title: Perfluorochemicals and endometriosis: the ENDO study.
abstract: BACKGROUND
  Environmental chemicals may be associated with endometriosis. No published research has focused on the possible role of perfluorochemicals (PFCs) despite their widespread presence in human tissues.
  
  
  METHODS
  We formulated two samples. The first was an operative sample comprising 495 women aged 18-44 years scheduled for laparoscopy/laparotomy at one of 14 participating clinical sites in the Salt Lake City or San Francisco area, 2007-2009. The second was a population-based sample comprising 131 women matched to the operative sample on age and residence within a 50-mile radius of participating clinics. Interviews and anthropometric assessments were conducted at enrollment, along with blood collection for the analysis of nine PFCs, which were quantified using liquid chromatography-tandem mass spectrometry. Endometriosis was defined based on surgical visualization (in the operative sample) or magnetic resonance imaging (in the population sample). Using logistic regression, we estimated odds ratios (ORs) and 95% confidence intervals (CIs) for each PFC (log-transformed), adjusting for age and body mass index, and then parity.
  
  
  RESULTS
  Serum perfluorooctanoic acid (PFOA; OR = 1.89 [95% CI = 1.17-3.06]) and perfluorononanoic acid (2.20 [1.02-4.75]) were associated with endometriosis in the operative sample; findings were moderately attenuated with parity adjustment (1.62 [0.99-2.66] and 1.99 [0.91-4.33], respectively). Perfluorooctane sulfonic acid (1.86 [1.05-3.30]) and PFOA (2.58 [1.18-5.64]) increased the odds for moderate/severe endometriosis, although the odds were similarly attenuated with parity adjustment (OR = 1.50 and 1.86, respectively).
  
  
  CONCLUSIONS
  Select PFCs were associated with an endometriosis diagnosis. These associations await corroboration.
authors.affiliation: Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Health, Rockville, MD 20852, USA. louisg@mail.nih.gov
authors.forename: Germaine M Buck
authors.initials: GM
authors.lastname: Louis
authors.forename: C Matthew
authors.initials: CM
authors.lastname: Peterson
authors.forename: Zhen
authors.initials: Z
authors.lastname: Chen
authors.forename: Mary L
authors.initials: ML
authors.lastname: Hediger
authors.forename: Mary S
authors.initials: MS
authors.lastname: Croughan
authors.forename: Rajeshwari
authors.initials: R
authors.lastname: Sundaram
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Stanford
authors.forename: Victor Y
authors.initials: VY
authors.lastname: Fujimoto
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: Linda C
authors.initials: LC
authors.lastname: Giudice
authors.forename: Anne
authors.initials: A
authors.lastname: Kennedy
authors.forename: Liping
authors.initials: L
authors.lastname: Sun
authors.forename: Qian
authors.initials: Q
authors.lastname: Wu
authors.forename: Kurunthachalam
authors.initials: K
authors.lastname: Kannan
mesh_terms: D000293:Adolescent; D000328:Adult; D002210:Caprylates / Q000097:blood; D004715:Endometriosis / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology*; D004781:Environmental Exposure / Q000009:adverse effects*; D004785:Environmental Pollutants / Q000009:adverse effects* / Q000097:blood; D005260:Female; D005466:Fluorocarbons / Q000009:adverse effects* / Q000097:blood; D006801:Humans; D012495:San Francisco / Q000453:epidemiology; D014589:Utah / Q000453:epidemiology; D055815:Young Adult
chemical_list: D002210:Caprylates; D004785:Environmental Pollutants; D005466:Fluorocarbons; C018959:hexadecafluoro-nonanoic acid; C023036:perfluorooctanoic acid