Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Medicon Village (402A), Scheelevägen 8, 223 81, Lund, Sweden.
Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
Environ Health. 2020 Jul 8;19(1):80. doi: 10.1186/s12940-020-00626-6.
Epidemiological associations between maternal concentrations of perfluoroalkyl substances (PFAS) and birth weight are inconsistent. There is concern that studies based on samples collected in late pregnancy may be confounded by kidney function but studies of the relation between pregnancy-induced changes in PFAS and kidney function are lacking. Our aims were to investigate changes in serum concentrations of perfluorononanoic acid (PFNA), perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS) and perfluorohexane sulfonate (PFHxS) from early to late pregnancy and to explore relations to changes in glomerular filtration rate (GFR) and glomerular pore size.
We conducted the study in a cohort of 73 pregnancies of normal-weight Swedish women without gestational diabetes and preeclampsia, enrolled 2009-2014. Blood was collected in median weeks 11 and 36, respectively, and analysed PFAS using liquid chromatography-tandem-mass-spectrometry. We estimated GFR based on creatinine and cystatin C and used the ratio eGFR/eGFR to indicate glomerular pore size. We used Wilcoxon signed-rank test to compare early and late measures and partial Spearman rank correlations to explore relations between changes in PFAS and kidney function.
Median concentrations of PFNA, PFOA and PFOS decreased by 15-21% but changes were uncorrelated to changes in kidney function (partial R = - 0.06-0.11). The observed increase in median PFHxS concentration of 69% was likely an artefact of systematic measurement error caused by coeluting endogenous inferences.
Serum concentrations of PFNA, PFOA and PFOS decrease during pregnancy but the magnitudes of change are unrelated to parallel changes in eGFR and glomerular pore size, suggesting that changes in these indicators of kidney function are not important confounders in studies of PFAS and birth weight in pregnancies without gestational diabetes and preeclampsia.
母体中全氟烷基物质 (PFAS) 浓度与出生体重之间的流行病学关联并不一致。有人担心，基于妊娠晚期采集样本的研究可能会受到肾功能的影响，但目前缺乏关于妊娠期间 PFAS 变化与肾功能关系的研究。我们的目的是研究正常体重、无妊娠糖尿病和子痫前期的瑞典孕妇在妊娠早期至晚期血清中全氟壬酸 (PFNA)、全氟辛酸 (PFOA)、全氟辛烷磺酸 (PFOS) 和全氟己烷磺酸 (PFHxS) 浓度的变化，并探讨其与肾小球滤过率 (GFR) 和肾小球孔径变化的关系。
我们在 2009 年至 2014 年间招募了 73 名正常体重、无妊娠糖尿病和子痫前期的瑞典孕妇，分别在妊娠中期（第 11 周）和妊娠晚期（第 36 周）采集血样，使用液相色谱-串联质谱法分析 PFAS。我们根据肌酐和胱抑素 C 估计 GFR，并使用 eGFR/eGFR 比值表示肾小球孔径。我们使用 Wilcoxon 符号秩检验比较早期和晚期的测量值，使用偏 Spearman 秩相关分析来探讨 PFAS 变化与肾功能之间的关系。
PFNA、PFOA 和 PFOS 的中位数浓度分别下降了 15-21%，但与肾功能变化无关（偏相关系数为-0.06 至-0.11）。PFHxS 浓度中位数增加了 69%，这可能是由于同系物内源性物质共洗脱引起的系统测量误差所致。
PFNA、PFOA 和 PFOS 的血清浓度在妊娠期间下降，但变化幅度与 eGFR 和肾小球孔径的平行变化无关，这表明在无妊娠糖尿病和子痫前期的妊娠中，这些肾功能指标的变化不是 PFAS 与出生体重研究的重要混杂因素。
