Potential confounders in the association between per- and polyfluoroalkyl substance exposure and diabetes
Potential confounders in the association between per- and polyfluoroalkyl substance exposure and diabetes
复制标题
全氟烷基物质和多氟烷基物质暴露与糖尿病之间的潜在混杂因素
DOI：
10.1007/s00125-022-05758-7
复制
发表时间：
2022
期刊：
影响因子：
8.2
通讯作者：
Harada Sassa Mariko
中科院分区：
文献类型：
--
作者：
Harada Kouji H.;Harada Sassa Mariko
致编辑：我们饶有兴趣地阅读了Park等人最近在Diabetologia [1]上发表的文章。全氟烷基和多氟烷基物质（PFAS）是一类因其广泛使用而引起公众健康关注的污染物[2]。PFAS的化学结构与脂肪酸相似，脂肪酸与代谢疾病有关。在这种情况下，作者在一项队列研究中研究了PFAS暴露与糖尿病风险之间的关系[1]。这是一项重要的研究，使用比以前的病例对照和横断面研究更高证据水平的研究设计来检查PFAS的影响。然而，我们想知道除了作者所包括的变量之外，是否还有其他重要的变量。正如作者所指出的，先前的研究表明，血液PFAS浓度受肾功能受损（包括糖尿病肾病）的影响[1]。Park et al的研究是一项队列研究，在糖尿病发作前评估血液PFAS浓度，这可能会降低潜在偏倚的影响。但是，未充分提供队列的基线特征。即使在糖尿病发病之前，也可能存在关于患糖尿病风险的偏见，
To the Editor: We read with interest the recent article by Park et al in Diabetologia [1]. Per-and polyfluoroalkyl substances (PFAS) are a class of contaminants of concern in public health because of their widespread use [2]. The chemical structure of PFAS is similar to that of fatty acids, which have been implicated in metabolic diseases. In this context, the authors investigated the association between PFAS exposure and the risk of developing diabetes in a cohort study [1]. This is an important study that examined the impact of PFAS using a study design with a higher level of evidence than in previous case–control and cross-sectional studies.In their statistical analysis, the authors adjusted for potential confounding factors in the regression model. However, we wonder if there are other important variables besides those included by the authors. As the authors point out, previous studies have shown that blood PFAS concentrations are affected by impaired renal function, including diabetic nephropathy [1]. The study by Park et al was a cohort study and blood PFAS concentrations were assessed before the onset of diabetes, which may reduce the influence of potential biases. However, the baseline characteristics of the cohort were not fully provided. Even before the onset of diabetes, there may be bias regarding the risk of developing diabetes,