Evidence map›Paper›PMID 39995619›Full record

ArticleFrontiers in public health2025

Association of per- and polyfluoroalkyl substances with gout risk: a cross-sectional analysis of NHANES 2007-2018 data emphasizing mixture effects.

Haixin Feng, Siran Li, Shiqing Huang, Linxi He, Ruihao Huang, Renhuizi Wei, Xin Peng, Haiyi Yan, Chongxiang Xiong, Bingsong Zhang

Abstract read
In one paragraph

Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Haixin Feng *Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Medical University, Dongguan, China.
Siran Li *Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Medical University, Dongguan, China.
Shiqing HuangDepartment of Epidemiology and Biostatistics, School of Public Health, Guangdong Medical University, Dongguan, China.
Linxi HeDepartment of Epidemiology and Biostatistics, School of Public Health, Guangdong Medical University, Dongguan, China.
Ruihao HuangDepartment of Epidemiology and Biostatistics, School of Public Health, Guangdong Medical University, Dongguan, China.
Renhuizi WeiOffice of Quality Management, Hospital of Huangjiang Dongguan, Dongguan, China.
Xin PengDepartment of Epidemiology and Biostatistics, School of Public Health, Guangdong Medical University, Dongguan, China.
Haiyi YanDepartment of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China.
Chongxiang XiongDepartment of Nephrology, The First Dongguan Affiliated Hospital of Guangdong Medical University, Dongguan, China.
Bingsong ZhangDepartment of Epidemiology and Biostatistics, School of Public Health, Guangdong Medical University, Dongguan, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: This study examined associations between serum concentrations of per- and polyfluoroalkyl substances (PFASs) and gout risk in the U.S. adult population using the National Health and Nutrition Examination Survey (NHANES) 2007-2018 data. And assessing the potential intermediary effect of uric acid. Methods: The study included 8,494 participants, with 385 having gout. Four PFAS compounds (PFOA, PFOS, PFHxS, PFNA) were measured. PFOS is the most prevalent PFAS in the environment, biota, and human tissues. It is rapidly absorbed and accumulates in the liver, kidneys, and blood, binding to serum albumin and low-density lipoprotein. PFOA is highly persistent in the body, mainly accumulating in the kidneys and liver through enterohepatic circulation, posing risks due to its difficulty in metabolism and excretion. PFHxS has the longest metabolic half-life in humans (7.3 years) and bioaccumulates in the endocrine, immune, nervous, and reproductive systems. PFNA is the second most detected PFAS in human serum after PFOS. It is more likely to accumulate and express toxicity in the reproductive organs, liver, and immune system compared to PFOS and PFOA. Multivariate logistic regression and weighted quantile sum regression were used to assess individual and mixture effects. Mediation analysis was conducted to estimate effect of uric acid. Results: In fully adjusted model, the associations were nonsignificant, with PFOA showing a marginally positive association. Mixture analysis revealed a significant positive association with gout risk across all models. PFOS was the largest contributor to the mixture effect. Stronger associations were observed in old people and females. Sensitivity analyses confirmed the robustness of these findings. Mediation analysis indicated significant intermediary effect of uric acid in the associations of PFAS with risk of gout, with the mediated proportion ranging from 48 to 77%. Conclusion: This study provides evidence for a potential link between PFAS exposure and gout risk, particularly when considering mixtures. While associations with individual PFASs are largely explained by demographic and lifestyle factors, the persistent association of mixtures with gout risk highlights the importance of considering combined exposures in environmental health research. Uric acid level plays a crucial intermediary effect.

Indexed as

Environmental ExposureEnvironmental PollutantsFluorocarbonsGoutAdultAgedCross-Sectional StudiesFemaleHumansMaleMiddle AgedNutrition SurveysRisk FactorsUnited StatesUric AcidEnvironmental PollutantsFluorocarbonsUric Acidgoutlogistic regressionmixture exposurePFAS (per- and polyfluoroalkyl substances)WQS regression

Identifiers

PMID39995619
PMCPMC11847820

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.