摘要：AbstractBackgroundHepato- and nephrotoxicity of fluoride have been demonstrated in animals, but few studies have examined potential effects in humans. This population-based study examines the relationship between chronic low-level fluoride exposure and kidney and liver function among United States (U.S.) adolescents. This study aimed to evaluate whether greater fluoride exposure is associated with altered kidney and liver parameters among U.S. youth.MethodsThis cross-sectional study utilized data from the National Health and Nutrition Examination Survey (2013–2016). We analyzed data from 1983 and 1742 adolescents who had plasma and water fluoride measures respectively and did not have kidney disease. Fluoride was measured in plasma and household tap water. Kidney parameters included estimated glomerular filtration rate (calculated by the original Schwartz formula), serum uric acid, and the urinary albumin to creatinine ratio. Liver parameters were assessed in serum and included alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, blood urea nitrogen, gamma-glutamyl transferase, and albumin. Survey-weighted linear regression examined relationships between fluoride exposure and kidney and liver parameters after covariate adjustment. A Holm-Bonferroni correction accounted for multiple comparisons.ResultsThe average age of adolescents was 15.4 years. Median water and plasma fluoride concentrations were 0.48 mg/L and 0.33 μmol/L respectively. A 1 μmol/L increase in plasma fluoride was associated with a 10.36 mL/min/1.73 m2lower estimated glomerular filtration rate (95% CI: −17.50, −3.22;p = 0.05), a 0.29 mg/dL higher serum uric acid concentration (95% CI: 0.09, 0.50;p = 0.05), and a 1.29 mg/dL lower blood urea nitrogen concentration (95%CI: −1.87, −0.70;p p = 0.007).ConclusionsFluoride exposure may contribute to complex changes in kidney and liver related parameters among U.S. adolescents. As the study is cross-sectional, reverse causality cannot be ruled out; therefore, altered kidney and/or liver function may impact bodily fluoride absorption and metabolic processes.Highlights•Plasma fluoride concentrations are associated with kidney and liver parameters among United States (U.S.) adolescents•Higher water fluoride concentrations are associated with lower blood urea nitrogen among U.S. adolescents•Fluoride exposure may contribute to complex changes in kidney and liver related parameters among U.S. adolescents•Altered kidney and/or liver function may impact bodily fluoride absorption and metabolic processes
关键词：AbbreviationseGFRestimated glomerular filtration rate;ACRurinary albumin to creatinine ratio;BUNblood urea nitrogen;ALTalanine aminotransferase;ALPalkaline phosphatase;ASTaspartate amino transferase;GGTgamma-glutamyl transferase;SUAserum uric acid;Fluoride;Kidney;Liver;United States;Adolescents
