Serum per- and polyfluoroalkyl substances and abnormal lipid metabolism: A nationally representative cross-sectional study

Bing Wu; Yitao Pan; Zheng Li; Jinghua Wang; Saisai Ji; Feng Zhao; Xiaochen Chang; Yingli Qu; Yuanduo Zhu; Linna Xie; Yawei Li; Zheng Zhang; Haocan Song; Xiaojian Hu; Yidan Qiu; Xulin Zheng; Wenli Zhang; Yanwei Yang; Heng Gu; Fangyu Li; Jiayi Cai; Ying Zhu; Zhaojin Cao; John S Ji; Yuebin Lv; Jiayin Dai; Xiaoming Shi

doi:10.1016/j.envint.2023.107779

Serum per- and polyfluoroalkyl substances and abnormal lipid metabolism: A nationally representative cross-sectional study

Environ Int. 2023 Feb:172:107779. doi: 10.1016/j.envint.2023.107779. Epub 2023 Jan 27.

Authors

Bing Wu¹, Yitao Pan², Zheng Li¹, Jinghua Wang², Saisai Ji¹, Feng Zhao¹, Xiaochen Chang², Yingli Qu¹, Yuanduo Zhu¹, Linna Xie¹, Yawei Li¹, Zheng Zhang³, Haocan Song¹, Xiaojian Hu¹, Yidan Qiu⁴, Xulin Zheng³, Wenli Zhang¹, Yanwei Yang¹, Heng Gu¹, Fangyu Li¹, Jiayi Cai¹, Ying Zhu¹, Zhaojin Cao¹, John S Ji⁵, Yuebin Lv¹, Jiayin Dai⁶, Xiaoming Shi⁷

Affiliations

¹ China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
² State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, Shanghai, China.
³ China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
⁴ China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Institute of Environmental Health, School of Public Health, and Bioelectromagnetics Laboratory, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
⁵ Vanke School of Public Health, Tsinghua University, Beijing, China.
⁶ State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, Shanghai, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China. Electronic address: daijy65@sjtu.edu.cn.
⁷ China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China. Electronic address: shixm@chinacdc.cn.

PMID: 36746113
DOI: 10.1016/j.envint.2023.107779

Abstract

Background: The associations of legacy per- and polyfluoroalkyl substances (PFAS) with lipid metabolism are controversial, and there is little information about the impact of emerging PFAS (6:2 Cl-PFESA) on lipid metabolism in China.

Objectives: We aimed to explore the associations of legacy and emerging PFAS with lipid profiles and dyslipidemia in Chinese adults.

Methods: We included 10,855 Chinese participants aged 18 years and above in the China National Human Biomonitoring. The associations of 8 PFAS with 5 lipid profiles and 4 dyslipidemia were investigated using weighted multiple linear regression or weighted logistic regression, and the dose-response associations were investigated using restricted cubic spline model.

Results: Among the 8 PFAS, the concentration of PFOS was the highest, with a geometric mean of 5.15 ng/mL, followed by PFOA and 6:2 Cl-PFESA, which were 4.26 and 1.63 ng/mL, respectively. Legacy (PFOA, PFOS, PFUnDA) or emerging (6:2 Cl-PFESA) PFAS were associated with lipid profiles (TC, LDL-C, HDL-C, non HDL-C) and dyslipidemia (high LDL-C, high TC, low HDL-C), and their effects on TC were most obvious. TC concentration increased by 0.595 mmol/L in the highest quartile (Q4) of PFOS when compared with the lowest quartile (Q1), (95 % CI:0.396, 0.794). Restricted cubic spline models showed that PFAS are nonlinearly associated with TC, non HDL-C, LDL-C and HDL-C, and that the lipid concentrations tend to be stable when PFOS and PFOA were > 20 ng/mL well as when the 6:2 Cl-PFESA level was > 10 ng/mL. The positive associations between PFAS mixtures and lipid profiles were also significant.

Conclusions: Single and mixed exposure to PFAS were positively associated with lipid profiles, and China's unique legacy PFAS substitutes (6:2 Cl-PFESA) contributed less to lipid profiles than legacy PFAS. In the future, cohort studies will be needed to confirm our findings.

Keywords: China National Human Biomonitoring; Dyslipidemia; Emerging per-/polyfluoroalkyl substances; Lipid profiles; Per- and polyfluoroalkyl substances (PFAS).

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Alkanesulfonic Acids* / toxicity
Cholesterol, LDL
Cross-Sectional Studies
Environmental Pollutants* / toxicity
Fluorocarbons*
Humans
Lipid Metabolism

Substances

Alkanesulfonic Acids
Cholesterol, LDL
Fluorocarbons
Environmental Pollutants