No association between perfluoroalkyl chemicals and hypertension in children

Background Hypertension is a leading cause of cardiovascular disease worldwide. Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) are perfluoroalkyl chemicals (PFCs) used in the manufacture of common consumer products and detected in the blood of the majority of Americans. Emerging biological data suggest that PFC exposure may have a role in the development of hypertension. However, the association between PFCs and hypertension has not yet been explored in humans. Therefore, we examined this association in a representative sample of US children. Methods A cross-sectional study was performed on 1,655 children from the National Health and Nutrition Examination Survey, 1999–2000 and 2003–2008. The main outcome of interest was hypertension, defined as age, height, and sex specific systolic and/or diastolic blood pressure level at the 95th percentile. Results We found no association between serum levels of PFOA and PFOS and hypertension in either unadjusted or multivariable-adjusted analyses controlling for age, sex, race-ethnicity, body mass index, annual household income, moderate activity, total serum cholesterol, and serum cotinine. Compared with the lowest quartile, the multivariable-adjusted odds ratio (95% confidence interval) of hypertension in the highest quartile of exposure was 0.69 (0.41–1.17) for PFOA and 0.77 (0.37–1.61) for PFOS (all P-trend values >0.30). Conclusion Our findings indicate that exposure to PFOA or PFOS is not significantly associated with hypertension in children at the lower PFC exposure levels typical of the general population

The Relationship between Insufficient Sleep and Self-Rated Health in a Nationally Representative Sample

Reduced sleep has been found to be associated with increased risk of diabetes mellitus, hypertension, cardiovascular disease (CVD), and mortality. Self-rated health (SRH) has been shown to be a predictor of CVD and mortality. However, study of the association between insufficient sleep and SRH is limited. We examined participants >18 years of age (n = 377, 160) from a representative, cross-sectional survey (2008 BRFSS). Self-reported insufficient sleep in the previous 30 days was categorized into six groups. The outcome was poor SRH. We calculated odds ratios ((OR) (95% confidence interval (CI)) of increasing categories of insufficient rest/sleep, taking zero days of insufficient sleep as the referent category. We found a positive association between increasing categories of insufficient sleep and poor SRH, independent of relevant covariates. In the multivariable-adjusted model, compared to 0 days insufficient sleep, the OR (95% CI) of poor SRH was 1.03 (0.97–1.10) for 1–6 days, 1.45 (1.34–1.57) for 7–13 days, 2.12 (1.97–2.27) for 14–20 days, 2.32 (2.09–2.58) for 21–29 days, and and 2.71 (2.53–2.90) for 30 days of insufficient sleep in the prior 30 days (P-trend <0.0001). In a nationally representative sample, increasing categories of insufficient sleep were associated with poor SRH

The Relationship between Sleep-Disordered Breathing and Hypertension in a Nationally Representative Sample

Sleep-disordered breathing (SDB), characterized by abnormal respiratory patterns or inadequate quantity of ventilation, is common in adults. A positive association between SDB and hypertension has been established, in both cross-sectional and longitudinal studies. One void in the literature concerns the role of race/ethnicity in the association between SDB and hypertension. In this context, a cross-sectional study was performed on 6,783 participants in the National Health and Nutrition Examination Survey 2005-2008. Participants were ≥age 20 and free from cardiovascular disease. The outcome of interest was hypertension, defined as ≥140 mmHg systolic blood pressure (BP), and/or ≥90 mmHg diastolic BP or antihypertensive medication use. Self-reported SDB was positively associated with hypertension, independent of confounders such as depression, diabetes, cholesterol levels, and body mass index, among others. The association persisted in subgroup analyses by gender, with a stronger association among males than females, as well as by race/ethnicity, with non-Hispanic blacks displaying the strongest association. In the multivariable-adjusted model, compared to a sleep summary score of zero (referent), the OR (95% CI) of hypertension for non-Hispanic blacks was 1.34 (0.98-1.83) for a sleep summary score of 1, 1.44 (1.06-1.97) for a score of 2 and 3.72 (1.98-7.00) for a score of &gt;3; p-trend &lt; 0.0001. SDB was positively associated with hypertension in a large, nationally representative sample of US adults. Along with being prevalent, SDB is also treatable. Therefore, our results are important for minority race/ethnic groups who typically experience a higher baseline for negative health outcomes

Interaction effects of polyfluoroalkyl substances and sex steroid hormones on asthma among children

To evaluate the interactions between polyfluoroalkyl substances (PFASs) and reproductive hormones and associated asthma, a total of 231 asthmatic and 225 non-asthmatic adolescents were selected from northern Taiwan in the Genetic and Biomarkers study for Childhood Asthma from 2009-2010. The interaction between PFASs and reproductive hormones on asthma was analyzed with a two-level binary logistic regression model. The results showed that, among asthmatics, PFASs were positively associated with estradiol levels and negatively associated with testosterone levels. However, only significant association was identified for PFNA and estradiol in control group. After controlling for hormone levels, associations between PFAS exposure and asthma were consistently stronger among children with higher than lower estradiol, with odds ratios (OR) for asthma ranging from 1.25 for PFOS (95% Confidence Interval [CI]: 0.90, 1.72) to 4.01 for PFDA (95% CI: 1.46, 11.06) among boys and 1.25 for PFOS (95% CI: 0.84, 1.86) to 4.16 for PFNA (95% CI: 1.36, 12.73) among girls. Notably, the interactions between estradiol and PFASs were significant for PFOS (p = 0.026) and PFNA (p = 0.043) among girls. However, testosterone significantly attenuated the association between PFOS and asthma across sex. In conclusions, our findings suggested that reproductive hormones amplify the association between PFASs and asthma among adolescents

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

The Relationship between Sleep-Disordered Breathing and Hypertension in a Nationally Representative Sample

Sleep-disordered breathing (SDB), characterized by abnormal respiratory patterns or inadequate quantity of ventilation, is common in adults. A positive association between SDB and hypertension has been established, in both cross-sectional and longitudinal studies. One void in the literature concerns the role of race/ethnicity in the association between SDB and hypertension. In this context, a cross-sectional study was performed on 6,783 participants in the National Health and Nutrition Examination Survey 2005–2008. Participants were ≥age 20 and free from cardiovascular disease. The outcome of interest was hypertension, defined as ≥140 mmHg systolic blood pressure (BP), and/or ≥90 mmHg diastolic BP or antihypertensive medication use. Self-reported SDB was positively associated with hypertension, independent of confounders such as depression, diabetes, cholesterol levels, and body mass index, among others. The association persisted in subgroup analyses by gender, with a stronger association among males than females, as well as by race/ethnicity, with non-Hispanic blacks displaying the strongest association. In the multivariable-adjusted model, compared to a sleep summary score of zero (referent), the OR (95% CI) of hypertension for non-Hispanic blacks was 1.34 (0.98–1.83) for a sleep summary score of 1, 1.44 (1.06–1.97) for a score of 2 and 3.72 (1.98–7.00) for a score of >3; p-trend < 0.0001. SDB was positively associated with hypertension in a large, nationally representative sample of US adults. Along with being prevalent, SDB is also treatable. Therefore, our results are important for minority race/ethnic groups who typically experience a higher baseline for negative health outcomes

Sex-specific difference in the association between poor sleep quality and abdominal obesity in rural Chinese: A large population-based study

- Journal is deposited in PubMed Central for public release after 2017-10-15 STUDY OBJECTIVES Existing studies on sleep quality and associated obesity are inconsistent, and few studies have prospectively evaluated the association between sleep quality and abdominal obesity among Chinese individuals. To fill this void, the current study aimed to assess the association between sleep quality and abdominal obesity in a rural Chinese population. METHODS A representative sample of 9,404 adults aged 20-93 years in northeastern China was selected between 2012 and 2013 by a multistage cluster and random sampling method. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI), where a score of 6 or higher indicated sleep disorder. Abdominal obesity was measured by waist circumference (WC), with abdominal obesity defined as WC > 90 cm for men and WC > 80 cm for women. RESULTS Male participants with abdominal obesity had higher global PSQI scores in addition to higher subscores in almost all of the elements compared to normal values. The odds ratios of abdominal obesity among participants with sleep disorders were 1.64 (95% confidence interval [CI]: 1.39-1.95) and 1.14 (95% CI: 0.98-1.32) for males and females compared to the reference group. The risk in all sleep elements was significantly increased, with odds ratios ranging from 1.28 (95% CI: 1.08-1.51) to 5.81 (95% CI: 3.54-9.53) for males. The risk only in four elements was significantly increased, from 1.28 (95% CI: 1.12-1.47) to 2.27 (95% CI: 1.36-3.80) for females. CONCLUSIONS Poor sleep quality was associated with abdominal obesity in Chinese. Furthermore, effects in males were larger than those in females

Associations of perfluorooctane sulfonate alternatives and serum lipids in Chinese adults

Background: Chlorinated polyfluorinated ether sulfonic acids (Cl-PFESAs), a group of perfluorooctane sulfonate (PFOS) alternatives, can be widely observed in humans and environmental matrices. However, associations between exposure to Cl-PFESAs and serum lipid levels in adults are unknown. Objective: To explore the relationships between Cl-PFESA levels and serum lipid levels in adults. Methods: We analyzed 1238 adults from the Isomers of C8 Health Project, a cross-sectional study conducted in China from July 2015 to October 2016. The average age of the participants was 61.98 ± 14.40 years. We quantified two select legacy per- and perfluoroalkyl substances [perfluorooctanoic acid (PFOA) and PFOS] and their alternatives (6:2 and 8:2 Cl-PFESAs). We also measured four serum lipids: low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglycerides (TG). We used generalized linear models to estimate the associations between PFASs and serum lipids, with PFASs defined as either a categorical variable divided into quartiles or as a continuous variable. Results: We found that 6:2 Cl-PFESA was positively associated with serum TC and LDL-C. For instance, LDL-C levels in the highest quartile of 6:2 Cl-PFESA exposure (Q4) were significantly higher than those in the lowest quartile (Q1) [β: 0.19, 95% confidence interval (CI): 0.08, 0.30]. Further analysis showed that one ln-ng/mL increase in 6:2 Cl-PFESA exposure corresponded to a 0.10 mmol/L (95% CI: 0.05, 0.16) LDL-C increase, and that exposure to 8:2 Cl-PFESA was negatively correlated with HDL-C (β: −0.03, 95% CI: −0.05, −0.01). TC had a similar relationship with both 6:2 Cl-PFESA and legacy PFASs. Participants with a BMI ≥ 25 kg/m2 exhibited a stronger association between 6:2 Cl-PFESA and TC. Conclusions: Our findings make the novel suggestion that exposure to Cl-PFESAs are adversely associated with serum lipid levels, and that such associations are also observed in legacy PFASs. Increased investigation into the effects of Cl-PFESAs exposure on human health is warranted

Associations between social, biologic, and behavioral factors and biomarkers of oxidative stress during pregnancy: Findings from four ECHO cohorts.

BackgroundLower socioeconomic status (SES) and elevated psychosocial stress are known contributors to adverse pregnancy outcomes; however, biological mechanisms linking these factors to adverse pregnancy outcomes are not well-characterized. Oxidative stress may be an important, yet understudied mechanistic pathway. We used a pooled study design to examine biological, behavioral, and social factors as predictors of prenatal oxidative stress biomarkers.MethodsLeveraging four pregnancy cohorts from the Environmental influences on Child Health Outcomes (ECHO) Program spanning multiple geographic regions across the United States (U.S.) (N = 2082), we measured biomarkers of oxidative stress in urine samples at up to three time points during pregnancy, including 8-isoprostane-prostaglandin F2α (8-isoPGF2α), its major metabolite, 2,3-dinor-5,6-dihydro-15-F2t-isoprostane, and prostaglandin F2α (PGF2α). Maternal age, pre-pregnancy body mass index, marital/partnered status, parity, and smoking status were included as biological and behavioral factors while race/ethnicity, maternal education, and stressful life events were considered social factors. We examined associations between each individual biological, behavioral, and social factor with oxidative stress biomarkers using multivariable-adjusted linear mixed models.ResultsNumerous biological, behavioral, and social factors were associated with elevated levels of 8-isoPGF2α, its major metabolite, and PGF2α. Pregnant people who were current smokers relative to non-smokers or had less than a high school education relative to a college degree had 11.04% (95% confidence interval [CI] = -1.97%, 25.77%) and 9.13% (95% CI = -1.02%, 20.32%) higher levels of 8-isoPGF2α, respectively.ConclusionsOxidative stress biomarkers are elevated among pregnant people with higher socioeconomic disadvantage and may represent one pathway linking biological, behavioral, and social factors to adverse pregnancy and child health outcomes, which should be explored in future work