美国成年人中全氟和多氟烷基物质暴露与肝损伤之间的关联。
Association between exposure to per- and polyfluoroalkyl substance and liver injury in American adults.
作者信息
Yan Yuqian, Zhang Lu, Xu Xin, Lu Jing, Ge Xinyuan, Liu Maojie, Yang Juan, Tian Chan, Ge Zijun, Yu Chengxiao, Guo Wen, Ye Chunyan, Zhang Qun
机构信息
Health Management Center, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
Department of Epidemiology, China International Cooperation Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China.
出版信息
J Biomed Res. 2024 May 25;38(6):1-12. doi: 10.7555/JBR.38.20240018.
Epidemiological data is scarce regarding the association between exposure to mixtures of per- and polyfluoroalkyl substances (PFASs) and liver injury in the general populace. The current research used data from the National Health and Nutrition Examination Survey (2009-2018). The PFAS exposure levels were defined by the serum concentrations of PFASs with > 70% detection in samples, namely perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorohexane sulfonic acid (PFHxS), perfluorodecanoic acid (PFDeA), and perfluorooctane sulfonic acid (PFOS). Liver injury was assessed from two aspects: first, the degree of liver inflammation was determined based on serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamyltransferase (GGT), and total bilirubin (TBIL) levels; second, the degree of liver fibrosis was determined based on fibrosis-4 (FIB-4) index. We assessed the associations between individual or total PFAS exposure and these outcomes using multivariable linear regression models and logistic regression models, restricted cubic splines, and weighted quantile sum regression. Among the samples of 7484 American adults, the median concentration of PFOS was the highest, followed by PFOA and PFHxS. Using multivariable linear regression, a positive correlation was observed between all PFASs and liver enzymes such as ALT, AST, and TBIL. Additionally, the weighted quantile sum model indicated an overall positive association between the five PFASs and liver injury indicators. For liver function biomarkers and liver fibrosis, PFNA and PFOS were the most heavily weighting chemicals, respectively. Our findings provide new epidemiological evidence indicating a potential association between PFAS exposure and adverse effects on liver injury biomarkers, highlighting the potentially harmful effects of PFAS exposure on liver health.
关于普通人群中全氟和多氟烷基物质(PFASs)混合物暴露与肝损伤之间的关联,流行病学数据匮乏。当前研究使用了美国国家健康与营养检查调查(2009 - 2018年)的数据。PFAS暴露水平由样本中检测率>70%的PFASs血清浓度定义,即全氟辛酸(PFOA)、全氟壬酸(PFNA)、全氟己烷磺酸(PFHxS)、全氟癸酸(PFDeA)和全氟辛烷磺酸(PFOS)。肝损伤从两个方面进行评估:第一,根据血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、谷氨酰转移酶(GGT)和总胆红素(TBIL)水平确定肝脏炎症程度;第二,根据纤维化-4(FIB-4)指数确定肝纤维化程度。我们使用多变量线性回归模型、逻辑回归模型、受限立方样条和加权分位数和回归评估个体或总PFAS暴露与这些结果之间的关联。在7484名美国成年人的样本中,PFOS的中位数浓度最高,其次是PFOA和PFHxS。使用多变量线性回归,观察到所有PFASs与ALT、AST和TBIL等肝酶之间呈正相关。此外,加权分位数和模型表明五种PFASs与肝损伤指标之间总体呈正相关。对于肝功能生物标志物和肝纤维化,PFNA和PFOS分别是权重最大的化学物质。我们的研究结果提供了新的流行病学证据,表明PFAS暴露与肝损伤生物标志物的不良反应之间存在潜在关联,突出了PFAS暴露对肝脏健康的潜在有害影响。