Dacula, GA, USA.
West Virginia University School of Public Health, Morgantown, WV, USA.
Sci Total Environ. 2019 Feb 25;653:74-81. doi: 10.1016/j.scitotenv.2018.10.362. Epub 2018 Oct 29.
Data from National Health and Nutrition Examination Survey (NHANES) for 2005-2014 for those aged ≥20 years fasting for ≥8 h (N = 3629) were analyzed to evaluate the role that gender and obesity play in defining correlations between selected perfluoroalkyl substances (PFAS) and total cholesterol (TC), low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL), and triglycerides. PFAS considered for analyses were: perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorodecanoic acid (PFDA), perfluorononanoic acid (PFNA), perfluorohexane sulfonate (PFHxS), perfluoroundecanoic acid (PFUnDA), and 2-(N-methyl-perfluorooctane sulfonamido) acetic acid (Me-FOSAA). Gender and obesity stratified regression models were fitted to estimate associations between PFAS and lipid/lipoproteins with adjustments made for confounders. For obese males, but not for nonobese males, positive associations were found between TC and LDL with PFOA (β = 0.0519, p = 0.01 for TC and β = 0.0822, p = 0.03 for LDL), and PFNA (β = 0.0328, p = 0.03 for TC and β = 0.0679, p = 0.04 for LDL). For obese females, adjusted concentrations of TC increased with increase in the concentrations of PFDA (β = 0.0247, p = 0.048), PFNA (β = 0.0286, p = 0.04), and Me-PFOSAA (β = 0.0274, p = 0.02), and there was a positive association of LDL with PFOS (β = 0.0375, p = 0.04), PFDA (β = 0.0397, p = 0.047), and PFNA (β = 0.0593, p = 0.02). The findings, concerning the relationship of longer chain PFAS to serum lipids, suggest greater susceptibility to elevated TC and LDL cholesterol in the obese participants, with some differences between men and women. The key contributing modifiable risk for nonalcoholic steatosis is obesity, and, the development of nonalcoholic steatosis is recognized to be sexually dimorphic. The epidemiologic observation of a susceptible obese subgroup in our data is consistent with toxicology literature findings of disrupted cholesterol metabolism via induced steatosis following PFAS exposure. Gender differences affect serum concentration of PFAS during the reproductive years, and our data add a secondary question concerning whether they also affect the interaction between PFAS exposure and lipid handling in males and females.
对 2005-2014 年年龄在≥20 岁且禁食≥8 小时的（N=3629）国家健康和营养检查调查（NHANES）的数据进行了分析，以评估性别和肥胖在定义选定全氟烷基物质（PFAS）与总胆固醇（TC）、低密度脂蛋白胆固醇（LDL）、高密度脂蛋白胆固醇（HDL）和甘油三酯之间的相关性中的作用。分析中考虑的 PFAS 包括：全氟辛酸（PFOA）、全氟辛烷磺酸（PFOS）、全氟癸酸（PFDA）、全氟壬酸（PFNA）、全氟己烷磺酸（PFHxS）、全氟十一烷酸（PFUnDA）和 2-（N-甲基-全氟辛烷磺酰胺基）乙酸（Me-FOSAA）。采用性别和肥胖分层回归模型来估计 PFAS 与脂质/脂蛋白之间的关联，并对混杂因素进行了调整。对于肥胖男性，但非非肥胖男性，TC 和 LDL 与 PFOA（β=0.0519，p=0.01）和 PFNA（β=0.0822，p=0.03）之间存在正相关，与 PFNA（β=0.0328，p=0.03）和 LDL（β=0.0679，p=0.04）之间存在正相关。对于肥胖女性，TC 浓度随着 PFDA（β=0.0247，p=0.048）、PFNA（β=0.0286，p=0.04）和 Me-PFOSAA（β=0.0274，p=0.02）浓度的增加而增加，LDL 与 PFOS（β=0.0375，p=0.04）、PFDA（β=0.0397，p=0.047）和 PFNA（β=0.0593，p=0.02）之间存在正相关。关于长链 PFAS 与血清脂质的关系的研究结果表明，肥胖参与者的 TC 和 LDL 胆固醇升高的易感性更高，男性和女性之间存在一些差异。非酒精性脂肪性肝病的主要可改变风险因素是肥胖，并且已经认识到非酒精性脂肪性肝病的发生具有性别二态性。我们的数据中观察到一个易受肥胖影响的亚组，这与毒理学文献中发现的全氟烷基物质暴露后诱导脂肪变性导致胆固醇代谢紊乱的结果一致。性别差异会影响生育期女性的 PFAS 血清浓度，我们的数据提出了一个次要问题，即它们是否也会影响男性和女性中 PFAS 暴露与脂质处理之间的相互作用。
