妇女血液中全氟烷基物质浓度与炎症性肠病风险：护士健康研究队列的巢式病例对照分析。
Plasma concentrations of perfluoroalkyl substances and risk of inflammatory bowel diseases in women: A nested case control analysis in the Nurses' Health Study cohorts.
机构信息
Clinical and Translational Epidemiology Unit, Massachusetts Hospital and Harvard Medical School, Boston, MA, USA; Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
出版信息
Environ Res. 2022 May 1;207:112222. doi: 10.1016/j.envres.2021.112222. Epub 2021 Oct 16.
BACKGROUND
Perfluoroalkyl substances (PFASs) are synthetic compounds used in a wide variety of industrial and consumer applications. An association between PFAS exposure and risk of ulcerative colitis (UC) has been reported in a highly exposed population. However, data are limited on risk of inflammatory bowel diseases (IBD) among individuals with background population levels of PFAS exposure.
OBJECTIVES
We set out to examine the association between plasma PFAS concentrations and risk of IBD among women in two population-based, prospective cohort studies in which pre-diagnostic blood specimens were available.
METHODS
We conducted a nested case-control study in the Nurses' Health Study and Nurses' Health Study II cohorts. We identified 73 participants with incident Crohn's disease (CD) and 80 participants with incident UC who had provided blood samples before diagnosis. Cases were matched 1:2 to IBD-free controls. Plasma concentrations of five major PFASs were measured by liquid chromatography and tandem mass spectrometry. We used conditional logistic models to estimated odds ratios for risk of IBD according to log-transformed PFAS concentrations, adjusting for potential confounders.
RESULTS
In multivariable models, we observed inverse associations between plasma concentrations of three PFASs and risk of CD (all P ≤ 0.012 for a standard deviation increase in logPFAS). The inverse association with CD was strongest for perfluorodecanoate, where, compared to the lowest tertile, the odds ratio (OR) for the highest tertile was 0.39 (95% confidence interval, 0.17-0.92). No associations were observed between PFAS concentrations and UC risk.
DISCUSSION
Our results do not support the hypothesis that elevated PFAS exposure is associated with higher risk of UC. Contrary to expectation, our data suggest that circulating concentrations of some PFASs may be inversely associated with CD development.
背景
全氟烷基物质（PFAS）是一种广泛应用于工业和消费品的合成化合物。在一个高度暴露的人群中，PFAS 暴露与溃疡性结肠炎（UC）风险之间存在关联。然而，在背景人群 PFAS 暴露水平下，PFAS 暴露与炎症性肠病（IBD）风险之间的关系数据有限。
目的
我们旨在研究两个基于人群的前瞻性队列研究中，血浆 PFAS 浓度与女性 IBD 风险之间的关系，这些研究中均有预先诊断的血样。
方法
我们在护士健康研究和护士健康研究 II 队列中进行了巢式病例对照研究。我们确定了 73 名患有新发克罗恩病（CD）的参与者和 80 名患有新发 UC 的参与者，他们在诊断前提供了血液样本。病例按 1:2 与 IBD 无病例相匹配。通过液相色谱-串联质谱法测量五种主要 PFAS 的血浆浓度。我们使用条件逻辑回归模型，根据 log 转换后的 PFAS 浓度，调整潜在混杂因素，估计 IBD 风险的比值比。
结果
在多变量模型中，我们观察到三种 PFAS 血浆浓度与 CD 风险呈负相关（所有 P 值均≤0.012，logPFAS 标准偏差增加）。与最低三分位相比，全氟癸酸的最高三分位的比值比（OR）为 0.39（95%置信区间，0.17-0.92），CD 的负相关最强。PFAS 浓度与 UC 风险之间没有关联。
讨论
我们的结果不支持 PFAS 暴露水平升高与 UC 风险增加相关的假设。与预期相反，我们的数据表明，一些 PFAS 的循环浓度可能与 CD 的发展呈负相关。
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