Association of per- and polyfluoroalkyl substances with constipation: The National Health and Nutrition Examination Survey (2005-2010)

Yifan Zhao; Ke Pu; Ya Zheng; Yuping Wang; Jun Wang; Yongning Zhou

doi:10.1371/journal.pone.0301129

Association of per- and polyfluoroalkyl substances with constipation: The National Health and Nutrition Examination Survey (2005-2010)

PLoS One. 2024 Apr 1;19(4):e0301129. doi: 10.1371/journal.pone.0301129. eCollection 2024.

Authors

Yifan Zhao^{1

2

3}, Ke Pu⁴, Ya Zheng^{2

3}, Yuping Wang^{2

3}, Jun Wang^{2

3}, Yongning Zhou^{2

3}

Affiliations

¹ The First Clinical Medical College, Lanzhou University, Lanzhou, China.
² Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou, China.
³ Gansu Province Clinical Research Center for Digestive Diseases, The First Hospital of Lanzhou University, Lanzhou, China.
⁴ Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College, Sichuan, China.

Abstract

Background: The impact of per- and polyfluoroalkyl substances (PFAS) on constipation, as mediated through gastrointestinal absorption and perturbations to the intestinal microecology, remains poorly understood.

Objective: This study seeks to explain the relationship between PFAS and constipation.

Methods: A total of 2945 adults from the National Health and Nutrition Examination Survey (NHANES) 2005-2010 were included in this study. Constipation was defined using the Bristol Stool Form Scale (BSFS) based on stool consistency. The relationship between PFAS and constipation was evaluated using weighted logistic regression and restricted cubic spline (RCS) analysis, while adjusting for confounding variables.

Results: The weighted median concentration of total PFAS (ΣPFAS) was significantly lower in individuals with constipation (19.01 μg/L) compared to those without constipation (23.30 μg/L) (p < 0.0001). Subgroup analysis revealed that the cumulative effect of PFAS was more pronounced in the elderly, men, individuals with obesity, high school education or equivalent, and high-income individuals (p < 0.05). After adjusting for confounding factors, multivariable analysis demonstrated an inverse association between PFOA [OR (95% CI), 0.666(0.486,0.914)] and PFHxS [OR (95% CI), 0.699(0.482,1.015)], and constipation. None of the personal and lifestyle factors showed a significant correlation with this negative association, as confirmed by subgroup analysis and interaction testing (p for interaction > 0.05). The RCS analysis demonstrated a linear inverse relationship between PFAS levels and constipation.

Conclusion: The findings of this study provide evidence of a significant inverse correlation between serum concentrations of PFAS, particularly PFOA and PFHxS, and constipation.

Copyright: © 2024 Zhao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

Adult
Aged
Alkanesulfonic Acids*
Constipation / epidemiology
Environmental Pollutants*
Fluorocarbons*
Humans
Male
Nutrition Surveys

Substances

Alkanesulfonic Acids
Environmental Pollutants
Fluorocarbons

Grants and funding

Yongning Zhou received funding from the National Natural Science Foundation of China (No. 71964021), and Ya Zheng received funding from the Natural Science Foundation of Gansu Province (NO. 23JRRA0939). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.