The Impact of Smoking on the Association between Perfluoroalkyl Acids (PFAS) and Thyroid Hormones: A National Health and Nutrition Examination Survey Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source and Study Population
2.2. NHANES Laboratory Assessments
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Variables | Total Population | PFOA (µmol/L) | PFOS (µmol/L) | PFHxS (µmol/L) | PFNA (µmol/L) | Total PFAS (µmol/L) | Free T4 (ng/dL) | Total T4 (µg/dL) | Free T3 (pg/mL) | Total T3 (ng/dL) | TSH (mIU/L) |
---|---|---|---|---|---|---|---|---|---|---|---|
n (%) | GM (SE) | GM (SE) | GM (SE) | GM (SE) | GM (SE) | Mean (SE) | Mean (SE) | Mean (SE) | Mean (SE) | GM (SE) | |
All | 1325 (100) | 8.89 (0.31) | 33.52 (1.13) | 5.20 (0.26) | 4.26 (0.19) | 55.18 (1.65) | 0.82 (0.01) | 7.78 (0.08) | 3.17 (0.03) | 114.03 (1.26) | 1.50 (0.03) |
Sex | |||||||||||
Male | 717 (52.1) | 10.13 (0.37) | 42.22 (1.91) | 6.91 (0.39) | 4.54 (0.27) | 67.52 (2.77) | 0.82 (0.01) | 7.60 (0.09) | 3.26 (0.03) | 115.14 (1.82) | 1.53 (0.04) |
Female | 608 (47.9) | 7.71 (0.38) | 26.07 (1.01) | 3.81 (0.23) | 3.99 (0.14) | 44.29 (1.45) | 0.82 (0.01) | 7.97 (0.10) | 3.08 (0.02) | 112.82 (1.11) | 1.47 (0.04) |
Age (years) | |||||||||||
20–39 | 510 (38.2) | 8.18 (0.38) | 28.70 (1.55) | 4.84 (0.30) | 3.95 (0.20) | 48.27 (2.43) | 0.83 (0.01) | 7.78 (0.10) | 3.31 (0.03) | 120.26 (1.30) | 1.42 (0.04) |
40–59 | 442 (40.1) | 8.76 (0.47) | 32.37 (1.12) | 4.80 (0.29) | 4.19 (0.27) | 53.50 (1.81) | 0.80 (0.01) | 7.68 (0.10) | 3.16 (0.03) | 112.19 (1.57) | 1.47 (0.08) |
≥60 | 373 (21.7) | 10.58 (0.61) | 46.97 (2.46) | 6.81 (0.52) | 5.04 (0.30) | 73.89 (3.57) | 0.84 (0.01) | 7.95 (0.13) | 2.96 (0.02) | 106.48 (1.57) | 1.72 (0.09) |
Race | |||||||||||
NHW | 469 (65.5) | 9.68 (0.46) | 35.66 (1.32) | 5.97 (0.36) | 4.20 (0.25) | 58.80 (2.11) | 0.81 (0.01) | 7.67 (0.10) | 3.16 (0.03) | 112.82 (1.69) | 1.56 (0.05) |
NHB | 344 (11.5) | 7.66 (0.28) | 34.17 (3.07) | 4.49 (0.20) | 4.55 (0.26) | 54.26 (3.76) | 0.82 (0.01) | 8.01 (0.19) | 3.16 (0.02) | 115.49 (2.24) | 1.25 (0.04) |
Hispanic/other | 512 (23) | 7.52 (0.45) | 27.85 (2.21) | 3.78 (0.30) | 4.31 (0.32) | 46.44 (3.27) | 0.84 (0.01) | 7.96 (0.08) | 3.22 (0.02) | 116.76 (1.33) | 1.47 (0.04) |
BMI (kg/m2) | |||||||||||
<25 | 446 (33.1) | 8.85 (0.42) | 32.75 (1.46) | 5.19 (0.39) | 4.16 (0.20) | 54.32 (2.28) | 0.83 (0.01) | 7.56 (0.11) | 3.17 (0.04) | 110.89 (1.62) | 1.44 (0.04) |
25–30 | 428 (34.6) | 9.88 (0.60) | 36.36 (2.02) | 5.86 (0.39) | 4.80 (0.26) | 60.64 (2.82) | 0.81 (0.01) | 7.79 (0.10) | 3.15 (0.03) | 114.87 (1.52) | 1.54 (0.05) |
≥30 | 451 (32.3) | 7.98 (0.35) | 31.46 (2.10) | 4.58 (0.34) | 3.84 (0.23) | 50.67 (3.03) | 0.81 (0.01) | 7.98 (0.11) | 3.20 (0.03) | 116.36 (1.84) | 1.51 (0.05) |
Smoking * | |||||||||||
Non-smoker | 1058 (79.4) | 9.30 (0.33) | 35.61 (1.27) | 5.38 (0.28) | 4.47 (0.20) | 58.33 (1.86) | 0.82 (0.01) | 7.79 (0.09) | 3.16 (0.02) | 113.11 (1.30) | 1.52 (0.04) |
Smoker | 266 (20.6) | 7.50 (0.51) | 26.56 (1.74) | 4.58 (0.35) | 3.57 (0.25) | 44.63 (2.74) | 0.82 (0.01) | 7.73 (0.15) | 3.24 (0.05) | 117.57 (1.92) | 1.41 (0.07) |
Serum cotinine (ng/mL) | |||||||||||
Non-smoker | 993 (74.9) | 9.28 (0.33) | 35.36 (1.10) | 5.35 (0.29) | 4.47 (0.04) | 58.04 (1.64) | 0.82 (0.01) | 7.78 (0.09) | 3.15 (0.02) | 112.91 (1.39) | 1.54 (0.03) |
Smoker | 332 (25.1) | 7.82 (0.43) | 28.57 (1.90) | 4.78 (0.29) | 3.70 (0.24) | 47.43 (2.71) | 0.82 (0.01) | 7.78 (0.14) | 3.24 (0.05) | 117.37 (1.76) | 1.38 (0.07) |
Ln TSH (mIU/L) | Ln Total T4 (µg/dL) | Ln Free T4 (ng/dL) | Ln Total T3 (ng/dL) | Ln Free T3 (pg/mL) | ||||||
---|---|---|---|---|---|---|---|---|---|---|
PFAS | Badj * (95% CI) | p-Value | Badj * (95% CI) | p-Value | Badj * (95% CI) | p-Value | Badj * (95% CI) | p-Value | Badj * (95% CI) | p-Value |
Ln PFOA (µmol/L) | 0.006 (−0.041; 0.053) | 0.787 | −0.008 (−0.027; 0.012) | 0.411 | 0.007 (−0.007; 0.021) | 0.311 | 0.011 (−0.009; 0.031) | 0.252 | 0.003 (−0.011; 0.018) | 0.612 |
Ln PFOS (µmol/L) | −0.002 (−0.055; 0.051) | 0.943 | −0.010 (−0.024; 0.004) | 0.138 | 0.021 (0.008; 0.035) | 0.003 | 0.001 (−0.015; 0.017) | 0.873 | 0.002 (−0.006; 0.010) | 0.565 |
Ln PFHxS (µmol/L) | 0.002 (−0.036; 0.040) | 0.899 | −0.005 (−0.023; 0.013) | 0.558 | 0.011 (−0.003; 0.025) | 0.127 | 0.010 (−0.006; 0.026) | 0.198 | −0.001 (−0.015; 0.012) | 0.834 |
Ln PFNA (µmol/L) | −0.005 (−0.050; 0.041) | 0.837 | 0.000 (−0.019; 0.020) | 0.968 | 0.021 (0.005; 0.038) | 0.014 | 0.013 (−0.006; 0.032) | 0.174 | 0.012 (0.002; 0.023) | 0.024 |
Ln total PFAS (µmol/L) | −0.004 (−0.056; 0.049) | 0.883 | −0.010 (−0.027; 0.007) | 0.216 | 0.023 (0.009; 0.038) | 0.004 | 0.003 (−0.014; 0.020) | 0.716 | 0.003 (−0.008; 0.014) | 0.613 |
Smoking Status | Ln TSH (mIU/L) | Ln Total T4 (µg/dL) | Ln Free T4 (ng/dL) | Ln Total T3 (ng/dL) | Ln Free T3 (pg/mL) | |||||
Non-Smoker | Badj * (95% CI) | p-Value | Badj * (95% CI) | p-Value | Badj * (95% CI) | p-Value | Badj * (95% CI) | p-Value | Badj * (95% CI) | p-Value |
Ln PFOA (µmol/L) | −0.001 (−0.050; 0.049) | 0.975 | −0.007 (−0.025; 0.011) | 0.435 | 0.010 (−0.005; 0.025) | 0.179 | 0.007 (−0.015; 0.029) | 0.494 | 0.003 (−0.013; 0.020) | 0.658 |
Ln PFOS (µmol/L) | −0.023 (−0.067; 0.021) | 0.299 | −0.010 (−0.024; 0.005) | 0.170 | 0.024 (0.009; 0.039) | 0.003 | −0.006 (−0.021; 0.00) | 0.447 | −0.001 (−0.009; 0.008) | 0.840 |
Ln PFHxS (µmol/L) | −0.015 (−0.057; 0.028) | 0.478 | −0.003 (−0.018; 0.012) | 0.675 | 0.014 (0.001; 0.026) | 0.034 | 0.010 (−0.005; 0.024) | 0.178 | −0.000 (−0.013; 0.012) | 0.994 |
Ln PFNA (µmol/L) | 0.005 (−0.047; 0.056) | 0.855 | 0.002 (−0.021; 0.025) | 0.866 | 0.026 (0.006; 0.045) | 0.012 | 0.007 (−0.015; 0.029) | 0.509 | 0.013 (−0.002; 0.027) | 0.094 |
Ln PFAS (µmol/L) | −0.021 (−0.066; 0.025) | 0.351 | −0.010 (−0.025; 0.006) | 0.205 | 0.026 (0.010; 0.043) | 0.003 | −0.004 (−0.021; 0.013) | 0.645 | 0.000 (−0.011; 0.012) | 0.938 |
Smoker | Badj * (95% CI) | p-Value | Badj * (95% CI) | p-Value | Badj * (95% CI) | p-Value | ||||
Ln PFOA (µmol/L) | 0.051 (−0.073; 0.175) | 0.396 | −0.016 (−0.058; 0.025) | 0.424 | −0.013 (−0.042; 0.017) | 0.385 | 0.029 (0.005; 0.054) | 0.021 | 0.002 (−0.025; 0.028) | 0.904 |
Ln PFOS (µmol/L) | 0.087 (−0.041; 0.214) | 0.170 | −0.016 (−0.057; 0.025) | 0.413 | 0.004 (−0.021; 0.028) | 0.746 | 0.032 (−0.002; 0.065) | 0.064 | 0.013 (−0.007; 0.034) | 0.180 |
Ln PFHxS (µmol/L) | 0.074 (−0.033; 0.180) | 0.164 | −0.019 (−0.062; 0.024) | 0.365 | −0.005 (−0.035; 0.025) | 0.707 | 0.015 (−0.023; 0.052) | 0.413 | −0.003 (−0.029; 0.022) | 0.786 |
Ln PFNA (µmol/L) | −0.023 (−0.129; 0.082) | 0.649 | −0.008 (−0.048; 0.031) | 0.661 | 0.006 (−0.028; 0.039) | 0.726 | 0.027 (0.006; 0.048) | 0.015 | 0.009 (−0.007; 0.026) | 0.251 |
Ln PFAS (µmol/L) | 0.074 (−0.055; 0.203) | 0.244 | −0.020 (−0.066; 0.027) | 0.389 | 0.003 (−0.023; 0.029) | 0.808 | 0.033 (−0.000; 0.067) | 0.054 | 0.011 (−0.012; 0.034) | 0.333 |
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van Gerwen, M.; Alpert, N.; Alsen, M.; Ziadkhanpour, K.; Taioli, E.; Genden, E. The Impact of Smoking on the Association between Perfluoroalkyl Acids (PFAS) and Thyroid Hormones: A National Health and Nutrition Examination Survey Analysis. Toxics 2020, 8, 116. https://doi.org/10.3390/toxics8040116
van Gerwen M, Alpert N, Alsen M, Ziadkhanpour K, Taioli E, Genden E. The Impact of Smoking on the Association between Perfluoroalkyl Acids (PFAS) and Thyroid Hormones: A National Health and Nutrition Examination Survey Analysis. Toxics. 2020; 8(4):116. https://doi.org/10.3390/toxics8040116
Chicago/Turabian Stylevan Gerwen, Maaike, Naomi Alpert, Mathilda Alsen, Kimia Ziadkhanpour, Emanuela Taioli, and Eric Genden. 2020. "The Impact of Smoking on the Association between Perfluoroalkyl Acids (PFAS) and Thyroid Hormones: A National Health and Nutrition Examination Survey Analysis" Toxics 8, no. 4: 116. https://doi.org/10.3390/toxics8040116