{
    "abstract": "Perfluoroalkyl substances (PFAS) are environmental contaminants present in a wide range of consumer products and frequently detected in drinking water. They have been linked to adverse reproductive health outcomes in women, but there is limited human evidence on the association of PFAS exposure with endometriosis.\nTo explore the association between plasma concentrations of several PFAS, considered individually and as a mixture, and the risk of endometriosis in women of childbearing age.\nBetween 2018 and 2020, 42 patients with endometriosis and 90 controls undergoing abdominal surgery were recruited at two public hospitals in Granada, Spain. The presence or absence of endometriosis was ascertained by laparoscopic inspection of the pelvis and biopsy of suspected lesions (histological diagnosis). Concentrations of 10 PFAS were quantified in plasma samples from participants. Unconditional logistic regression was employed to examine associations of individual PFAS and summed concentrations of short (\u2211SC) and long-chain (\u2211LC) PFAS with odds of endometriosis, and quantile g-computation was used to assess their mixture effect.\nIn models adjusted for age, schooling, and parity, perfluorotridecanoic acid (PFTrDA) was associated with higher odds of endometriosis (odds ratio [OR]\u00a0=\u00a01.74; 95\u00a0% CI\u00a0=\u00a01.11-2.73 per 2-fold increase in plasma concentrations), while marginally significant associations were found for perfluorohexane sulfonate (PFHxS) (OR\u00a0=\u00a01.45, 95\u00a0% CI\u00a0=\u00a00.94-2.21) and \u2211SC PFAS (OR\u00a0=\u00a01.48; 95\u00a0% CI\u00a0=\u00a00.96-2.30). No associations were found for the remaining PFAS. The PFAS mixture was non-significantly associated with 1.7-fold higher odds of endometriosis (95\u00a0% CI\u00a0=\u00a00.73-3.80), with perfluorononanoic acid (PFNA), PFHxS, and PFTrDA being the major contributors to this effect.\nThese findings suggest that exposure to certain PFAS may increase the odds of endometriosis. However, given the modest sample size, further studies are warranted to verify these results.",
    "authors": [
        {
            "affiliation": "Instituto de Investigaci\u00f3n Biosanitaria de Granada (ibs.GRANADA), 18016 Granada, Spain; Clinical Laboratory Management Unit, San Cecilio University Hospital, 18016 Granada, Spain. Electronic address: mariat.haro.sspa@juntadeandalucia.es.",
            "firstname": "Teresa",
            "initials": "T",
            "lastname": "de Haro-Romero"
        },
        {
            "affiliation": "Instituto de Investigaci\u00f3n Biosanitaria de Granada (ibs.GRANADA), 18016 Granada, Spain; Biomedical Research Centre (CIBM), University of Granada, 18100 Granada, Spain; Department of Radiology and Physical Medicine, University of Granada, 18071 Granada, Spain. Electronic address: franciscopeinado@correo.ugr.es.",
            "firstname": "Francisco M",
            "initials": "FM",
            "lastname": "Peinado"
        },
        {
            "affiliation": "Instituto de Investigaci\u00f3n Biosanitaria de Granada (ibs.GRANADA), 18016 Granada, Spain; Clinical Laboratory Management Unit, San Cecilio University Hospital, 18016 Granada, Spain. Electronic address: fervs@ugr.es.",
            "firstname": "Fernando",
            "initials": "F",
            "lastname": "Vela-Soria"
        },
        {
            "affiliation": "Gynaecology and Obstetrics Unit, Virgen de las Nieves University Hospital, 18016 Granada, Spain.",
            "firstname": "Ana",
            "initials": "A",
            "lastname": "Lara-Ramos"
        },
        {
            "affiliation": "Gynaecology and Obstetrics Unit, Virgen de las Nieves University Hospital, 18016 Granada, Spain.",
            "firstname": "Jorge",
            "initials": "J",
            "lastname": "Fern\u00e1ndez-Parra"
        },
        {
            "affiliation": "Instituto de Investigaci\u00f3n Biosanitaria de Granada (ibs.GRANADA), 18016 Granada, Spain; Gynaecology and Obstetrics Unit, San Cecilio University Hospital, 18016 Granada, Spain.",
            "firstname": "Ana",
            "initials": "A",
            "lastname": "Molina-Lopez"
        },
        {
            "affiliation": "General Surgery Unit, San Cecilio University Hospital, E-18016, Granada, Spain.",
            "firstname": "Alfredo",
            "initials": "A",
            "lastname": "Ubi\u00f1a"
        },
        {
            "affiliation": "Instituto de Investigaci\u00f3n Biosanitaria de Granada (ibs.GRANADA), 18016 Granada, Spain; Gynaecology and Obstetrics Unit, San Cecilio University Hospital, 18016 Granada, Spain. Electronic address: ooconh@ugr.es.",
            "firstname": "Olga",
            "initials": "O",
            "lastname": "Oc\u00f3n"
        },
        {
            "affiliation": "Instituto de Investigaci\u00f3n Biosanitaria de Granada (ibs.GRANADA), 18016 Granada, Spain; Department of Radiology and Physical Medicine, University of Granada, 18071 Granada, Spain; General Surgery Unit, San Cecilio University Hospital, E-18016, Granada, Spain. Electronic address: fartacho@ugr.es.",
            "firstname": "Francisco",
            "initials": "F",
            "lastname": "Artacho-Cord\u00f3n"
        },
        {
            "affiliation": "Instituto de Investigaci\u00f3n Biosanitaria de Granada (ibs.GRANADA), 18016 Granada, Spain; CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; Department of Legal Medicine, Toxicology and Physical Anthropology, School of Medicine, University of Granada, 18016 Granada, Spain. Electronic address: cfreire@ugr.es.",
            "firstname": "Carmen",
            "initials": "C",
            "lastname": "Freire"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2024 The Authors. Published by Elsevier B.V. All rights reserved.",
    "doi": "10.1016/j.scitotenv.2024.175593",
    "journal": "The Science of the total environment",
    "keywords": [
        "Case-control",
        "Endocrine disruption",
        "Endometriosis",
        "Female reproductive health",
        "Perfluoroalkyl substances"
    ],
    "methods": null,
    "publication_date": "2024-08-24",
    "pubmed_id": "39179042",
    "results": "In models adjusted for age, schooling, and parity, perfluorotridecanoic acid (PFTrDA) was associated with higher odds of endometriosis (odds ratio [OR]\u00a0=\u00a01.74; 95\u00a0% CI\u00a0=\u00a01.11-2.73 per 2-fold increase in plasma concentrations), while marginally significant associations were found for perfluorohexane sulfonate (PFHxS) (OR\u00a0=\u00a01.45, 95\u00a0% CI\u00a0=\u00a00.94-2.21) and \u2211SC PFAS (OR\u00a0=\u00a01.48; 95\u00a0% CI\u00a0=\u00a00.96-2.30). No associations were found for the remaining PFAS. The PFAS mixture was non-significantly associated with 1.7-fold higher odds of endometriosis (95\u00a0% CI\u00a0=\u00a00.73-3.80), with perfluorononanoic acid (PFNA), PFHxS, and PFTrDA being the major contributors to this effect.",
    "title": "Association between exposure to perfluoroalkyl substances (PFAS) and endometriosis in the ENDEA case-control study.",
    "xml": "<Element 'PubmedArticle' at 0x78850427da30>"
}