Effects of perfluoroalkyl chemicals on stroke incidence, mortality and morbidity

慢性病是巨大的公共卫生和经济负担，新的和不断增长的 科学证据支持外来环境化学物质(XECs)在发展中的因果作用 以及慢性疾病的进展，包括心脑血管疾病(中风)。几个班级 的XECs，包括持久性有机污染物和重金属，已被确定为中风增加 风险，而且有新的证据表明，另一类XEC，全氟烷基化学品(PFCs)也可能 影响中风风险。然而，在理解不同的PFC可能的情况方面仍然存在知识差距 影响中风风险和中风结果，或这些健康影响如何通过其他条件进行调节 会对中风的风险和严重程度产生因果影响。该项目的三个目标是：1)确定 全氟化碳与卒中发病率之间的关联；2)确定全氟化碳与中风发病率之间的关联 卒中死亡率和发病率；以及3)描述全氟化碳对卒中发病率和发病率的自然间接影响 死亡率和发病率，通过高胆固醇血症和高血压以及甲状腺和 免疫功能。该项目将作为国立卫生研究院资助的有关研究的一项辅助研究进行。 已确定招生人数为30,000人的队列研究。建议的工作的贡献 这里将对多种PFC化合物对中风风险和中风的影响进行系统评估 结果在不同的队列中，有广泛的PFC暴露。本文提出的研究具有创新性。 因为：1)将对多种PFC化合物进行评估；2)一系列与PFC相关的健康影响和结果 将确定死亡率以外的因素；3)与PFC相关的自然、间接健康影响和结果将是 4)本研究将建立在一项既定研究的基础上，因此将有效地处理 本研究的目的是。预计这里提出的研究结果将大大进步。 了解PFC如何影响脑血管健康将是一项重要的进展 预期将为公共卫生战略的发展提供有意义的信息的连续研究 以及关于全氟化碳暴露安全水平的建议。

Chronic diseases are an enormous public health and economic burden, and new and growing lines of scientific evidence support a causal role for xenobiotic environmental chemicals (XECs) in the development and progression of chronic diseases, including cardio- and cerebrovascular disease (stroke). Several classes of XECs, including persistent organic pollutants and heavy metals, have been identified as increasing stroke risk, and there is emerging evidence that another class of XECs, perfluoralkyi chemicals (PFCs), may also influence stroke risk. However, there remains a knowledge gap in understanding how different PFCs may affect stroke risk and stroke outcome or how these health effects may be mediated through other conditions that causally affect stroke risk and severity. The three aims of this project are to: 1) Determine the association between PFCs and the incidence of stroke; 2) Determine the association between PFCs and stroke mortality and morbidity; and 3) Describe the natural Indirect effect of PFCs on stroke incidence and mortality and morbidity, as mediated through hypercholesterolemia and hypertension, and thyroid and immune function. This project will be conducted as an ancillary study within the REGARDS Study, an NIHfunded cohort study with an established enrollment of >30,000 people. The contribution of the work proposed here will be a systematic evaluation of the effect of multiple PFC compounds on stroke risk and stroke outcome in a diverse cohort, with a wide range of PFC exposure. The research proposed here is innovative because: 1) multiple PFC compounds will be evaluated; 2) a range PFC-related health effects and outcomes beyond mortality will be determined; 3) natural, indirect PFC-related health effects and outcomes will be determined; and 4) the present study will build upon a well-established study and so will efficiently address the study aims. It is anticipated that the results from the research proposed here will substantially advance the understanding of how PFCs affect cerebrovascular health and so will be an important progression in a continuum of research that is expected to meaningfully inform the development of public health strategies and recommendations regarding safe levels of exposure to PFCs.