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Selective Associations of Recent Low Concentrations of Perfluoroalkyl Substances With Liver Function Biomarkers

NHANES 2011 to 2014 Data on US Adults Aged ≥20 Years

Jain, Ram B., PhD; Ducatman, Alan, MD, MS

Journal of Occupational and Environmental Medicine: April 2019 - Volume 61 - Issue 4 - p 293–302
doi: 10.1097/JOM.0000000000001532

Objective: Perfluoroalkyl substances (PFAS) and liver function biomarkers were reexamined for relatively lower serum concentrations of PFAS observed in recent years.

Methods: National Health and Nutrition Examination Survey 2011 to 2014 data were analyzed for obese and nonobese participants for serum perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorodecanoic acid (PFDA), perfluorohexane sulfonate (PFHxS), perfluorononanoic acid (PFNA) as well as four liver function biomarkers in risk-adjusted analysis.

Results: Among obese participants only, alanine aminotransferase (ALT) was positively associated with PFOA (β = 0.07065, P < 0.01), PFHxS (β = 0.051349, P < 0.01), and with PFNA (β = 0.072742, P < 0.01). PFOA (β = 0.07422, P = 0.03) and PFNA (β = 0.077995, P < 0.01) were associated with gamma glutamyl transferase (GGT) in obese participants.

Conclusions: Recent lower levels of PFOA, PFHxS, and PFNA are associated with higher serum liver functions but only among obese participants. The findings are consistent with PFAS animal toxicology concerning steatosis.

Independent Researcher, Dacula, Georgia (Dr Jain); West Virginia University School of Public Health, Morgantown, West Virginia (Dr Ducatman).

Address correspondence to: Ram B. Jain, PhD, 2959 Estate View Ct, Dacula, GA 30019 (

Dr Jain declares that he had no financial and/or other conflicts that could have affected the conclusions arrived at in this communication. Dr Ducatman has received funding for health communications related to the enrollment of the C8 Health Population, and he has provided scientific support to communities seeking similar class actions class action support to institute medical monitoring.

No human subjects were involved in this research and all data used in this research are available free of cost at

Copyright © 2019 by the American College of Occupational and Environmental Medicine