Brosset Eloïse, Ngueta Gerard
Université Clermont Auvergne, Clermont Auvergne INP, CNRS, Institut Pascal, F-63000, Clermont-Ferrand, France; Department of Community Health Sciences, Faculty of Medicine & Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada.
CHU de Sherbrooke Research Center, Sherbrooke, Québec, Canada; Department of Community Health Sciences, Faculty of Medicine & Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada.
Environ Res. 2023 Jan 1;216(Pt 3):114697. doi: 10.1016/j.envres.2022.114697. Epub 2022 Nov 2.
Perfluoroalkyl substances (PFAS) have been associated with impaired glucose homeostasis. We aimed to examine associations of serum concentrations of PFAS with poor glycemic control (PGC) in US adults aged ≥65 years with type 2 diabetes mellitus (T2DM).
We abstracted data from the 1999 to 2018 NHANES examination. In main analyses, we defined PGC as glycated haemoglobin A1C ≥ 8.0% in adults aged ≥75 years and A1C ≥ 7.0% (in main analyses) or A1C ≥ 7.5% (in sensitivity analyses) in those aged 65-74 years. We considered PFAS detected in >80% of the US population: perfluorodecanoic acid (PFDeA), perfluorononanoic acid (PFNA), perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), and perfluorohexane sulfonic acid (PFHxS). We estimated the adjusted odds ratio (aOR) and 95% confidence intervals (95% CI) of PGC across quartiles of PFAS concentrations using generalized linear mixed models, with the logit link.
Of the 4575 adults included, 42.2% were ≥75 years of age and men represented 53.2%. Compared to adults in the bottom quartile, the odds of PGC was lower in the third quartile of PFDeA (aOR = 0.46, 95% CI: 0.29-0.77; P = 0.0026) and PFHxS (aOR = 0.56, 95% CI: 0.32-0.96; P = 0.0368), the second quartile of PFNA (aOR = 0.41, 95% CI: 0.23-0.71), the upper quartile of PFOA (aOR = 0.29, 95% CI: 0.12-0.73; P = 0.0017), and higher in the second quartile of ΣPFAS (aOR = 1.85, 95% CI: 1.16-2.95; P = 0.0102). In sensitivity analyses, likelihood for PGC was higher in the upper quartile of PFNA (aOR = 2.30, 95% CI: 1.25-4.21; P = 0.0071) and PFHxS (aOR = 2.87, 95% CI: 1.56-5.30; P = 0.0007), the second quartile of PFOS (aOR = 2.81, 95% CI: 1.11-7.14; P = 0.0297), PFHxS (aOR = 1.90, 95% CI: 1.09-3.32; P = 0.0240) and ΣPFAS (aOR = 2.29, 95% CI: 1.40-3.77; P = 0.0010).
In US adults aged ≥65 years with known T2DM, PGC is more likely to be observed in those with high serum levels of PFNA and PFHxS (independent of sex) and PFDeA (in men), after controlling for confounders.
全氟烷基物质（PFAS）与葡萄糖稳态受损有关。我们旨在研究美国≥65岁2型糖尿病（T2DM）成年人中PFAS血清浓度与血糖控制不佳（PGC）之间的关联。
我们从1999年至2018年的美国国家健康与营养检查调查（NHANES）中提取数据。在主要分析中，我们将PGC定义为≥75岁成年人糖化血红蛋白A1C≥8.0%，65 - 74岁成年人糖化血红蛋白A1C≥7.0%（主要分析）或≥7.5%（敏感性分析）。我们考虑了在美国人群中检测率>80%的PFAS：全氟癸酸（PFDeA）、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）。我们使用广义线性混合模型和logit链接估计PFAS浓度四分位数间PGC的调整优势比（aOR）和95%置信区间（95%CI）。
纳入的4575名成年人中，42.2%年龄≥75岁，男性占53.2%。与处于最低四分位数的成年人相比，PFDeA（aOR = 0.46，95%CI：0.29 - 0.77；P = 0.0026）和PFHxS（aOR = 0.56，95%CI：0.32 - 0.96；P = 0.0368）的第三四分位数、PFNA的第二四分位数（aOR = 0.41，95%CI：0.23 - 0.71）、PFOA的最高四分位数（aOR = 0.29，95%CI：0.12 - 0.73；P = 0.0017）时PGC的几率较低，而ΣPFAS的第二四分位数时PGC的几率较高（aOR = 1.85，95%CI：1.16 - 2.95；P = 0.0102）。在敏感性分析中，PFNA（aOR = 2.30，95%CI：1.25 - 4.21；P = 0.0071）和PFHxS（aOR = 2.87，95%CI：1.56 - 5.30；P = 0.0007）的最高四分位数、PFOS（aOR = 2.81，95%CI：1.11 - 7.14；P = 0.0297）、PFHxS（aOR = 1.90，95%CI：1.09 - 3.32；P = 0.0240）和ΣPFAS（aOR = 2.29，95%CI：1.40 - 3.77；P = 0.0010）的第二四分位数时PGC的可能性较高。
在已知患有T2DM的美国≥65岁成年人中，在控制混杂因素后，血清PFNA和PFHxS水平高（与性别无关）以及PFDeA水平高（男性）的人群中更易观察到PGC。
