Association among serum perfluroalkyl chemicals,chronic kidney disease and cardio

描述(由申请人提供)：这项建议描述了一项基于人群的研究，在两项独立的研究中，在以人群为基础的阿巴拉契亚成年人样本中，检查全氟烷基化合物(PFC)的血液水平与慢性肾脏疾病(CKD)和心血管疾病(CVD)的存在之间的关系。我们正在为数据的二次分析申请资金。这项建议利用了已经收集的基于人口的横断面样本的暴露和结果数据，样本为56,554名阿巴拉契亚成年人，年龄为E18岁，其中53%是女性，居住在俄亥俄州和西弗吉尼亚州的六个社区，称为C8健康研究。在这项研究中，我们有关于所有队列成员的血清PFC水平的数据，包括全氟辛烷磺酸(PFOS或C8S)、全氟辛酸(PFOA或C8)、全氟己烷磺酸(PFHxS或C6S)、全氟己酸(PFHxA或C6)、全氟戊酸(PFPeA或C5)、全氟庚酸(PFHpA或C7)、全氟辛酸(PFNA或C9)、全氟十一酸(PFDA或C10)、全氟十一酸(UnA或Fd11)和全碘酸(P12)的血清水平，这是先前法院强制进行的健康调查的一部分。我们还拥有相关的数据，这将使我们能够定义CKD和CVD，这是人们感兴趣的主要结果。这包括所有研究对象都可用的血清肌酐测量，使我们能够估计肾小球滤过率(EGFR)，通过修改肾脏疾病饮食(MDRD)方程来估计。我们将CKD定义为EGFR为每1.73米2 60毫升/分钟，与当前指南一致。我们也有经过验证的、医生诊断的心血管疾病的数据，包括冠心病和中风。我们将使用标准的流行病学技术，包括对年龄、性别、种族、教育程度、体重指数和其他混杂因素进行调整的多变量Logistic回归模型，来检验血清PFC和相关结果(CKD或CVD)之间的假定关联。我们的研究提供了一个独特且经济有效的机会来评估血清PFC与阿巴拉契亚大型社区队列中CVD和CKD的存在之间的独立关联，阿巴拉契亚是一个指定的健康差距人群。我们研究的数据将提高对全氟化碳对人类健康影响的理解。目前研究的结果还将指导规划未来对同一队列人群的后续研究。 公共卫生相关性：98%的S成年人的血液中可检出全氟烷基化合物(PFC)。我们将研究全血PFC与肾脏疾病和心血管疾病之间的关系。如果我们发现了关联，这间接地表明减少PFC可能在预防这些疾病方面起到了作用。

DESCRIPTION (provided by applicant): This proposal describes a population-based study to examine the relation of blood levels of perfluroalkyl chemicals (PFCs) to the presence of chronic kidney disease (CKD) and cardiovascular disease (CVD) in two separate studies in a population-based sample of Appalachian adults. We are requesting funding for secondary analysis of data. This proposal takes advantage of the data on exposures and outcomes already gathered on a population-based cross-sectional sample of 56,554 Appalachian adults who were aged e18 years and 53% of whom were women, residing in six communities in Ohio and West Virginia, called the C8 Health Study. In the study, we have data available on serum PFC levels, the main exposure of interest, on all members of the cohort, including serum levels of perfluorooctane sulfonate (PFOS or C8s), perfluorooctanoic acid (PFOA or C8), perfluorohexane sulfonate (PFHxS or C6S), perfluorohexanoic acid (PFHxA or C6), perfluoropentanoic acid (PFPeA or C5), perfluoroheptanoic acid (PFHpA or C7), perfluorononaoic acid (PFNA or C9), perfluorodecanoic acid (PFDA or C10), perfluoroundecanoic acid (PFUnA or C11), and perfluorododecanoic acid (PFDoA or C12) as part of a previous court-mandated health survey. We also have available pertinent data that will enable us to define CKD and CVD, the main outcomes of interest. This includes serum creatinine measurement that is available on all study subjects, enabling us to estimate glomerular filtration rate (eGFR), estimated by the Modification of Diet in Renal Disease (MDRD) equation. We will define CKD as an eGFR of <60 mL/min per 1.73 meter2, consistent with current guidelines. We also have data on validated, physician diagnosed CVD, including coronary heart disease and stroke. We will examine the putative association between serum PFCs and the outcomes of interest (CKD or CVD) employing standard epidemiological techniques, including multivariable logistic regression models adjusting for age, gender, race- ethnicity, education, body mass index, and other confounders. Our study provides a unique and cost-effective opportunity to assess the independent association between serum PFC and the presence of CVD and CKD in a large community-based cohort in Appalachia, which is a designated health disparity population. Data from our study will improve the understanding of the health effects of PFCs on humans. Results from the current study will also guide the planning of future follow-up studies of the same cohort population. PUBLIC HEALTH RELEVANCE: Perfluroalkyl chemicals (PFC) are detectable in the blood of >98% of S adults. We will study the association between blood PFCs and kidney disease and cardiovascular disease. If we find an association, it indirectly suggests that reducing PFCs may have a role in preventing these diseases.