Age- and body mass index-specific associations of individual and mixed per- and polyfluoroalkyl substance exposures with sex steroid hormone levels in female: A cross-sectional NHANES study.
Description
end. xlsx: study population(processed data files); PFASandPCOS.R: The code used in the research; rstudio.exe：software.
Files
Steps to reproduce
We derived data from National Health and Nutrition Examination Survey (NHANES) in the United States, which was approved by the Ethics Review Board, with written informed consent obtained from all participants(NCHS, 2018). We utilized data from the 2013-2016 cycles, initially comprising 20,146 individuals. Exclusion criteria are: (1) missing data on PFAS or sex steroid hormones (n=15,986), (2) male participants (n=1,995), (3) pregnancy (n=41), and (4) individuals with a history of oophorectomy (n=189). Additional 11 participants using steroid hormones were excluded, leading to a final sample of 1,935 females. All analyses were conducted using R software (version 4.5.1). To ensure national representativeness, we accounted for the complex survey design by applying subsample B weights matched to PFAS variables. For the pooled 2013-2016 data, final weights were calculated as half of the original 2-year weights per cycle. Continuous and categorical variables are presented as median (IQR) and n (%), respectively. After addressing missing data through multiple imputation (mice package), right-skewed PFAS and hormone concentrations were 95% winsorized and natural log-transformed to enhance model robustness.