{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:34:32Z","timestamp":1790836472994,"version":"4.1.0"},"reference-count":54,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2020,10,19]],"date-time":"2020-10-19T00:00:00Z","timestamp":1603065600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,10,19]],"date-time":"2020-10-19T00:00:00Z","timestamp":1603065600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Per\u2010 and polyfluoroalkyl substances (PFAS) are widespread and persistent pollutants that have been shown to have hepatotoxic effects in animal models. However, human evidence is scarce. We evaluated how prenatal exposure to PFAS associates with established serum biomarkers of liver injury and alterations in serum metabolome in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach and Results<\/jats:title>\n                    <jats:p>We used data from 1,105 mothers and their children (median age, 8.2\u00a0years; interquartile range, 6.6\u20109.1) from the European Human Early\u2010Life Exposome cohort (consisting of six existing population\u2010based birth cohorts in France, Greece, Lithuania, Norway, Spain, and the United Kingdom). We measured concentrations of perfluorooctane sulfonate, perfluorooctanoate, perfluorononanoate, perfluorohexane sulfonate, and perfluoroundecanoate in maternal blood. We assessed concentrations of alanine aminotransferase, aspartate aminotransferase, and gamma\u2010glutamyltransferase in child serum. Using Bayesian kernel machine regression, we found that higher exposure to PFAS during pregnancy was associated with higher liver enzyme levels in children. We also measured child serum metabolomics through a targeted assay and found significant perturbations in amino acid and glycerophospholipid metabolism associated with prenatal PFAS. A latent variable analysis identified a profile of children at high risk of liver injury (odds ratio, 1.56; 95% confidence interval, 1.21\u20101.92) that was characterized by high prenatal exposure to PFAS and increased serum levels of branched\u2010chain amino acids (valine, leucine, and isoleucine), aromatic amino acids (tryptophan and phenylalanine), and glycerophospholipids (phosphatidylcholine [PC] aa C36:1 and Lyso\u2010PC a C18:1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Developmental exposure to PFAS can contribute to pediatric liver injury.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hep.31483","type":"journal-article","created":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T10:09:12Z","timestamp":1596276552000},"page":"1758-1770","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":160,"title":["Prenatal Exposure to Perfluoroalkyl Substances Associated With Increased Susceptibility to Liver Injury in Children"],"prefix":"10.1097","volume":"72","author":[{"given":"Nikos","family":"Stratakis","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine,Keck School of Medicine,University of Southern California,Los Angeles,CA"},{"name":"Department of Complex Genetics and Epidemiology,CAPHRI School for Public Health and Primary Care,University of Maastricht,Maastricht,the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"V. Conti","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine,Keck School of Medicine,University of Southern California,Los Angeles,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine,Keck School of Medicine,University of Southern California,Los Angeles,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Margetaki","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine,Keck School of Medicine,University of Southern California,Los Angeles,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damaskini","family":"Valvi","sequence":"additional","affiliation":[{"name":"Department of Environmental Medicine and Public Health,Icahn School of Medicine at Mount Sinai,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandros 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Clinic of Navarra,Pamplona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinqi","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine,Keck School of Medicine,University of Southern California,Los Angeles,CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theano","family":"Roumeliotaki","sequence":"additional","affiliation":[{"name":"Department of Social Medicine,Faculty of Medicine,University of Crete,Heraklion,Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Vafeiadi","sequence":"additional","affiliation":[{"name":"Department of Social Medicine,Faculty of Medicine,University of Crete,Heraklion,Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Urquiza","sequence":"additional","affiliation":[{"name":"ISGlobal,Barcelona,Spain"},{"name":"Universitat Pompeu Fabra (UPF),Barcelona,Spain"},{"name":"Consortium for Biomedical 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for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiolog\u00eda y Salud P\u00fablica \u2010 CIBERESP),Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maribel","family":"Casas","sequence":"additional","affiliation":[{"name":"ISGlobal,Barcelona,Spain"},{"name":"Universitat Pompeu Fabra (UPF),Barcelona,Spain"},{"name":"Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiolog\u00eda y Salud P\u00fablica \u2010 CIBERESP),Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Fossati","sequence":"additional","affiliation":[{"name":"ISGlobal,Barcelona,Spain"},{"name":"Universitat Pompeu Fabra (UPF),Barcelona,Spain"},{"name":"Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiolog\u00eda y Salud P\u00fablica \u2010 CIBERESP),Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina","family":"Gra\u017eulevi\u010dien\u0117","sequence":"additional","affiliation":[{"name":"Department of Environmental Sciences,Vytauto Did\u017eiojo Universitetas,Kaunas,Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Andru\u0161aityt\u0117","sequence":"additional","affiliation":[{"name":"Department of Environmental Sciences,Vytauto Did\u017eiojo Universitetas,Kaunas,Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karan","family":"Uppal","sequence":"additional","affiliation":[{"name":"Clinical Biomarkers Laboratory,Division of Pulmonary, Allergy, and Critical Care Medicine, School of Medicine,Emory University,Atlanta,GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemary R.C.","family":"McEachan","sequence":"additional","affiliation":[{"name":"Bradford Institute for Health Research,Bradford Teaching 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B.","family":"Vos","sequence":"additional","affiliation":[{"name":"Department of Pediatrics,School of Medicine and Nutrition Health Sciences,Emory University,Atlanta,GA"},{"name":"Children\u2019s Healthcare of Atlanta,Atlanta,GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hector C.","family":"Keun","sequence":"additional","affiliation":[{"name":"Department of Surgery & Cancer and Department of Metabolism,Digestion & Reproduction,Imperial College London,London,United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine","family":"Vrijheid","sequence":"additional","affiliation":[{"name":"ISGlobal,Barcelona,Spain"},{"name":"Universitat Pompeu Fabra (UPF),Barcelona,Spain"},{"name":"Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiolog\u00eda y Salud P\u00fablica \u2010 CIBERESP),Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiros 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