Table 3.

Strip plots for the $z$-scores of the analyses of PFAS on ALT.

Reference	Population	Age (y)	Sex	Weight	$n$	Exposure	PFAS Blood Conc.	$z$-Score ($p$-value)
PFOA (cross-sectional studies)
Sakr et al.43,a	GHS	$\ge 18$	Overall	All	1,024	PFOA	$0.428\text{\hspace{0.17em}ppm}$ b	1.53 (0.13)
Olsen and Zobel38,a	Plant employees	21–67	Male	All	506	PFOA	$2,210\text{\hspace{0.17em}ng}/\mathrm{mL}$ b	$-0.59$ (0.56)
Emmett et al.69	Little Hocking, Ohio	2–90	Overall	All	371	PFOA	$354\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	0.45 (0.67)
Gallo et al.70,a	C8HP	$\ge 18$	Overall	All	46,452	PFOA	$28.0\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	12.32 ($<0.001$)
Darrow et al.39	C8HP	$>20$	Overall	All	28,047	PFOA	NS	6.72 ($<0.001$)
Darrow et al.39	C8HP	$>20$	Male	All	12,364	PFOA	$17.1\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	4.63 ($<0.001$)
Darrow et al.39	C8HP	$>20$	Female	All	15,683	PFOA	$16.0\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	3.92 ($<0.001$)
Nian et al.41,a	I C8HP	22–95	Overall	All	1,605	PFOA	$6.19\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	4.23 ($<0.001$)
Lin et al.75,a	NHANES 1999–2003	$\ge 20$	Overall	All	2,197	PFOA	$4.51\text{\hspace{0.17em}ng}/\mathrm{mL}$ b	2.99 (0.003)
Lin et al.75	NHANES 1999–2003	$\ge 20$	Male	All	1,063	PFOA	$5.05\text{\hspace{0.17em}ng}/\mathrm{mL}$ b	1.85 (0.064)
Lin et al.75	NHANES 1999–2003	$\ge 20$	Female	All	1,134	PFOA	$4.06\text{\hspace{0.17em}ng}/\mathrm{mL}$ b	1.65 (0.098)
Gleason et al.40,a	NHANES 2007–2010	$\ge 12$	Overall	All	4,333	PFOA	$3.5\text{\hspace{0.17em}ng}/\mathrm{mL}$ d	3.10 (0.002)
Jain and Ducatman72,a	NHANES 2011–2014	$\ge 20$	Overall	Non-obese	1,082	PFOA	$2.2\text{\hspace{0.17em}ng}/\mathrm{mL}$ d	0.22 (0.84)
Jain and Ducatman72,a	NHANES 2011–2014	$\ge 20$	Overall	Obese	1,801	PFOA	$2.0\text{\hspace{0.17em}ng}/\mathrm{mL}$ d	3.17 (0.002)
Attanasio67,a	NHANES 2013–2016	12–19	Male	All	354	PFOA	$1.50\text{\hspace{0.17em}ng}/\mathrm{mL}$ d	$-2.29$ (0.022)
Attanasio67,a	NHANES 2013–2016	12–19	Female	All	305	PFOA	$1.22\text{\hspace{0.17em}ng}/\mathrm{mL}$ d	2.35 (0.019)
Mora et al.76	Project Viva	6–11	Overall	All	630	PFOA	$4.3\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	$-0.35$ (0.74)
Mora et al.76	Project Viva	6–11	Male	All	332	PFOA	$4.4\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	$-1.18$ (0.24)
Mora et al.76	Project Viva	6–11	Female	All	298	PFOA	$4.2\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	$-1.96$ (0.050)
Khalil et al.74	DCH	8–12	Overall	Obese	48	PFOA	$0.99\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	1.62 (0.11)
Weighted $z\text{-score}$								6.20 ($<0.001$)
PFOA (longitudinal studies)
Sakr et al.44,a	GHS	$\ge 18$	Overall	All	205	PFOA	$1.13\text{\hspace{0.17em}ppm}$ b	1.06 (0.29)
Darrow et al.39,a	C8HP	$>20$	Overall	All	28,047	PFOA	NS	5.88 ($<0.001$)
Darrow et al.39	C8HP	$>20$	Male	All	12,364	PFOA	$17.1\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	4.57 ($<0.001$)
Darrow et al.39	C8HP	$>20$	Female	All	15,683	PFOA	$16.0\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	3.92 ($<0.001$)
Salihovic et al.42,a	Swedish	70	Overall	All	1,002	PFOA	$3.31\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	5.20 ($<0.001$)
Mora et al.76	Project Viva	6–11	Overall	All	508	PFOA	$5.4\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	$-1.31$ (0.19)
Mora et al.76	Project Viva	6–11	Male	All	273	PFOA	$5.5\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	$-0.89$ (0.38)
Mora et al.76	Project Viva	6–11	Female	All	235	PFOA	$5.4\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	$-1.31$ (0.19)
Weighted $z\text{-score}$								5.12 ($<0.001$)
PFOS (cross-sectional studies)
Gallo et al.70,a	C8HP	$\ge 18$	Overall	All	46,452	PFOS	$20.3\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	6.53 ($<0.001$)
Nian et al.41,a	I C8HP	22–95	Overall	All	1,605	PFOS	$24.22\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	2.31 (0.021)
Lin et al.75,a	NHANES 1999–2003	$\ge 20$	Overall	All	2,216	PFOS	$24.6\text{\hspace{0.17em}ng}/\mathrm{mL}$ b	1.90 (0.057)
Gleason et al.40,a	NHANES 2007–2010	$\ge 12$	Overall	All	4,333	PFOS	$11.3\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	1.19 (0.24)
Jain and Ducatman72,a	NHANES 2011–2014	$\ge 20$	Overall	Non-obese	1,082	PFOS	$6.3\text{\hspace{0.17em}ng}/\mathrm{mL}$ d	$-1.02$ (0.31)
Jain and Ducatman72,a	NHANES 2011–2014	$\ge 20$	Overall	Obese	1,801	PFOS	$5.5\text{\hspace{0.17em}ng}/\mathrm{mL}$ d	1.26 (0.21)
Attanasio67,a	NHANES 2013–2016	12–19	Male	All	354	PFOS	$3.68\text{\hspace{0.17em}ng}/\mathrm{mL}$ d	0.21 (0.85)
Attanasio67,a	NHANES 2013–2016	12–19	Female	All	305	PFOS	$2.76\text{\hspace{0.17em}ng}/\mathrm{mL}$ d	1.86 (0.063)
Mora et al.76	Project Viva	6–11	Overall	All	630	PFOS	$6.2\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	$-1.07$ (0.29)
Mora et al.76	Project Viva	6–11	Male	All	332	PFOS	$6.3\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	$-0.69$ (0.50)
Mora et al.76	Project Viva	6–11	Female	All	298	PFOS	$6.1\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	$-1.21$ (0.23)
Khalil et al.74	DCH	8–12	Overall	Obese	48	PFOS	$2.79\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	0.16 (0.88)
Weighted $z\text{-score}$								3.55 ($<0.001$)
PFNA (cross-sectional studies)
Nian et al.41,a	I C8HP	22–95	Overall	All	1,605	PFNA	$1.96\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	3.86 ($<0.001$)
Lin et al.75,a	NHANES 1999–2003	$\ge 20$	Overall	All	2,216	PFNA	$0.79\text{\hspace{0.17em}ng}/\mathrm{mL}$ b	1.55 (0.12)
Gleason et al.40,a	NHANES 2007–2010	$\ge 12$	Overall	All	4,333	PFNA	$1.2\text{\hspace{0.17em}ng}/\mathrm{mL}$ d	3.51 ($<0.001$)
Jain and Ducatman72,a	NHANES 2011–2014	$\ge 20$	Overall	Non-obese	1,082	PFNA	$0.83\text{\hspace{0.17em}ng}/\mathrm{mL}$ d	0.47 (0.65)
Jain and Ducatman72,a	NHANES 2011–2014	$\ge 20$	Overall	Obese	1,801	PFNA	$0.73\text{\hspace{0.17em}ng}/\mathrm{mL}$ d	3.53 ($<0.001$)
Attanasio67,a	NHANES 2013–2016	12–19	Male	All	354	PFNA	$0.58\text{\hspace{0.17em}ng}/\mathrm{mL}$ d	$-2.49$ (0.013)
Attanasio67,a	NHANES 2013–2016	12–19	Female	All	305	PFNA	$0.49\text{\hspace{0.17em}ng}/\mathrm{mL}$ d	3.02 (0.003)
Mora et al.76	Project Viva	6–11	Overall	All	630	PFNA	$1.5\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	$-2.94$ (0.003)
Mora et al.76	Project Viva	6–11	Male	All	332	PFNA	$1.5\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	$-3.92$ ($<0.001$)
Mora et al.76	Project Viva	6–11	Female	All	298	PFNA	$1.5\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	$-1.31$ (0.19)
Khalil et al.74	DCH	8–12	Overall	Obese	48	PFNA	$0.24\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	$-0.18$ (0.86)
Weighted $z\text{-score}$								2.27 (0.023)
PFHxS (cross-sectional studies)
Nian et al.41,a	I C8HP	22–95	Overall	All	1,605	PFHxS	$0.73\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	0.39 (0.71)
Lin et al.75,a	NHANES 1999–2003	$\ge 20$	Overall	All	2,216	PFHxS	$1.98\text{\hspace{0.17em}ng}/\mathrm{mL}$ b	0.40 (0.71)
Gleason et al.40,a	NHANES 2007–2010	$\ge 12$	Overall	All	4,333	PFHxS	$1.8\text{\hspace{0.17em}ng}/\mathrm{mL}$ d	2.61 (0.009)
Jain and Ducatman72,a	NHANES 2011–2014	$\ge 20$	Overall	Non-obese	1,082	PFHxS	$1.41\text{\hspace{0.17em}ng}/\mathrm{mL}$ d	0.26 (0.81)
Jain and Ducatman72,a	NHANES 2011–2014	$\ge 20$	Overall	Obese	1,801	PFHxS	$1.24\text{\hspace{0.17em}ng}/\mathrm{mL}$ d	3.33 ($<0.001$)
Attanasio67,a	NHANES 2013–2016	12–19	Male	All	354	PFHxS	$1.31\text{\hspace{0.17em}ng}/\mathrm{mL}$ d	0.49 (0.64)
Attanasio67,a	NHANES 2013–2016	12–19	Female	All	305	PFHxS	$0.88\text{\hspace{0.17em}ng}/\mathrm{mL}$ d	2.35 (0.019)
Mora et al.76	Project Viva	6–11	Overall	All	630	PFHxS	$1.9\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	0.00 (1.0)
Mora et al.76	Project Viva	6–11	Male	All	332	PFHxS	$1.9\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	$-0.65$ (0.52)
Mora et al.76	Project Viva	6–11	Female	All	298	PFHxS	$1.9\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	0.78 (0.44)
Khalil et al.74	DCH	8–12	Overall	Obese	48	PFHxS	$1.09\text{\hspace{0.17em}ng}/\mathrm{mL}$ c	0.08 (0.94)
Weighted $z\text{-score}$								1.42 (0.15)

Notes: Both overall and sex-specific results are presented where available. ALT, alanine aminotransferase; C8HP, C8 Health Project; DCH, Dayton Children’s Hospital; GHS, General Health Survey; I C8HP, Isomers of C8 Health Project; NHANES, National Health and Nutrition Examination Survey; NS, not specified; PFAS, per- and polyfluorinated substances; PFHxS, perfluorohexanesulfonic acid; PFNA, perfluorononanoic acid; PFOA, perfluorooctanoic acid; PFOS, perfluorooctanesulfonic acid.

^aThe weighted $z$ -score calculation was performed for those $\ge 12\text{\hspace{0.17em}years}$ of age, using the larger of overlapping cohorts.

^bMean.

^cMedian.

^dGeometric mean.