Perfluoroalkyl acids serum concentrations and their relationship to biomarkers of renal failure: Serum and urine albumin, creatinine, and albumin creatinine ratios across the spectrum of glomerular function among US adults
Perfluoroalkyl acids serum concentrations and their relationship to biomarkers of renal failure: Serum and urine albumin, creatinine, and albumin creatinine ratios across the spectrum of glomerular function among US adults
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DOI：
10.1016/j.envres.2019.04.034
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发表时间：
2019-07-01
影响因子：
8.3
通讯作者：
Ducatman, Alan
中科院分区：
文献类型：
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作者：
Jain, Ram B.;Ducatman, Alan
在2005-2014年的国家健康和营养检查调查中，美国20岁成年人(N=8220)评估了选定的全氟烷基酸(PFAA)与肾功能生物标志物之间的相关性。根据估计的肾小球滤过率(EGFR和GT；90mL/min/1.73m(2))、GF-2(EGFR 60-89mL/min/1.73 m(2))、GF-3A(45-59mL/min/1.73m(2))和GF-3B/4(15-44mL/min/1.73m(2))对肾小球滤过率(GF)分级回归模型进行分类。对于GF-1，全氟辛烷磺酸、全氟辛烷磺酸和全氟辛烷磺酸与血肌酐呈显著正相关。在所有阶段，血清白蛋白水平与PFAA呈正相关，且大多数相关性显着。此外，在GF-3B/4组中，PFAS血清浓度与血清白蛋白的相关性约为GF-1组的2-3倍。在肾功能的各个阶段，尿白蛋白与全氟辛酸和全氟辛烷磺酸呈显著负相关，而全氟辛烷磺酸和全氟辛酸与尿白蛋白在GF-3A和GF-3B/4呈显著负相关。尿白蛋白/肌酐比值与肾功能各阶段的全氟辛酸、全氟辛烷磺酸和全氟辛烷磺酸呈显著负相关，与全氟辛酸和全氟辛烷磺酸的血清浓度呈显著负相关，与全氟辛酸和全氟辛烷磺酸在肾功能各阶段的浓度呈显著负相关。这项工作补充说，在肾功能衰竭的进展阶段，蛋白尿对已经存在的PFAA与EGFR的负面关联有额外的负面贡献。我们假设进行性肾功能衰竭本身，特别是伴有蛋白尿的肾功能衰竭，都会导致肾脏重新吸收较少，并排泄更多所研究的PFAA。我们怀疑这一发现可能推广到其他一些全氟烷基物质(PFAS)。这些发现还暗示了评估与疾病和与肾功能衰竭相关的生物标记物(如糖尿病)的相关性的研究设计考虑。
Associations between selected perfluoroalkyl acids (PFAAs) and biomarkers of renal function were evaluated for US adult aged >= 20 years (N = 8220) in the National Health and Nutrition Examination Survey for 2005-2014. Glomerular filtration (GF) stage-stratified regression models were classified by estimated glomerular filtration rate (eGFR) with GF-1 (eGFR > 90 mL/min/1.73 m(2)), GF-2 (eGFR 60-89 mL/min/1.73 ma), GF-3A (45-59 mL/min/1.73 m(2)), and GF-3B/4 (15-44 mL/min/1.73 m(2)). For GF-1, PFOA, PFOS, and PFHxS were positively and significantly associated with serum creatinine. Serum albumin levels were positively associated with the PFAA considered at all stages and most associations were significant. Further, PFAS serum concentration associations to serum albumin were about 2-3 times stronger at GF-3B/4 than at GF-1. In contrast, urine albumin was negatively and significantly associated with PFOA and PFHxS serum concentrations at all stages of renal function, while, PFOS and PFNA were negatively and significantly associated to urine albumin at GF-3A and GF-3B/4. Urine albumin/creatinine ratios were negatively and significantly associated with PFOA, PFOS, and, and PFHxS serum concentrations at all stages of renal function, as well as with PFNA and PFDA at GF-3A and GF-3B/4. Recent work revealed that serum PFAAs have an inverted U-shaped association to the calculated stages of renal failure based on eGFR; this work adds that albuminuria makes additional negative contributions to already existing negative associations of PFAA to eGFR in advancing stages of renal failure. We hypothesize that both progressive renal failure per se and especially renal failure with albuminuria cause the kidneys to reabsorb less and to excrete more of the PFAAs studied. We suspect this finding may generalize to some other perfluoroalkyl substances (PFAS). The findings also imply study design considerations for evaluating associations to diseases and biomarkers associated with renal failure, such as diabetes.