School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Box 414, SE, 405 30, Gothenburg, Sweden.
Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
Environ Health. 2020 Mar 14;19(1):33. doi: 10.1186/s12940-020-00588-9.
Exposures to perfluoroalkyl substances (PFAS) have shown positive associations with serum lipids in previous studies. While many studies on lipids investigated associations with perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA), there are only a few studies regarding other PFAS, such as perfluorohexane sulfonic acid (PFHxS). The purpose of the current study is to investigate if associations with serum lipids were present, not only for serum PFOS and PFOA, but also for PFHxS, and if the associations with PFAS remained also in a comparison based only on residency in areas with contrasting exposure to PFAS.
1945 adults aged 20-60 were included from Ronneby, Sweden, a municipality where one out of two waterworks had been heavily contaminated from aqueous fire-fighting foams, and from a nearby control area. The exposure was categorized based on either been living in areas with contrasting PFAS exposure or based on the actual serum PFAS measurements. Regression analyses of serum lipids were fitted against serum PFAS levels, percentile groups, smooth splines and between exposed and reference areas, adjusting for age, sex and BMI.
Drinking water contamination caused high serum levels of PFOS (median 157 ng/ml) and PFHxS (median 136 ng/ml) and PFOA (median 8.6 ng/ml). These serum PFAS levels in the exposed groups were 5 to 100-fold higher than in the controls. In this population with mixed PFAS exposure, predominantly PFOS and PFHxS, PFAS exposure were positively associated with serum lipids. This was observed both when quantifying exposure as contrast between exposed and controls, and in terms of serum PFAS. Due to high correlations between each PFAS, we cannot separate them.
In conclusion, the present study provides further evidence of a causal association between PFAS and serum lipids, especially for PFHxS.
先前的研究表明，接触全氟烷基物质（PFAS）与血清脂质呈正相关。虽然许多关于脂质的研究调查了与全氟辛烷磺酸（PFOS）和全氟辛酸（PFOA）的关联，但只有少数研究涉及其他 PFAS，如全氟己烷磺酸（PFHxS）。本研究的目的是调查是否存在与血清脂质的关联，不仅针对血清 PFOS 和 PFOA，还针对 PFHxS，并且如果基于居住在具有对比 PFAS 暴露的区域的比较，这种关联仍然存在。
从瑞典罗尼比纳入了 1945 名年龄在 20-60 岁的成年人，该市一个自来水厂受到了水基消防泡沫的严重污染，另一个自来水厂来自附近的对照区。暴露情况是基于居住在具有对比 PFAS 暴露的区域或基于实际的血清 PFAS 测量进行分类的。对血清脂质的回归分析是针对血清 PFAS 水平、百分位组、平滑样条和暴露区与参照区之间进行拟合的，调整了年龄、性别和 BMI。
饮用水污染导致 PFOS（中位数 157ng/ml）和 PFHxS（中位数 136ng/ml）和 PFOA（中位数 8.6ng/ml）的血清水平升高。暴露组的这些血清 PFAS 水平比对照组高 5 到 100 倍。在这个具有混合 PFAS 暴露的人群中，主要是 PFOS 和 PFHxS，PFAS 暴露与血清脂质呈正相关。这在将暴露作为暴露组与对照组之间的对比进行量化以及在血清 PFAS 方面都观察到了。由于每种 PFAS 之间存在高度相关性，因此我们无法将它们分开。
总之，本研究进一步提供了 PFAS 与血清脂质之间存在因果关联的证据，特别是对于 PFHxS。
