Correlation analysis between per-fluoroalkyl and poly-fluoroalkyl substances exposure and depressive symptoms in adults: NHANES 2005-2018

Xiaoyi Sun; Xupu Yang; Yizhe Zhang; Yi Liu; Fang Xiao; Huicai Guo; Xuehui Liu

doi:10.1016/j.scitotenv.2023.167639

Correlation analysis between per-fluoroalkyl and poly-fluoroalkyl substances exposure and depressive symptoms in adults: NHANES 2005-2018

Sci Total Environ. 2024 Jan 1:906:167639. doi: 10.1016/j.scitotenv.2023.167639. Epub 2023 Oct 7.

Authors

Xiaoyi Sun¹, Xupu Yang¹, Yizhe Zhang², Yi Liu³, Fang Xiao³, Huicai Guo³, Xuehui Liu⁴

Affiliations

¹ Department of Occupational and Environmental Health, School of Public Health, Hebei Medical University, Hebei Key Laboratory of Environment and Human Health, Zhongshan East Road 361, Shijiazhuang 050017, Hebei, PR China.
² Department of Preventive Medicine, School of Public Health, Hebei Medical University, Zhongshan East Road 361, Shijiazhuang 050017, Hebei, PR China.
³ Department of Toxicology, School of Public Health, Hebei Medical University, Hebei Key Laboratory of Environment and Human Health, Zhongshan East Road 361, Shijiazhuang 050017, Hebei, PR China.
⁴ Department of Occupational and Environmental Health, School of Public Health, Hebei Medical University, Hebei Key Laboratory of Environment and Human Health, Zhongshan East Road 361, Shijiazhuang 050017, Hebei, PR China. Electronic address: lxh19762006@163.com.

PMID: 37813256
DOI: 10.1016/j.scitotenv.2023.167639

Abstract

Background: Excessive exposure to per and poly-fluoroalkyl compounds (PFAS) can lead to various negative health effects. However, there's a lack of research studying the link between PFAS exposure and depression in adults, and the existing findings are inconsistent.

Objectives: Utilizing data collected from the National Health and Nutrition Examination Survey (NHANES) database spanning 2005 to 2018, this study aimed to examine the potential connection between PFAS exposure and depressive symptoms in adults.

Methods: The correlation between individual PFAS exposure and depressive symptoms was examined through the establishment of weighted logistic regression models (crude model, model 1, model 2) and restricted cubic spline models. To verify the stability of the model, receiver operating characteristic (ROC) curves of the logistic regression model were generated, and a ten-fold cross-validation model was employed. Additionally, the relationship between adult depressive symptoms and mixed PFAS exposure was tested through the utilization of quantile g-computation (qgcomp).

Results: The findings revealed that heightened exposure levels to PFOA, PFHxS, and PFUnDA, were connected with a diminished risk of depressive symptoms in adults (OR_PFOA: 0.67, 95 % confidence interval (CI): 0.47, 0.95; OR_PFHxS: 0.66, 95 %CI: 0.49, 0.89; OR_PFUnDA: 0.65, 95 %CI: 0.45, 0.96). PFOS, PFHxS, and PFDA demonstrated a dose-response relationship with the risk of depressive symptoms. The ROC curve indicated model stability, with recognition accuracy exceeding 90 % in the cross-validation model. The outcomes of qgcomp demonstrated that an increase in serum PFAS concentration was linked to a decreased risk of depressive symptoms in adults (OR: 0.85, 95 %CI: 0.75, 0.96).

Discussion: Due to the cross-sectional design of this study, it's important to acknowledge the potential for reverse causality between PFAS exposure and depressive symptoms. As a result, the outcomes should not be oversimplified to interpret PFAS exposure as a protective factor against adult depressive symptoms.

Keywords: Depressive symptoms; Mixed exposure; Per-fluoroalkyl substances; Poly-fluoroalkyl substances.

MeSH terms

Alkanesulfonic Acids*
Cross-Sectional Studies
Depression / chemically induced
Depression / epidemiology
Environmental Pollutants*
Fluorocarbons* / toxicity
Nutrition Surveys

Substances

perfluoroundecanoic acid
Environmental Pollutants
Alkanesulfonic Acids
Fluorocarbons