Institute of Health Sciences, Korea University, Seoul, South Korea; School of Health and Environmental Science, Korea University, Seoul, South Korea; Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea.
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Chemosphere. 2024 Sep;364:143167. doi: 10.1016/j.chemosphere.2024.143167. Epub 2024 Aug 22.
Despite various health effects of per- and polyfluoroalkyl substances (PFAS) exposure, the association between PFAS exposure and age-related macular degeneration (AMD) has not been investigated. We aimed to assess associations of PFAS exposure with AMD, using data from 1722 U.S. adults aged 40 years or more participating in the National Health and Nutrition Examination Survey 2005-2008 with complete data on PFAS measurement, AMD diagnosis, and covariates. Serum concentrations of PFAS, including perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorohexane sulfonic acid (PFHxS), and perfluorooctane sulfonic acid (PFOS), were measured. An overall PFAS burden score was calculated using item response theory scoring. Individual PFAS concentration and overall PFAS burden score were categorized into low (reference), medium, and high groups. Diagnosis of AMD was based on retinal image examination. Any AMD was defined as the presence of early or late AMD. Survey-weighted logistic regression adjusted for potential confounders was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for presence of AMD according to PFAS exposure. Overall, 132 (6.5%) individuals were diagnosed as any AMD, including 115 (5.7%) individuals with early AMD. A significant dose-response association was observed between serum PFOS concentration and any AMD (p-trend = 0.03), with a significant OR of 1.99 (95% CI: 1.05, 3.79) for the high group compared to the reference. Overall PFAS burden showed a non-monotonic association with any AMD, with a significant OR of 2.18 (95% CI: 1.18, 4.04) for the medium. Inverted U-shaped associations were observed by restricted cubic spline analyses. Also, early AMD showed similar patterns in PFOS and overall PFAS burden and additionally an inverted U-shape association in PFNA. Our findings suggest that exposure to PFAS estimated by serum PFOS and PFNA as well as overall PFAS burden might be a risk factor for AMD in middle-aged and older population.
尽管全氟和多氟烷基物质（PFAS）暴露对健康有多种影响，但 PFAS 暴露与年龄相关性黄斑变性（AMD）之间的关联尚未得到研究。我们旨在使用 2005-2008 年美国全国健康和营养调查中年龄在 40 岁或以上的 1722 名美国成年人的数据，评估 PFAS 暴露与 AMD 的关联，这些数据包含 PFAS 测量、AMD 诊断和协变量的完整信息。测量了血清中 PFAS 的浓度，包括全氟辛酸（PFOA）、全氟壬酸（PFNA）、全氟己烷磺酸（PFHxS）和全氟辛烷磺酸（PFOS）。使用项目反应理论评分计算了总体 PFAS 负担评分。个体 PFAS 浓度和总体 PFAS 负担评分分为低（参考）、中、高组。AMD 的诊断基于视网膜图像检查。任何 AMD 定义为早期或晚期 AMD 的存在。使用经过潜在混杂因素调整的调查加权逻辑回归计算了根据 PFAS 暴露存在 AMD 的比值比（OR）和 95%置信区间（CI）。总体而言，有 132 人（6.5%）被诊断为任何 AMD，其中 115 人（5.7%）为早期 AMD。血清 PFOS 浓度与任何 AMD 之间存在显著的剂量反应关系（p 趋势=0.03），与参考组相比，高组的 OR 为 1.99（95%CI：1.05，3.79）。总体 PFAS 负担与任何 AMD 呈非单调关联，中组的 OR 为 2.18（95%CI：1.18，4.04）。受限立方样条分析显示出倒 U 形关联。此外，早期 AMD 在 PFOS 和总体 PFAS 负担中表现出相似的模式，并且在 PFNA 中还表现出倒 U 形关联。我们的研究结果表明，血清 PFOS 和 PFNA 以及总体 PFAS 负担估计的 PFAS 暴露可能是中年及以上人群 AMD 的一个危险因素。
