Per- and polyfluoroalkyl substances and calcifications of the coronary and aortic arteries in adults with prediabetes: Results from the diabetes prevention program outcomes study.
Per- and polyfluoroalkyl substances and calcifications of the coronary and aortic arteries in adults with prediabetes: Results from the diabetes prevention program outcomes study.
复制标题
糖尿病前期成人冠状动脉和主动脉的全氟烷基和多氟烷基物质和钙化：糖尿病预防项目结果研究的结果
DOI：
10.1016/j.envint.2021.106446
复制
发表时间：
2021-06
影响因子：
11.8
通讯作者：
Oken E
中科院分区：
文献类型：
--
作者：
Osorio-Yáñez C;Sanchez-Guerra M;Cardenas A;Lin PD;Hauser R;Gold DR;Kleinman KP;Hivert MF;Fleisch AF;Calafat AM;Webster TF;Horton ES;Oken E
全氟和多氟烷基物质(PFAS)是干扰内分泌的化学物质，与心血管风险因素有关，包括体重增加和高胆固醇血症。因此，PFAS可能参与动脉粥样硬化和心血管疾病(CVD)的发生发展。然而，以前没有研究评估过PFAS暴露与动脉钙化之间的关系。这项研究使用了参加糖尿病预防计划试验的666名糖尿病前期成年人的数据，他们在基线和随机分组两年后对血浆中的六种PFA进行了定量，并在基线13-14年后测量了冠状动脉钙(CAC)、升主动脉(ASAC)和降主动脉(DAC)的钙化。我们根据Agatston评分[低(<；10)，中(11-400)和重度(>；400)]对PFAS和CAC之间的相关性进行了多项回归检验。我们使用Logistic回归来评估PFAS与ASAC和DAC的存在之间的关系。我们调整了基线性别、年龄、BMI、种族/民族、吸烟、教育、治疗分配(安慰剂或生活方式干预)和他汀类药物使用的模型。PFAS浓度与全国平均水平相似；53.9%的参与者患有CAC>；11，7.7%的参与者患有ASAC，42.6%的参与者患有DAC。全氟辛烷磺酸(PFOS)线性和分支异构体的平均血浆浓度之和每增加一倍，严重CAC与低CAC的风险增加1.49倍(95%CI：1.01，2.21)。这种关联主要是由线性(n-全氟辛烷磺酸)异构体驱动的[1.54(95%可信区间：1.05，2.25)重度与低度CAC的几率更高]。血浆N-乙基全氟辛烷磺胺乙酸平均浓度每增加一倍，发生CAC的几率就越大，且呈剂量依赖关系[中度CAC的OR=1.26(95%CI：1.08，1.47)，重度CAC的OR=1.37(95%CI：1.07，1.74)，与低CAC相比，OR=1.26(95%CI：1.08，1.47)]。血浆全氟辛烷磺酸和n-全氟辛烷磺酸水平与ASAC的发病风险[OR=1.67(95%CI：1.10，2.54)和OR=1.70(95%CI：1.13，2.56)]相关，但与DAC无关。其他全氟辛烷磺酸与结果无关。血浆中选择的PFAS浓度较高的糖尿病前期成人发生冠状动脉和胸主动脉钙化的风险较高。全氟辛烷磺酸暴露可能是高危人群心血管健康不良的一个危险因素。
Per- and polyfluoroalkyl substances (PFAS) are endocrine disrupting chemicals that have been associated with cardiovascular risk factors including elevated body weight and hypercholesterolemia. Therefore, PFAS may contribute to the development of atherosclerosis and cardiovascular disease (CVD). However, no previous study has evaluated associations between PFAS exposure and arterial calcification. This study used data from 666 prediabetic adults enrolled in the Diabetes Prevention Program trial who had six PFAS quantified in plasma at baseline and two years after randomization, as well as measurements of coronary artery calcium (CAC) and ascending (AsAC) and descending (DAC) thoracic aortic calcification 13–14 years after baseline. We performed multinomial regression to test associations between PFAS and CAC categorized according to Agatston score [low (<10), moderate (11–400) and severe (>400)]. We used logistic regression to assess associations between PFAS and presence of AsAC and DAC. We adjusted models for baseline sex, age, BMI, race/ethnicity, cigarette smoking, education, treatment assignment (placebo or lifestyle intervention), and statin use. PFAS concentrations were similar to national means; 53.9% of participants had CAC > 11, 7.7% had AsAC, and 42.6% had DAC. Each doubling of the mean sum of plasma concentrations of linear and branched isomers of perfluorooctane sulfonic acid (PFOS) was associated with 1.49-fold greater odds (95% CI: 1.01, 2.21) of severe versus low CAC. This association was driven mainly by the linear (n-PFOS) isomer [1.54 (95% CI: 1.05, 2.25) greater odds of severe versus low CAC]. Each doubling of mean plasma N-ethyl-perfluorooctane sulfonamido acetic acid concentration was associated with greater odds of CAC in a dose-dependent manner [OR = 1.26 (95% CI:1.08, 1.47) for moderate CAC and OR = 1.37 (95% CI:1.07, 1.74) for severe CAC, compared to low CAC)]. Mean plasma PFOS and n-PFOS were also associated with greater odds of AsAC [OR = 1.67 (95% CI:1.10, 2.54) and OR = 1.70 (95% CI:1.13, 2.56), respectively], but not DAC. Other PFAS were not associated with outcomes. Prediabetic adults with higher plasma concentrations of select PFAS had higher risk of coronary and thoracic aorta calcification. PFAS exposure may be a risk factor for adverse cardiovascular health among high-risk populations.
登录
查看更多内容
影响因子：
5.4
作者：
Kälsch H;Lehmann N;Moebus S;Hoffmann B;Stang A;Jöckel KH;Erbel R;Mahabadi AA
通讯作者：
Mahabadi AA
影响因子：
4.1
作者：
Kato, Kayoko;Basden, Brian J.;Calafat, Antonia M.
通讯作者：
Calafat, Antonia M.
影响因子：
158.5
作者：
Detrano, Robert;Guerci, Alan D.;Kronmal, Richard A.
通讯作者：
Kronmal, Richard A.
影响因子：
37.8
作者：
Goldberg RB;Aroda VR;Bluemke DA;Barrett-Connor E;Budoff M;Crandall JP;Dabelea D;Horton ES;Mather KJ;Orchard TJ;Schade D;Watson K;Temprosa M;Diabetes Prevention Program Research Group
通讯作者：
Diabetes Prevention Program Research Group
DOI：
10.1016/0735-1097(90)90282-t
发表时间：
1990-03-15
影响因子：
24
作者：
AGATSTON, AS;JANOWITZ, WR;DETRANO, R
通讯作者：
DETRANO, R