title: Positive association between perfluoroalkyl chemicals and hyperuricemia in children.
abstract: Hyperuricemia in children is associated with increased risk of high blood pressure, metabolic syndrome, and future cardiovascular disease. Serum perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) levels have been shown to be positively associated with hyperuricemia in adults, but the association in children remains unexplored. We therefore examined the association between serum PFOA and PFOS levels and hyperuricemia in a representative sample of US children. A cross-sectional study was performed on 1,772 participants ≤18 years of age from the National Health and Nutrition Examination Survey 1999-2000 and 2003-2008. The main outcome of interest was hyperuricemia, defined as serum uric acid levels ≥6 mg/dL. We found that serum levels of PFOA and PFOS were positively associated with hyperuricemia, independent of age, sex, race/ethnicity, body mass index, annual household income, physical activity, serum total cholesterol, and serum cotinine levels. Compared with subjects in quartile 1 (referent), subjects in quartile 4 had multivariable-adjusted odds ratios for hyperuricemia of 1.62 (95% confidence interval: 1.10, 2.37) for PFOA and 1.65 (95% confidence interval: 1.10, 2.49) for PFOS. Our findings indicate that serum perfluoroalkyl chemical levels are significantly associated with hyperuricemia in children even at the lower "background" exposure levels of the US general population.
authors.affiliation: University of Wisconsin Population Health Institute, Room 575 WARF, 614 Walnut Street, Madison, WI 53726, USA. sarahdeemurphy@gmail.com
authors.forename: Sarah Dee
authors.initials: SD
authors.lastname: Geiger
authors.forename: Jie
authors.initials: J
authors.lastname: Xiao
authors.forename: Anoop
authors.initials: A
authors.lastname: Shankar
mesh_terms: D000293:Adolescent; D017738:Alkanesulfonic Acids / Q000097:blood*; D002210:Caprylates / Q000097:blood*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005466:Fluorocarbons / Q000097:blood*; D006801:Humans; D033461:Hyperuricemia / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D009749:Nutrition Surveys; D014481:United States / Q000453:epidemiology; D014527:Uric Acid / Q000097:blood*
chemical_list: D017738:Alkanesulfonic Acids; D002210:Caprylates; D005466:Fluorocarbons; D014527:Uric Acid; C023036:perfluorooctanoic acid; C076994:perfluorooctane sulfonic acid
keywords: NHANES; PFC; hyperuricemia; pediatrics; perfluoroalkyl chemicals; perfluorooctane sulfonate; perfluorooctanoic acid; uric acid
references.citation: Matern Child Nutr. 2005 Jul;1(3):204-15
references.pmid: 16881901
references.citation: J Chin Med Assoc. 2006 Nov;69(11):512-6
references.pmid: 17116612
references.citation: N Engl J Med. 2008 Oct 23;359(17):1811-21
references.pmid: 18946066
references.citation: J Occup Environ Med. 2009 Mar;51(3):364-72
references.pmid: 19225424
references.citation: Circ J. 2010 Aug;74(8):1570-7
references.pmid: 20534946
references.citation: J Rheumatol. 2001 Jul;28(7):1640-6
references.pmid: 11469473
references.citation: J Occup Environ Med. 2007 Oct;49(10):1086-96
references.pmid: 18000414
references.citation: J Occup Environ Med. 2007 Aug;49(8):872-9
references.pmid: 17693785
references.citation: BMJ. 2001 Feb 17;322(7283):375-6
references.pmid: 11179140
references.citation: Arch Pediatr Adolesc Med. 2010 Sep;164(9):860-9
references.pmid: 20819969
references.citation: J Am Soc Nephrol. 2005 Dec;16(12):3553-62
references.pmid: 16251237
references.citation: Hypertension. 2005 Jan;45(1):34-8
references.pmid: 15569853
references.citation: Anal Chem. 2002 Feb 1;74(3):584-90
references.pmid: 11842814
references.citation: JAMA. 1991 Dec 4;266(21):3008-11
references.pmid: 1820474
references.citation: Circulation. 2007 May 15;115(19):2526-32
references.pmid: 17470699
references.citation: Clin Epidemiol. 2011;3:251-8
references.pmid: 22003309
references.citation: Int J Endocrinol. 2011;2011:604715
references.pmid: 22114591
references.citation: Environ Health Perspect. 2010 Dec;118(12):1762-7
references.pmid: 20551004
references.citation: Environ Health Perspect. 2010 Aug;118(8):1100-8
references.pmid: 20423814
references.citation: Pediatr Int. 2003 Oct;45(5):642-6
references.pmid: 14521550
references.citation: Hypertension. 2003 Sep;42(3):247-52
references.pmid: 12900431
references.citation: J Hum Hypertens. 2006 Dec;20(12):937-45
references.pmid: 17024135
references.citation: Environ Health Perspect. 2010 Jun;118(6):796-802
references.pmid: 20146964
references.citation: J Environ Monit. 2005 Nov;7(11):1074-8
references.pmid: 16252056
references.citation: Physiol Chem Phys. 1972;4(4):349-60
references.pmid: 4680784
references.citation: Physiol Genomics. 2008 Apr 22;33(2):180-92
references.pmid: 18270321
references.citation: Environ Health Perspect. 2010 Feb;118(2):229-33
references.pmid: 20123605
references.citation: Risk Anal. 2008 Apr;28(2):251-69
references.pmid: 18419647
references.citation: Atherosclerosis. 2012 Feb;220(2):575-80
references.pmid: 22178428
references.citation: Curr Hypertens Rep. 2006 May;8(2):111-5
references.pmid: 16672142
references.citation: Nephrol Dial Transplant. 2010 Nov;25(11):3593-9
references.pmid: 20501458
references.citation: Environ Health Perspect. 2007 Nov;115(11):1596-602
references.pmid: 18007991
references.citation: Mutat Res. 2005 Nov 10;587(1-2):38-44
references.pmid: 16219484
references.citation: N Engl J Med. 2003 Oct 23;349(17):1647-55
references.pmid: 14573737
references.citation: Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2010 Apr;27(4):530-45
references.pmid: 20198525
references.citation: Environ Sci Technol. 2004 Mar 1;38(5):1313-20
references.pmid: 15046331
references.citation: Toxicol Appl Pharmacol. 2001 May 15;173(1):56-64
references.pmid: 11350215
references.citation: Asia Pac J Clin Nutr. 2007;16 Suppl 2:594-600
references.pmid: 17724000
references.citation: Environ Health Perspect. 2011 Jan;119(1):119-24
references.pmid: 20870569
references.citation: Curr Pharm Des. 2005;11(32):4145-51
references.pmid: 16375736
references.citation: Food Addit Contam. 2005 Oct;22(10):1023-31
references.pmid: 16227186
references.citation: JAMA. 2000 May 10;283(18):2404-10
references.pmid: 10815083
references.citation: Toxicol Sci. 2007 Oct;99(2):366-94
references.pmid: 17519394
references.citation: Environ Sci Pollut Res Int. 2008 Oct;15(7):614-9
references.pmid: 18763004