Department of Community Medicine, Mercer University School of Medicine, Macon, GA, USA.
Department of Mathematics and Computer Science, Fort Valley State University, Fort Valley, GA, USA.
Ecotoxicol Environ Saf. 2021 Jan 15;208:111670. doi: 10.1016/j.ecoenv.2020.111670. Epub 2020 Nov 20.
Exposure to excessive fluoride has been associated with a number of adverse health outcomes; however, there is a lack of evidence on the relation between fluoride exposure and serum uric acid levels, especially in human populations. The present study examined a potential relationship between fluoride exposure, measured as both plasma and water fluoride concentrations, and uric acid levels in an adolescent population. A nationally representative subsample of 1933 adolescents, aged 12-19 years, in the 2013-2016 National Health and Nutrition Examination Survey was analyzed for the association of fluoride concentrations with serum uric acid levels using multivariate general linear and logistic regression models, adjusting for potential confounders. Since uric acid levels change during development, hyperuricemia was defined in this study as over the mean plus one standard deviation for each sex and age group of adolescents. Of the study participants, 276 adolescents (weighted prevalence, 16.56%) had hyperuricemia. A significant and dose-dependent increase in prevalence of hyperuricemia was seen among the participants cross increasing quartiles of plasma fluoride (p-trend = 0.0017). After adjusting for potential confounders, we found that adolescents in the higher quartiles of plasma fluoride (≥0.32 µmol/L) and in the highest quartile of water fluoride (≥0.73 mg/L) had significantly increased odds of hyperuricemia compared with those in the lowest quartile. A 1.95-fold increased odds (95% CI: 1.37, 2.77) of hyperuricemia was also observed when analyzing plasma fluoride concentrations as continuous variable. A general linear model revealed that a 1 µmol/L increase in ln-plasma fluoride was associated with a 0.212 mg/dL (p < 0.0001) increased serum uric acid level. Furthermore, a positive relationship was observed between water and plasma fluoride concentrations (β = 0.1907; p < 0.0001). Our study demonstrates a potential relation between fluoride exposure and hyperuricemia in adolescents. Further studies are warranted to overcome the limitations of this study to examine the impact of long-term exposure to low levels of fluoride during development on hyperuricemia and its related health outcomes.
氟化物暴露与许多不良健康结果有关;然而，关于氟化物暴露与血清尿酸水平之间的关系，特别是在人类人群中，证据不足。本研究在青少年人群中，研究了氟化物暴露（以血浆和水氟浓度衡量）与尿酸水平之间的潜在关系。利用多元一般线性和逻辑回归模型，对 2013-2016 年全国健康和营养调查中的 1933 名 12-19 岁青少年的全国代表性亚样本进行了氟浓度与血清尿酸水平的关联分析，调整了潜在的混杂因素。由于尿酸水平在发育过程中会发生变化，因此本研究将高尿酸血症定义为每个性别和年龄组的青少年平均值加一个标准差以上。在研究参与者中，有 276 名青少年（加权患病率为 16.56%）患有高尿酸血症。随着血浆氟四分位（p 趋势=0.0017）的增加，高尿酸血症的患病率呈显著且剂量依赖性增加。在校正潜在混杂因素后，我们发现，与最低四分位组相比，血浆氟四分位较高（≥0.32 μmol/L）和水中氟四分位较高（≥0.73 mg/L）的青少年患高尿酸血症的几率显著增加。当分析血浆氟浓度作为连续变量时，高尿酸血症的几率也观察到增加了 1.95 倍（95%CI：1.37，2.77）。一般线性模型显示，ln-血浆氟增加 1 μmol/L，与血清尿酸水平增加 0.212 mg/dL（p<0.0001）相关。此外，还观察到水氟和血浆氟浓度之间存在正相关关系（β=0.1907;p<0.0001）。本研究表明，氟化物暴露与青少年高尿酸血症之间存在潜在关系。需要进一步的研究来克服本研究的局限性，以研究在发育过程中长期暴露于低水平氟化物对高尿酸血症及其相关健康结果的影响。
