title: Associations of perfluorinated chemical serum concentrations and biomarkers of liver function and uric acid in the US population (NHANES), 2007-2010.
abstract: BACKGROUND
  Perfluorinated chemicals (PFCs) are a group of manmade compounds that are not broken down in the body. Four PFCs (PFHxS, PFOS, PFOA, and PFNA) have been found in the blood of more than 98% of the United States population.
  
  
  OBJECTIVE
  Our goal was to assess associations between PFHxS, PFOS, PFOA, and PFNA and uric acid, alanine transferase (ALT), gamma-glutamyl transferase (GGT), asparate aminotransferase (AST), alkaline phosphate (ALP), and total bilirubin in 2007-2008 and 2009-2010 combined National Health and Nutrition Examination Survey (NHANES).
  
  
  METHODS
  We used multivariate linear regression and logistic regression adjusted for age, gender, race/ethnicity and BMI group, poverty, smoking, and/or alcohol consumption to estimate associations. Trend analysis was performed.
  
  
  RESULTS
  PFHxS was associated with ALT. Each quartile of PFOS was statistically associated with total bilirubin [(Q2: OR=1.44, 95% CI 1.12-1.84), (Q3: OR=1.65, 95% CI 1.25-2.18), and (Q4: OR=1.51, 95% CI 1.06-2.15)], with evidence of an increasing trend (p-value=0.028). PFOA was associated with uric acid, ALT, GGT, and total bilirubin. PFNA was linearly associated with ALT (p-value <0.001), and there was statistically significant increasing trend (p-value=0.042).
  
  
  CONCLUSIONS
  Our analysis found evidence of associations of biomarkers of liver function and uric acid with PFHxS, PFOS, PFOA, and PFNA at levels found in the general U.S. population.
authors.affiliation: Environmental and Occupational Health Surveillance Program, New Jersey Department of Health, 135 East State Street, P.O. Box 369, Trenton, NJ 08625 USA. Electronic address: jessie.gleason@doh.state.nj.us.
authors.forename: Jessie A
authors.initials: JA
authors.lastname: Gleason
authors.affiliation: Office of Science, New Jersey Department of Environmental Protection, 428 East State Street, Trenton, NJ 08609 USA. Electronic address: gloria.post@dep.nj.gov.
authors.forename: Gloria B
authors.initials: GB
authors.lastname: Post
authors.affiliation: Environmental and Occupational Health Surveillance Program, New Jersey Department of Health, 135 East State Street, P.O. Box 369, Trenton, NJ 08625 USA. Electronic address: jerald.fagliano@doh.state.nj.us.
authors.forename: Jerald A
authors.initials: JA
authors.lastname: Fagliano
mesh_terms: D015415:Biomarkers / Q000097:blood*; D005466:Fluorocarbons / Q000097:blood*; D006801:Humans; D009749:Nutrition Surveys; D014481:United States; D014527:Uric Acid / Q000097:blood*
chemical_list: D015415:Biomarkers; D005466:Fluorocarbons; D014527:Uric Acid
keywords: Liver function; NHANES; Perfluorochemicals; Uric acid