Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, 550 First Avenue New York, NY, 10016, USA.
Department of Population Health, New York University School of Medicine, 180 Madison Avenue, New York, NY, 10016, USA.
Environ Res. 2022 Sep;212(Pt B):113339. doi: 10.1016/j.envres.2022.113339. Epub 2022 Apr 18.
Perfluoroalkyl substances (PFAs) are ubiquitous, anthropogenic organic compounds that have been linked with cardiovascular disease and cardiovascular risk factors. Older, long-chain PFAs have been phased out due to adverse cardiometabolic health effect and replaced by newer short-chain PFAs. However, emerging research suggests that short-chain PFAs may also have adverse cardiovascular effects. Non-invasive measures of vascular function can detect preclinical cardiovascular disease and serve as a useful surrogate for early CVD risk. We hypothesized that serum concentrations of PFAs would be associated with noninvasive measures of vascular function, carotid-femoral pulse wave velocity (PWV) and brachial artery reactivity testing (BART), in adults with non-occupational exposure to PFAs.
We measured serum concentrations of 14 PFAs with hybrid solid-phase extraction and ultrahigh-performance liquid chromatography-tandem mass spectrometry in 94 adult outpatients with no known cardiovascular disease. We collected clinical and demographic data; and measured vascular function, PWV and BART, using standard protocols. We assessed associations of individual PFAs with log-transformed BART and PWV using linear regression. We used weighted quantile sum regression to assess effects of correlated PFA mixtures on BART and PWV.
Ten PFAs were measured above the limit of detection in >50% of participants. Each standard deviation increase in concentration of perfluoroheptanoic acid (PFHpA) was associated with 15% decrease in BART (95% CI: -28.5, -0.17). The weighted index of a mixture of PFAs with correlated concentrations was inversely associated with BART: each tertile increase in the weighted PFA mixture was associated with 25% lower BART, with 73% of the effect driven by PFHpA. In contrast, no PFAs or mixtures were associated with PWV.
Serum concentration of PFHpA, a new, short-chain PFA, was associated with impaired vascular function among outpatients without CVD. Our findings support a potential adverse cardiovascular effect of newer, short-chain PFAs.
全氟烷基物质（PFAs）是无处不在的人为有机化合物，已与心血管疾病和心血管危险因素相关联。由于不良的心脏代谢健康影响，旧的长链 PFAs 已逐步淘汰，取而代之的是新的短链 PFAs。然而，新出现的研究表明，短链 PFAs 也可能对心血管产生不良影响。血管功能的非侵入性测量可以检测出临床前心血管疾病，并作为早期 CVD 风险的有用替代指标。我们假设，在非职业性接触 PFAs 的成年人中，血清中 PFAs 的浓度与血管功能的非侵入性测量值（颈动脉-股动脉脉搏波速度（PWV）和肱动脉反应性测试（BART））相关。
我们使用混合固相萃取和超高效液相色谱-串联质谱法测量了 94 名无已知心血管疾病的成年门诊患者血清中 14 种 PFAs 的浓度。我们收集了临床和人口统计学数据；并使用标准方案测量了血管功能、PWV 和 BART。我们使用线性回归评估了个体 PFAs 与对数转换的 BART 和 PWV 的相关性。我们使用加权分位数总和回归来评估相关 PFA 混合物对 BART 和 PWV 的影响。
在 >50%的参与者中，有 10 种 PFAs 的浓度高于检测限。每增加一个标准差的全氟庚酸（PFHpA）浓度与 BART 下降 15%相关（95%CI：-28.5，-0.17）。具有相关浓度的 PFAs 混合物的加权指数与 BART 呈负相关：加权 PFA 混合物每增加一个三分位，BART 就会降低 25%，其中 73%的效应是由 PFHpA 驱动的。相比之下，没有 PFAs 或混合物与 PWV 相关。
PFHpA，一种新型的短链 PFA，在没有 CVD 的门诊患者中与血管功能受损相关。我们的发现支持了新型短链 PFAs 可能对心血管系统产生不良影响。
