Association among serum perfluroalkyl chemicals,chronic kidney disease and cardio

描述（由申请人提供）：本提案描述了一项基于人群的研究，以两项独立的研究为基础，在阿巴拉契亚成年人的人群样本中，研究全氟烷基化学物质（PFCs）的血液水平与慢性肾脏疾病（CKD）和心血管疾病（CVD）的关系。我们请求为数据的二次分析提供资金。该提案利用了一项名为C8健康研究的以人口为基础的横断面样本所收集的暴露和结果数据，该样本包括56,554名年龄在18岁至18岁之间的阿巴拉契亚成年人，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。在这项研究中,我们有数据可以在血清PFC的水平,主要的暴露感兴趣的群体的所有成员,包括血清perfluorooctane磺酸盐(卵圆孔未闭或C8),并酸(PFOA和C8)它们perfluorohexane磺酸盐(PFHxS或C6), perfluorohexanoic酸(PFHxA或C6), perfluoropentanoic酸(PFPeA或C5), perfluoroheptanoic酸(PFHpA或C7), perfluorononaoic酸(PFNA或制备过程),perfluorodecanoic酸(PFDA或C10), perfluoroundecanoic酸(PFUnA或C11),以及全氟十二烷酸（PFDoA或C12），这是之前法院强制进行的健康调查的一部分。我们也有可用的相关数据，使我们能够定义CKD和CVD，这是我们感兴趣的主要结果。这包括在所有研究对象中可用的血清肌酐测量，使我们能够估计肾小球滤过率（eGFR），通过肾脏疾病饮食修正（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、教育程度、体重指数和其他混杂因素的多变量logistic回归模型，检验血清PFCs与相关结果（CKD或CVD）之间的推定关联。我们的研究提供了一个独特的、具有成本效益的机会来评估血清PFC与CVD和CKD存在之间的独立关联，在阿巴拉契亚地区的一个大型社区队列中，这是一个指定的健康差异人群。我们的研究数据将增进对全氟化合物对人类健康影响的理解。本研究的结果也将指导对同一队列人群的后续研究的规划。

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.