Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, China.
Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, China; Key Laboratory for Prevention and Control of Emerging Infectious Diseases and Public Health Security, the Xinjiang Production and Construction Corps, China; Key Laboratory of Preventive Medicine, Shihezi University, Shihezi, Xinjiang, China; Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), School of Medicine, Shihezi University, Shihezi, Xinjiang, China.
Sci Total Environ. 2024 Nov 25;953:176187. doi: 10.1016/j.scitotenv.2024.176187. Epub 2024 Sep 10.
Per- and polyfluoroalkyl substances (PFAS) pose potential risks to human health. In real-world settings, humans are exposed to various PFAS through numerous pathways.
This study evaluated the associations between co-exposure to PFAS and obesity and its comorbidities, along with the mediating roles of inflammation and oxidative stress.
We analyzed 11,090 participants from National Health and Nutrition Examination Survey (NHANES), 2003-2018. Linear regression, logistic regression, and generalized additive models were used to assess the individual effects of PFAS exposure on obesity and its comorbidities. The environmental risk score (ERS) was calculated using the adaptive elastic-net model to assess the co-exposure effects. Linear and logistic regression models explored the associations between ERS and obesity and its comorbidities. Mediation analyses explored the roles of inflammatory (neutrophils, lymphocytes, and alkaline phosphatase) and oxidative stress (gamma-glutamyl transferase, total bilirubin, and uric acid) markers in the associations between ERS and obesity and its comorbidities.
For each unit increase in ERS, the odds of obesity and type 2 diabetes mellitus (T2DM) increased 3.60-fold (95 % CI: 2.03, 6.38) and 1.91-fold (95 % CI: 1.28, 2.86), respectively. For each unit increase in ERS, BMI increased by 2.36 (95 % CI: 1.24, 3.48) kg/m, waist circumference increased by 6.47 (95 % CI: 3.56, 9.37) cm, and waist-to-height ratio increased by 0.04 (95 % CI: 0.02, 0.06). Lymphocytes, alkaline phosphatase, and total bilirubin were significantly associated with both ERS and obesity, with mediation proportions of 4.17 %, 3.62 %, and 7.37 %, respectively. Lymphocytes, alkaline phosphatase, total bilirubin, and uric acid were significantly associated with both ERS and T2DM, with the mediation proportions of 8.90 %, 8.74 %, 29.73 %, and 38.19 %, respectively.
Co-exposure to PFAS was associated with obesity and T2DM, and these associations may be mediated by inflammation and oxidative stress. Further mechanistic and prospective studies are required to verify these associations.
全氟和多氟烷基物质（PFAS）对人类健康构成潜在风险。在实际环境中，人类通过多种途径接触各种 PFAS。
本研究评估了 PFAS 共同暴露与肥胖及其合并症之间的关系，并探讨了炎症和氧化应激的中介作用。
我们分析了来自 2003 年至 2018 年全国健康和营养检查调查（NHANES）的 11090 名参与者。线性回归、逻辑回归和广义加性模型用于评估 PFAS 暴露对肥胖及其合并症的个体影响。使用自适应弹性网模型计算环境风险评分（ERS），以评估共同暴露的影响。线性和逻辑回归模型探讨了 ERS 与肥胖及其合并症之间的关系。中介分析探讨了炎症（中性粒细胞、淋巴细胞和碱性磷酸酶）和氧化应激（γ-谷氨酰转移酶、总胆红素和尿酸）标志物在 ERS 与肥胖及其合并症之间的关联中的作用。
ERS 每增加一个单位，肥胖和 2 型糖尿病（T2DM）的患病风险分别增加 3.60 倍（95%CI：2.03，6.38）和 1.91 倍（95%CI：1.28，2.86）。ERS 每增加一个单位，BMI 增加 2.36（95%CI：1.24，3.48）kg/m，腰围增加 6.47（95%CI：3.56，9.37）cm，腰高比增加 0.04（95%CI：0.02，0.06）。淋巴细胞、碱性磷酸酶和总胆红素与 ERS 和肥胖均显著相关，中介比例分别为 4.17%、3.62%和 7.37%。淋巴细胞、碱性磷酸酶、总胆红素和尿酸与 ERS 和 T2DM 均显著相关，中介比例分别为 8.90%、8.74%、29.73%和 38.19%。
PFAS 共同暴露与肥胖和 T2DM 相关，这些关联可能通过炎症和氧化应激介导。需要进一步的机制和前瞻性研究来验证这些关联。
