China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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.
Environ Int. 2023 Feb;172:107779. doi: 10.1016/j.envint.2023.107779. Epub 2023 Jan 27.
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.
We aimed to explore the associations of legacy and emerging PFAS with lipid profiles and dyslipidemia in Chinese adults.
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.
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.
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.
关于 legacy 全氟和多氟烷基物质（PFAS）与脂质代谢之间的关联，目前仍存在争议，而且关于新兴 PFAS（6:2 Cl-PFESA）对中国成年人脂质代谢影响的信息也很少。
本研究旨在探索 legacy 和新兴 PFAS 与中国成年人脂质谱和血脂异常的关系。
我们纳入了中国国家人群生物监测计划中的 10855 名年龄在 18 岁及以上的中国成年人。使用加权多线性回归或加权 logistic 回归研究 8 种 PFAS 与 5 种脂质谱和 4 种血脂异常之间的关系，并使用限制性立方样条模型研究剂量-反应关系。
在 8 种 PFAS 中，全氟辛烷磺酸（PFOS）的浓度最高，几何均数为 5.15ng/mL，其次是 PFOA 和 6:2 Cl-PFESA，分别为 4.26ng/mL 和 1.63ng/mL。legacy（PFOA、PFOS、PFUnDA）或新兴（6:2 Cl-PFESA）PFAS 与脂质谱（TC、LDL-C、HDL-C、非 HDL-C）和血脂异常（高 LDL-C、高 TC、低 HDL-C）有关，其对 TC 的影响最明显。与最低四分位（Q1）相比，全氟辛烷磺酸（PFOS）最高四分位（Q4）组的 TC 浓度增加了 0.595mmol/L（95%CI：0.396，0.794）。限制性立方样条模型显示，PFAS 与 TC、非 HDL-C、LDL-C 和 HDL-C 呈非线性相关，当全氟辛烷磺酸（PFOS）和 PFOA 浓度>20ng/mL 以及 6:2 Cl-PFESA 水平>10ng/mL 时，脂质浓度趋于稳定。PFAS 混合物与脂质谱之间的正相关关系也很显著。
单一和混合暴露于 PFAS 与脂质谱呈正相关，中国特有的 legacy PFAS 替代品（6:2 Cl-PFESA）对脂质谱的贡献小于 legacy PFAS。未来需要开展队列研究来证实我们的发现。
