Department of Public Health, Syracuse University, United States.
Department of Public Health, Syracuse University, United States.
Environ Res. 2023 Nov 1;236(Pt 2):116758. doi: 10.1016/j.envres.2023.116758. Epub 2023 Jul 31.
Per- and polyfluoro-alkyl substances (PFAS) and lead (Pb) are ubiquitous environmental toxicants with apparent impact on cardiovascular disease (CVD) risk. As one possible mechanism for this increased risk, we have previously demonstrated an association between Pb exposure and heightened cardiovascular reactivity to acute psychological stress, a CVD risk factor. The present study expands this approach and considers both PFAS and Pb exposures (and the possible interaction).
We assessed 14 serum PFAS and whole blood Pb concentrations in a sample of 9-11 year-old children (N = 291; 43.2% White, 56.8% Black; 53.5% female). We measured cardiovascular functioning at rest and during psychological stress as well as multiple indicators of subclinical CVD including resting blood pressure (BP), carotid-femoral pulse wave velocity (cfPWV), carotid intima-media thickness (cIMT), and left ventricular mass (LVM). Data analysis included general linear modeling as well as a non-parametric approach to study metal mixtures, specifically Bayesian Kernel Machine Regression (BKMR).
Significant interactions between different PFAS and with Pb suggest the importance of considering toxicant mixtures when assessing potential disruption of the cardiovascular system. The pattern of findings suggests that greater "vascular reactivity" (elevated BP and vascular resistance during acute psychological stress) was associated with higher concentrations of perfluorononanoic acid (PFNA), perfluorohexane sulfonate (PFHxS), and Pb, but only when perfluorooctanoic acid (PFOA) was concurrently elevated. With respect to subclinical outcomes, increasing perfluorodecanoic acid (PFDA) was associated with greater cIMT (β = 0.21, p = 0.010).
To our knowledge this is the first study to consider how PFAS exposures might affect cardiovascular functioning and subclinical disease. Although a complex pattern of associations emerged, it does appear that PFAS and Pb can be classified as "cardiovascular disruptors" in children. Further research is needed to replicate these novel findings and determine whether these disruptions produce future cardiovascular disease.
全氟和多氟烷基物质（PFAS）和铅（Pb）是普遍存在的环境毒物，对心血管疾病（CVD）风险有明显影响。作为这种风险增加的一个可能机制，我们之前已经证明了 Pb 暴露与急性心理应激时心血管反应性升高之间存在关联，而急性心理应激是 CVD 的一个风险因素。本研究扩展了这一方法，并考虑了 PFAS 和 Pb 暴露（以及可能的相互作用）。
我们评估了 9-11 岁儿童样本中的 14 种血清 PFAS 和全血 Pb 浓度（N=291；43.2%为白人，56.8%为黑人；53.5%为女性）。我们在静息和心理应激期间测量心血管功能，以及包括静息血压（BP）、颈动脉-股动脉脉搏波速度（cfPWV）、颈动脉内膜中层厚度（cIMT）和左心室质量（LVM）在内的多个亚临床 CVD 指标。数据分析包括一般线性模型以及一种非参数方法来研究金属混合物，特别是贝叶斯核机器回归（BKMR）。
不同 PFAS 之间以及与 Pb 之间的显著相互作用表明，在评估潜在的心血管系统破坏时，考虑有毒混合物的重要性。研究结果的模式表明，在急性心理应激期间，更高的“血管反应性”（血压和血管阻力升高）与更高浓度的全氟壬酸（PFNA）、全氟己烷磺酸（PFHxS）和 Pb 相关，但仅在全氟辛酸（PFOA）同时升高时才相关。关于亚临床结果，全氟癸酸（PFDA）的增加与更大的 cIMT 相关（β=0.21，p=0.010）。
据我们所知，这是第一项研究考虑 PFAS 暴露如何影响心血管功能和亚临床疾病的研究。尽管出现了复杂的关联模式，但似乎 PFAS 和 Pb 可以被归类为儿童的“心血管破坏者”。需要进一步的研究来复制这些新发现，并确定这些破坏是否会导致未来的心血管疾病。
