tertile, the odds ratios (ORs) with 95% confidence intervals (CIs) of hypertension for the highest tertile of perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS) and perfluorononanoic acid (PFNA) were 1.32 (1.13, 1.54), 1.14 (0.97, 1.34), 1.16 (0.99, 1.36) and 1.18 (1.01, 1.37), respectively. PFOA and PFNA displayed a J-shaped relationship with the prevalence of hypertension. Furthermore, threshold effect analysis showed that the inflection point of PFOA was 1.80 ng/ml. Each 10-fold change in PFOA exhibited a 44% decrease (OR 0.56, 95%CI (0.32, 0.99)) in the odds of hypertension on the left side of the inflection point, and an 85% increase (OR 1.85, 95%CI (1.34, 2.54)) on the right side of the inflection point. Threshold effect analysis also indicated that the inflection point of PFNA was 0.53 ng/ml. Each 10-fold change in PFNA exhibited a 60% decrease (OR 0.40, 95%CI (0.18, 0.85)) in the odds of hypertension on the left side of the inflection point, and an 85% increase (OR 1.64, 95%CI (1.25, 2.14)) on the right side of the inflection point. These cross-sectional data showed a J-shaped association between perfluoroalkyl acids and hypertension.
血清全氟烷基酸（PFAAs）与高血压和血压的非线性关联尚未得到解决。对来自 2003-2012 年全国健康和营养检查调查（NHANES）的 6967 名成年人（年龄≥20 岁）的横断面数据进行了分析。高血压定义为平均收缩压高于 140mmHg，平均舒张压高于 90mmHg 或报告使用处方药治疗确诊的高血压。经过多变量调整后，与最低三分位相比，全氟辛酸（PFOA）、全氟辛烷磺酸（PFOS）、全氟己烷磺酸（PFHxS）和全氟壬酸（PFNA）最高三分位的高血压比值比（OR）及其 95%置信区间（CI）分别为 1.32（1.13，1.54）、1.14（0.97，1.34）、1.16（0.99，1.36）和 1.18（1.01，1.37）。PFOA 和 PFNA 与高血压患病率呈 J 型关系。此外，阈效应分析显示 PFOA 的拐点为 1.80ng/ml。在拐点左侧，PFOA 每 10 倍变化使高血压的几率降低 44%（OR 0.56，95%CI（0.32，0.99）），而在拐点右侧，高血压的几率增加 85%（OR 1.85，95%CI（1.34，2.54））。阈效应分析还表明 PFNA 的拐点为 0.53ng/ml。PFNA 每 10 倍变化使高血压的几率降低 60%（OR 0.40，95%CI（0.18，0.85）），而在拐点右侧，高血压的几率增加 85%（OR 1.64，95%CI（1.25，2.14））。这些横断面数据显示全氟烷基酸与高血压之间存在 J 型关联。
