全氟和多氟烷基物质暴露与肾功能之间的关联：一项人群研究。
Association between exposure to per- and polyfluoroalkyl substances and kidney function: a population study.
作者信息
Zhang Xue, Cao Yongping, Yang Xiaona, Ma Fei, Zhang Hengyang, Xiao Wenwen
机构信息
School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, China.
Eastern Theater Command Centers for Disease Control and Prevention, Nanjing, China.
出版信息
Front Med (Lausanne). 2025 Mar 26;12:1569031. doi: 10.3389/fmed.2025.1569031. eCollection 2025.
BACKGROUND
The relationship between per- and polyfluoroalkyl substances (PFAS) and kidney function markers remains uncertain.
METHODS
We used PFAS detection data from 5,947 adults in NHANES 2005-2012. We employed multivariable linear regression models to examine associations between PFAS and estimated glomerular filtration rate (eGFR), urine creatinine (UCR), urine albumin (UAL), and urine albumin/creatinine ratio (UACR). To capture non-linear trends, restricted cubic splines were applied. The WQS (weighted quantile sum) and Q-gcomp (quantile g computation) models were used for the mixture analysis. Subgroup analyses were conducted to explore potential interactions.
RESULTS
Perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), 2-(N-methyl-perfluorooctane sulfonamido) acetic acid (N-MEFOSAA), and perfluorononanoic acid (PFNA) were negatively related to eGFR ( = -2.04, 95% CI = -2.85, -1.23; = -0.97, 95% CI = -1.78, -0.16; = -1.50, 95% CI = -2.24, -0.76; = -0.49, 95% CI = -1.25, 0.27; = -0.68, 95% CI = -1.46, 0.10). PFOA and PFOS were positive associated with UCR ( = 10.61, 95% CI = -1.89, 23.11; = 12.98, 95% CI = 0.56, 25.41). PFOA, PFOS, PFHxS, PFNA, and PFUA were negatively related to UAL ( = -0.53, 95% CI = -0.73, -0.32; = -0.39, 95% CI = -0.59, -0.18; = -0.59, 95% CI = -0.78, -0.40; = -0.42, 95% CI = -0.65, -0.19; = -0.04, 95% CI = -0.22, 0.14). PFDA, PFOA, PFOS, PFHxS, and PFNA are significantly inversely associated with UACR ( = -0.01, 95% CI = -0.16, 0.14; = -0.52, 95% CI = -0.69, -0.35; = -0.50, 95% CI = -0.67, -0.33; = -0.49, 95% CI = -0.64, -0.33; = -0.27, 95% CI = -0.44, -0.10). Nonlinear relationships were found between PFAS and all kidney function indicators. Mixed PFAS exposure showed a negative association with eGFR, UAL and UACR, while showed a positive relationship with UCR. Interactions between PFASs and most subgroups were observed.
CONCLUSION
Our study revealed significant associations between PFAS exposure and various kidney function indicators. These findings provide an epidemiological perspective on how PFAS may lead to kidney dysfunction.
背景
全氟和多氟烷基物质（PFAS）与肾功能指标之间的关系仍不明确。
方法
我们使用了2005 - 2012年美国国家健康与营养检查调查（NHANES）中5947名成年人的PFAS检测数据。我们采用多变量线性回归模型来研究PFAS与估计肾小球滤过率（eGFR）、尿肌酐（UCR）、尿白蛋白（UAL）以及尿白蛋白/肌酐比值（UACR）之间的关联。为捕捉非线性趋势，应用了受限立方样条。采用加权分位数和（WQS）模型与分位数g计算（Q - gcomp）模型进行混合分析。进行亚组分析以探索潜在的相互作用。
结果
全氟辛酸（PFOA）、全氟辛烷磺酸（PFOS）、全氟己烷磺酸（PFHxS）、2 -（N - 甲基 - 全氟辛烷磺酰胺基）乙酸（N - MEFOSAA）以及全氟壬酸（PFNA）与eGFR呈负相关（β = -2.04，95%置信区间[CI] = -2.85，-1.23；β = -0.97，95% CI = -1.78，-0.16；β = -1.50，95% CI = -2.24，-0.76；β = -0.49，95% CI = -1.25，0.27；β = -0.68，95% CI = -1.46，0.10）。PFOA和PFOS与UCR呈正相关（β = 10.61，95% CI = -1.89，23.11；β = 12.98，95% CI = 0.56，25.41）。PFOA、PFOS、PFHxS、PFNA以及全氟十一酸（PFUA）与UAL呈负相关（β = -0.53，95% CI = -0.73, -0.32；β = -0.39，95% CI = -0.59，-0.18；β = -0.59，95% CI = -0.78，-0.40；β = -0.42，95% CI = -0.65，-0.19；β = -0.04，95% CI = -0.22，0.14）。全氟癸二酸（PFDA）、PFOA、PFOS、PFHxS以及PFNA与UACR呈显著负相关（β = -0.01，95% CI = -0.16，0.14；β = -0.52，95% CI = -0.69，- \n0.35；β = -0.50，95% CI = -0.67，-0.33；β = -0.49，95% CI = -0.64，-0.33；β = -0.27，95% CI = -0.44，-0.10）。发现PFAS与所有肾功能指标之间存在非线性关系。混合PFAS暴露与eGFR、UAL以及UACR呈负相关，而与UCR呈正相关。观察到PFAS之间以及大多数亚组之间存在相互作用。
结论
我们的研究揭示了PFAS暴露与各种肾功能指标之间的显著关联。这些发现为PFAS可能导致肾功能障碍提供了一个流行病学视角。
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