Khan Durdana, Franks Stephen, Wang Zhilin, Miles Angela, Hu Howard, Malin Ashley J
College of Public Health and Health Professions, University of Florida, Gainesville, FL 32611, USA.
College of Medicine, University of Florida, Gainesville, FL 32610, USA.
Nutrients. 2025 Jan 16;17(2):309. doi: 10.3390/nu17020309.
BACKGROUND/OBJECTIVES: Urinary fluoride (UF) is the most well-established biomarker for fluoride exposure, and understanding its distribution can inform risk assessment for potential adverse systemic health effects. To our knowledge, this study is the first to report distributions of UF among youth according to sociodemographic factors in a nationally representative United States (US) sample.
The study included 1191 children aged 6-11 years and 1217 adolescents aged 12-19 years from the National Health and Nutrition Examination Survey (NHANES) 2015-2016. We examined UF according to sociodemographic variables as well as Spearman correlations between UF and plasma fluoride. Survey-weighted quantile regression examined associations between tap water fluoride and UF levels adjusted for covariates.
The average age of participants was 12.5 years. The median (IQR) UF and water fluoride concentrations were 0.52 (0.50) mg/L and 0.39 (0.54) mg/L, respectively. Children had higher UF levels than adolescents and males had higher UF levels than females. UF differed according to race/ethnicity among both children and adolescents. Specifically, non-Hispanic Black youth tended to have higher UF levels than all participants except for those classified as other race/multiracial. UF and plasma fluoride were moderately correlated for children and adolescents. Higher water fluoride levels were associated with higher UF levels, and the magnitudes of association were larger at higher quantiles of UF (β = 0.14, < 0.001; β = 0.20, < 0.001 at the 25th and 50th quantiles, respectively). The magnitude of association between water fluoride and UF was the largest for non-Hispanic Black participants (predictive margin = 0.3, < 0.001).
Non-Hispanic Black youth in the US may have greater fluoride exposure and receive more of their fluoride intake from tap water than youth of other races/ethnicities. Factors contributing to potential racial/ethnic disparities in fluoride exposure within the US warrant further investigation so that they can be mitigated to reduce the potential for harm.
背景/目的：尿氟是最成熟的氟暴露生物标志物，了解其分布情况有助于对潜在的全身性健康不良影响进行风险评估。据我们所知，本研究首次在美国具有全国代表性的样本中，根据社会人口学因素报告青少年尿氟的分布情况。
该研究纳入了2015 - 2016年美国国家健康与营养检查调查（NHANES）中的1191名6 - 11岁儿童和1217名12 - 19岁青少年。我们根据社会人口学变量检查尿氟情况，并分析尿氟与血浆氟之间的斯皮尔曼相关性。采用调查加权分位数回归分析经协变量调整后自来水氟与尿氟水平之间的关联。
参与者的平均年龄为12.5岁。尿氟和水氟浓度的中位数（四分位间距）分别为0.52（0.50）mg/L和0.39（0.54）mg/L。儿童的尿氟水平高于青少年，男性的尿氟水平高于女性。儿童和青少年的尿氟水平因种族/族裔而异。具体而言，非西班牙裔黑人青少年的尿氟水平往往高于所有参与者，除了那些被归类为其他种族/多种族的参与者。儿童和青少年的尿氟与血浆氟呈中度相关。较高的水氟水平与较高的尿氟水平相关，且在尿氟较高分位数时关联强度更大（在第25和50分位数时，β分别为0.14，P < 0.001；β为0.20，P < 0.001）。对于非西班牙裔黑人参与者，水氟与尿氟之间的关联强度最大（预测边际 = 0.3，P < 0.001）。
在美国，非西班牙裔黑人青少年可能比其他种族/族裔的青少年接触到更多的氟，且其氟摄入量更多来自自来水。导致美国氟暴露潜在种族/族裔差异的因素值得进一步研究，以便减轻这些差异，降低潜在危害。
