Exposure to Perfluoroalkyl Chemicals and its Relation to Serum Lipids, Serum Uric Acid, and Blood Pressure Levels in Children.

Introduction: PFCs are manmade chemicals that are very pervasive in the US. They have been found to be present in the blood of more than 98% of Americans and have a long half-life. Studies have shown that perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) have endocrine-disrupting properties and exposure is positively associated with serum lipids, serum uric acid, reproductive effects, low birth weight and cancers, among other negative health effects. Cardiovascular disease is a leading cause of death worldwide and risk factors include dyslipidemia, hyperuricemia, and hypertension. In this context, we examined the association between PFOA and PFOS and serum lipid levels, serum uric acid levels, and blood pressure levels among children in three related studies using nationally representative data. Methods: A cross-sectional study was performed on participants ≤ 18 years of age from the National Health and Nutrition Examination Survey, 1999-2000 and 2003-2008. The main outcomes of interest for three related studies were dyslipidemia (n=815), hyperuricemia (n=1,772), and hypertension (n=1,655). Consistent with current guidelines and existing literature, dyslipidemia was defined as ≥170 mg/dL for total-C, ≥110 mg/dL for LDL-C, \u3c40 mg/dL for HDL-C and ≥150 mg/dL for triglycerides; hyperuricemia was defined as serum uric acid levels ≥6 mg/dL; and hypertension was defined as age, height, and gender-specific systolic and/or diastolic blood pressure measured at the 95th percentile or greater on repeated measurement. Results: We conducted linear and logistic regression analysis for each study, using unadjusted, age, sex-adjusted, and multivariable adjusted models. Results showed positive associations between increasing levels of exposure to PFOA and PFOS and serum lipid levels and serum uric acid levels overall, but no association between PFOA and PFOS and blood pressure levels in children. Compared to those in quartile 1 of PFOA exposure (referent), participants in the highest exposure group experienced a multivariable-adjusted odds ratio (OR) of 1.49 (95% confidence interval [CI] 1.05-2.12) for high total cholesterol, 1.62 (1.10-2.37) for hyperuricemia, and .69 (.41, 1.17) for hypertension. Conclusion: Our findings indicate that exposure to PFOA or PFOS is significantly associated with dyslipidemia and hyperuricemia, but not hypertension in children at the lower PFC exposure levels typical of the general population