ArticleEnvironmental research2025
Short-chain per- and polyfluoroalkyl substances associate with elevated alanine aminotransferase: Cross-sectional analysis results from the STRIVE cohort.
Article in Environmental research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Review
- Associations between per- and polyfluoroalkyl substances and metabolic dysfunction-associated steatotic liver disease in adolescents and young adults: modifying roles of age, lifestyle factors, and PNPLA3 genotype.Environmental research · 2026Article
- Environmental epigenomics and the human imprintome.Environmental epigenetics · 2025Article
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21 authors.
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Abstract
backgroundThe impact of short-chain, low molecular weight polyfluoroalkyl substances (PFAS) and long-chain, high molecular weight PFAS on elevated alanine aminotransferase (ALT) remains unclear. Additionally, demographic and behavioral factors influencing PFAS levels in the U.S. population are not well understood.
objectivesTo examine (1) associations between short- and long-chain PFAS mixtures and elevated ALT, and (2) participant characteristics linked to PFAS levels.
methodsThis study included 378 adults (196 with detailed liver disease evaluations and 135 with cirrhosis), aged 40-75 years, from the Southern Liver Health Study (STRIVE), an ongoing prospective cohort. Logistic regression assessed associations between serum PFAS and elevated ALT. Quantile g-computation evaluated PFAS mixture effects, while linear regression identified demographic and behavioral factors linked to PFAS levels.
resultsA one-quartile increase in short-chain PFAS mixture levels was associated with higher odds of elevated ALT (adjusted odds ratio [aOR], 95 % confidence interval [CI]: 2.14, 1.31-3.50; P = 0.002) and higher log-transformed ALT levels (adjusted β, 95 % CI: 0.09, 0.01-0.17; P = 0.02). Long-chain PFAS mixtures showed no significant association. Individually, perfluoroheptanoic acid (a short-chain PFAS) (aOR, 95 % CI: 1.51, 1.001-2.27; P = 0.049) and perfluorohexanesulfonic acid (a long-chain PFAS) (aOR, 95 % CI: 1.53, 1.08-2.15; P = 0.015) were positively associated with elevated ALT. PFAS levels were lower in bottled water users but higher in current alcohol users. Males and older individuals exhibited higher long-chain PFAS levels, whereas non-water drinkers and current everyday smokers had lower levels of long-chain PFAS. DISCUSSION: Higher short-chain PFAS mixture levels were linked to elevated ALT, with individual PFAS levels varying by sex and lifestyle factors. Limiting short-chain PFAS exposure may help prevent liver injury.
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