Analysis of 4,470 children and adolescents in NHANES (2013–2016) used household tap-water fluoride as an instrumental variable to estimate associations between predicted plasma fluoride and a wide panel of clinical biomarkers.
Using tap-water fluoride as an instrument, higher predicted plasma fluoride was associated with lower systolic blood pressure in the study sample, though the estimate has wide uncertainty.
Predicted plasma fluoride was associated with lower testosterone (geometric mean ratio ~0.49) and higher serum sodium (+3.41 mmol/L) and uric acid (+0.92 mg/dL) per modeled exposure increment.
# Summary A University of Memphis team led by Shaheryar Shafqat used NHANES 2013–2016 data to examine how circulating fluoride relates to clinical biomarkers in children and adolescents. Their sample included 4,470 participants aged 6–19 who had both plasma fluoride and household tap-water fluoride measured. The authors used an instrumental variable approach that treats tap-water fluoride as a source of variation in plasma fluoride to reduce confounding by individual behaviors and socioeconomic factors.
# Methods and scope
# Main findings
# Interpretation and caveats
# Practical takeaways
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