title: Negative association between serum perfluorooctane sulfate concentration and bone mineral density in US premenopausal women: NHANES, 2005-2008.
abstract: BACKGROUND
  Perfluorooctanoic acid (PFOA) and perfluorooctane sulfate (PFOS) are used in a variety of products worldwide. However, the relationship among serum PFOA, PFOS concentration, bone mineral density (BMD), and the risk of fractures has never been addressed.
  
  
  OBJECTIVE
  The study examined the association among serum PFOA, PFOS concentration, and lumbar spine and total hip BMD in the general US population.
  
  
  METHODS
  We analyzed data on 2339 adults (aged ≧20 y) from the National Health and Nutrition Examination Survey conducted in 2005-2006 and 2007-2008 to determine the relationship among serum PFOA, PFOS concentration, and total lumbar spine and total hip BMD measured by dual-energy x-ray absorptiometry and history of fractures cross-sectionally.
  
  
  RESULTS
  After weighting for sampling strategy, a 1-U increase in the natural log-transformed serum PFOS level was associated with a decrease in total lumbar spine BMD by 0.022 g/cm(2) (95% confidence interval -0.038, -0.007; P = .006) in women not in menopause. There was no association among PFOA, PFOS concentration, and self-reported fracture in adults.
  
  
  CONCLUSIONS
  Serum PFOS concentration is associated with decreased total lumbar spine BMD in women not in menopause. However, the potential biological significance of this effect is marginal and subclinical in the general US population. Further studies are warranted to clarify the causal relationship between perfluorinated chemical exposure and BMD.
authors.affiliation: Department of Internal Medicine (L.-Y.L.), National Taiwan University Hospital, Taipei 100, Taiwan; and Departments of Clinical Laboratory (L.-L.W., T.-C.S.) and Internal Medicine (C.-Y.L.), En Chu Kong Hospital, New Taipei City 237, Taiwan; Institute of Occupational Medicine and Industrial Hygiene (P.-C.C.) and Department of Public Health (P.-C.C.), National Taiwan University College of Public Health, Taipei 100, Taiwan; Department of Environmental and Occupational Medicine (P.-C.C.), National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei 100, Taiwan; and School of Medicine (C.-Y.L.), Fu Jen Catholic University, New Taipei City 242, Taiwan.
authors.forename: Lian-Yu
authors.initials: LY
authors.lastname: Lin
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Wen
authors.forename: Ta-Chen
authors.initials: TC
authors.lastname: Su
authors.forename: Pau-Chung
authors.initials: PC
authors.lastname: Chen
authors.forename: Chien-Yu
authors.initials: CY
authors.lastname: Lin
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D004781:Environmental Exposure / Q000706:statistics & numerical data; D004785:Environmental Pollutants / Q000097:blood*; D005260:Female; D005466:Fluorocarbons / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D017697:Premenopause / Q000097:blood*; D013431:Sulfates / Q000097:blood*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D004785:Environmental Pollutants; D005466:Fluorocarbons; D013431:Sulfates; C073608:perfluorooctane