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Fluoride exposure and kidney and liver function among adolescents in the United States: NHANES, 2013-2016.

ABSTRACT: BACKGROUND:Hepato- 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. METHODS:This 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. RESULTS:The average age of adolescents was 15.4?years. Median water and plasma fluoride concentrations were 0.48?mg/L and 0.33??mol/L respectively. A 1??mol/L increase in plasma fluoride was associated with a 10.36?mL/min/1.73?m2 lower 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?

SUBMITTER: Malin AJ

PROVIDER: S-EPMC6754771 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Fluoride exposure and kidney and liver function among adolescents in the United States: NHANES, 2013-2016.

Malin Ashley J AJ Lesseur Corina C Busgang Stefanie A SA Curtin Paul P Wright Robert O RO Sanders Alison P AP

Environment international 20190808

<h4>Background</h4>Hepato- 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.<h4>Methods</h4>This cross-sectional study ut ...[more]

PMID: 31402058

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Project description:Exposure to trihalomethanes (or THMs: chloroform, bromoform, bromodichloromethane, and dibromochloromethane [DBCM]) formed via drinking water disinfection has been associated with adverse reproductive outcomes and cancers of the digestive or genitourinary organs. However, few studies have examined potential associations between THMs and liver injury in humans, even though experimental studies suggest that these agents exert hepatotoxic effects, particularly among obese individuals. This study examined participants in the National Health and Nutrition Examination Survey (1999-2006, N=2781) to test the hypothesis that THMs are associated with liver injury as assessed by alanine aminotransferase (ALT) activity in circulation. Effect modification by body mass index (BMI) or alcohol consumption also was examined. Associations between blood THM concentrations and ALT activity were assessed using unconditional multiple logistic regression to calculate prevalence odds ratios (ORs) with 95% confidence intervals (CIs) for exposure among cases with elevated ALT activity (men: >40IU/L, women: >30IU/L) relative to those with normal ALT, after adjustment for variables that may confound the relationship between ALT and THMs. Compared to controls, cases were 1.35 times more likely (95% CI: 1.02, 1.79) to have circulating DBCM concentrations exceeding median values in the study population. There was little evidence for effect modification by BMI, although the association varied by alcohol consumption. Among non-drinkers, cases were more likely than controls to be exposed to DBCM (OR: 3.30, 95% CI: 1.37, 7.90), bromoform (OR: 2.88, 95% CI: 1.21, 6.81), or brominated THMs (OR: 4.00, 95% CI: 1.31, 12.1), but no association was observed among participants with low, or moderate to heavy alcohol consumption. Total THM levels exceeding benchmark exposure limits continue to be reported both in the United States and globally. Results from this study suggest a need for further characterization of ALT activity and possibly other hepatic or metabolic diseases in populations with elevated drinking water THM concentrations.

Dataset Information

Fluoride exposure and kidney and liver function among adolescents in the United States: NHANES, 2013-2016.

Publications

Fluoride exposure and kidney and liver function among adolescents in the United States: NHANES, 2013-2016.

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