Association among serum perfluroalkyl chemicals,chronic kidney disease and cardio

描述（由申请方提供）：本提案描述了一项基于人群的研究，旨在对基于人群的阿巴拉契亚成年人样本进行两项独立研究，以检查全氟烷基化学品（PFCs）血液水平与慢性肾脏疾病（CKD）和心血管疾病（CVD）的关系。我们正在申请资金用于数据的二次分析。该提案利用了基于人群的横断面样本中收集的56，554名年龄在18岁以上的阿巴拉契亚成年人的暴露和结果数据，其中53%为女性，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，我们有关于血清PFC水平的数据，这是所有队列成员的主要暴露量，包括全氟辛烷磺酸的血清水平（全氟辛烷磺酸或C8）、全氟辛酸（PFOA或C8）、全氟己烷磺酸盐（PFHxS或C6 S），全氟己酸（PFHxA或C6），全氟戊酸（PFPeA或C5），全氟庚酸（PFHpA或C7），全氟壬酸（PFNA或C9），全氟癸酸（PFDA或C10）、全氟十一烷酸（PFUnA或C11）和全氟十二烷酸（PFDoA或C12）作为先前法院授权的健康调查的一部分。我们也有可用的相关数据，这将使我们能够定义CKD和CVD，这是我们感兴趣的主要结果。这包括所有研究受试者的血清肌酐测量值，使我们能够估计肾小球滤过率（eGFR），通过肾脏疾病饮食改良（MDRD）方程估计。我们将CKD定义为eGFR <60 mL/min/1.73 m2，与现行指南一致。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。我们将采用标准流行病学技术，包括调整年龄、性别、种族-民族、教育、体重指数和其他混杂因素的多变量logistic回归模型，检查血清PFC与关注结局（CKD或CVD）之间的假定关联。我们的研究提供了一个独特的和具有成本效益的机会，以评估血清PFC和CVD和CKD的存在之间的独立关联，在一个大型的社区为基础的队列在阿巴拉契亚，这是一个指定的健康差距的人口。我们的研究数据将提高对PFC对人类健康影响的理解。本研究的结果也将指导同一队列人群未来随访研究的计划。 公共卫生相关性：全氟烷基化学品（PFC）在超过98%的S成年人的血液中可检测到。我们将研究血液PFCs与肾脏疾病和心血管疾病之间的关系。如果我们发现了这种关联，它间接表明减少PFCs可能在预防这些疾病方面发挥作用。

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.