Exposure to per- and Polyfluoroalkyl Substances and Markers of Liver Injury: A Systematic Review and Meta-Analysis.
Exposure to per- and Polyfluoroalkyl Substances and Markers of Liver Injury: A Systematic Review and Meta-Analysis.
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DOI：
10.1289/ehp10092
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发表时间：
2022-04
影响因子：
10.4
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中科院分区：
文献类型：
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实验证据表明，暴露于某些污染物与肝损伤有关。全氟烷基和多氟烷基物质（PFAS）是广泛用于工业和消费品的持久性合成化学品，并在食物网和人体组织（如肝脏）中生物累积。本研究的目的是对文献和荟萃分析进行系统综述，评价PFAS暴露以及啮齿动物和流行病学研究中的肝损伤证据。使用PFAS暴露和肝损伤对应的关键词，检索PubMed和Embase中最早可用索引年至2021年12月1日的所有研究。对于数据合成，结果仅限于评估以下肝损伤指标的人类和啮齿动物研究：血清丙氨酸氨基转移酶（ALT）、非酒精性脂肪肝、非酒精性脂肪性肝炎或脂肪变性。对于人体研究，每个PFAS至少使用三项观察性研究进行加权评分荟萃分析，以确定相关性的方向和意义。对于啮齿类动物研究，对数据进行了综合，以定性总结作用的方向和意义。我们的搜索产生了85项啮齿动物研究和24项流行病学研究，主要是来自美国的人。研究主要集中在传统的全氟辛烷磺酸：全氟辛酸（PFOA）、全氟辛烷磺酸（PFOS）、全氟壬酸（PFNA）和全氟己烷磺酸。对人体研究的荟萃分析显示，ALT水平较高与接触全氟辛酸（6.20，）、全氟辛烷磺酸（3.55，）和全氟萘甲酸（2.27，）有关。全氟辛酸暴露还与人体天冬氨酸转氨酶和γ-谷氨酰转移酶水平升高有关。在啮齿类动物中，PFAS暴露持续导致ALT水平升高和脂肪变性。啮齿动物研究中有一致的PFAS肝毒性证据，并得到了观察性人类研究中PFAS与肝功能标志物相关性的支持。本次审查确定了需要额外的研究评估下一代PFAS，混合物，和早期生活的曝光。https://doi.org/10.1289/EHP10092
Experimental evidence indicates that exposure to certain pollutants is associated with liver damage. Per- and polyfluoroalkyl substances (PFAS) are persistent synthetic chemicals widely used in industry and consumer products and bioaccumulate in food webs and human tissues, such as the liver. The objective of this study was to conduct a systematic review of the literature and meta-analysis evaluating PFAS exposure and evidence of liver injury from rodent and epidemiological studies. PubMed and Embase were searched for all studies from earliest available indexing year through 1 December 2021 using keywords corresponding to PFAS exposure and liver injury. For data synthesis, results were limited to studies in humans and rodents assessing the following indicators of liver injury: serum alanine aminotransferase (ALT), nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, or steatosis. For human studies, at least three observational studies per PFAS were used to conduct a weighted -score meta-analysis to determine the direction and significance of associations. For rodent studies, data were synthesized to qualitatively summarize the direction and significance of effect. Our search yielded 85 rodent studies and 24 epidemiological studies, primarily of people from the United States. Studies focused primarily on legacy PFAS: perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluorohexanesulfonic acid. Meta-analyses of human studies revealed that higher ALT levels were associated with exposure to PFOA ( 6.20, ), PFOS ( 3.55, ), and PFNA ( 2.27, ). PFOA exposure was also associated with higher aspartate aminotransferase and gamma-glutamyl transferase levels in humans. In rodents, PFAS exposures consistently resulted in higher ALT levels and steatosis. There is consistent evidence for PFAS hepatotoxicity from rodent studies, supported by associations of PFAS and markers of liver function in observational human studies. This review identifies a need for additional research evaluating next-generation PFAS, mixtures, and early life exposures. https://doi.org/10.1289/EHP10092