The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, China.
Department of Psychological Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian, China.
Sci Total Environ. 2024 May 15;925:171742. doi: 10.1016/j.scitotenv.2024.171742. Epub 2024 Mar 15.
No study has examined the association between per- and polyfluoroalkyl substances (PFAS) exposure and chronic obstructive pulmonary disease (COPD) risk. This study aims to explore this relationship.
This study enrolled 4541 individuals who had available data on PFAS, COPD, and covariates from NHANES 2007-2018. Serum PFAS including perfluorohexane sulfonate (PFHxS), perfluorononanoic acid (PFNA), perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS) were analyzed, because of high detective rates. Considering the skew distribution of PFAS levels, the natural logarithm-transformed PFAS (Ln-PFAS) was used. Logistic regression analysis, restricted cubic spline (RCS), and weighted quantile sum (WQS) regression were performed to explore the single, nonlinear, and mixed effects. A mediating analysis was used to evaluate the mediated effects of albumin.
Individuals with COPD had higher levels of PFHxS, PFNA, PFOA, and PFOS compared to those without COPD. Ln-PFNA (OR : 1.92, 95 % CI:1.31 to 2.80, P: <0.001; OR : 1.07, 95 % CI: 0.81 to 1.40, P: 0.636) and ln-PFOA (OR : 2.17, 95 % CI:1.38 to 3.41, P: <0.001; OR : 1.49, 95 % CI: 1.08 to 2.05, P: 0.016) were associated with COPD risk especially in males. The interaction between PFNA exposure and sex on COPD risk was significant (P : <0.001). The RCS curve demonstrated the nonlinear relationship between the ln-PFOA (P :0.001), ln-PFNA (P :0.045), and COPD risk in males. WQS analysis showed mixed PFAS exposure was correlated with COPD risk in males (OR: 1.44, 95 % CI:1.18 to 1.75, P: <0.001). Albumin mediated the relationship between PFOA and COPD (mediated proportion: -17.94 %).
This study concludes PFOA and PFNA are linked to a higher COPD risk in males, and serum albumin plays a mediating role in the relationship between PFOA and COPD. Thess findings are beneficial for the prevention of COPD. Further studies are required to explore potential mechanisms.
目前尚无研究探讨全氟和多氟烷基物质（PFAS）暴露与慢性阻塞性肺疾病（COPD）风险之间的关系。本研究旨在对此进行探讨。
本研究纳入了 4541 名个体，他们来自 2007 年至 2018 年 NHANES 研究，这些个体的数据涵盖 PFAS、COPD 及协变量。由于高检出率，我们分析了血清 PFAS 包括全氟己烷磺酸（PFHxS）、全氟壬酸（PFNA）、全氟辛酸（PFOA）和全氟辛烷磺酸（PFOS）。鉴于 PFAS 水平呈偏态分布，我们使用了自然对数转换后的 PFAS（Ln-PFAS）。采用 logistic 回归分析、限制性立方样条（RCS）和加权分位数总和（WQS）回归来探讨单一、非线性和混合效应。采用中介分析来评估白蛋白的中介作用。
与无 COPD 者相比，COPD 患者的 PFHxS、PFNA、PFOA 和 PFOS 水平更高。Ln-PFNA（比值比 [OR]：1.92，95%置信区间 [CI]：1.31 至 2.80，P：<0.001；OR：1.07，95%CI：0.81 至 1.40，P：0.636）和 ln-PFOA（OR：2.17，95%CI：1.38 至 3.41，P：<0.001；OR：1.49，95%CI：1.08 至 2.05，P：0.016）与 COPD 风险相关，尤其是在男性中。PFNA 暴露与性别对 COPD 风险的交互作用具有统计学意义（P：<0.001）。RCS 曲线显示，ln-PFOA（P：0.001）和 ln-PFNA（P：0.045）与男性 COPD 风险之间存在非线性关系。WQS 分析表明，男性混合 PFAS 暴露与 COPD 风险相关（OR：1.44，95%CI：1.18 至 1.75，P：<0.001）。白蛋白介导了 PFOA 与 COPD 之间的关系（中介比例：-17.94%）。
本研究表明，PFOA 和 PFNA 与男性 COPD 风险升高相关，血清白蛋白在 PFOA 与 COPD 之间的关系中发挥中介作用。这些发现有助于 COPD 的预防。需要进一步研究以探讨潜在机制。
