Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
Front Public Health. 2024 Oct 10;12:1431001. doi: 10.3389/fpubh.2024.1431001. eCollection 2024.
Research on the correlation between exposure to per- and polyfluoroalkylated substances (PFASs)/heavy metals and bone health during childhood and adolescence is limited. Considering their role as endocrine disruptors, we examined relationships of six PFASs and three heavy metals with bone mineral density (BMD) in children and adolescents using representative samples from the National Health and Nutrition Examination Survey (NHANES).
The study included 622 participants aged 12-19. The relationship between single pollutant and lumbar spine and total BMD was studied using linear regression analyses. Additionally, Bayesian Kernel Machine Regression (BKMR) models were applied to assess the joint effects of multiple PFASs and heavy metals exposure on the lumbar spine and total BMD.
Statistically significant differences were noted in the serum concentrations of perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), blood lead (Pb), and blood manganese (Mn) between male and female participants (all < 0.05). Single-exposure studies have shown that Mn was negatively correlated with lumbar spine BMD and total BMD. Multivariate linear regression models revealed that, in the male group, total bone density decreased as the blood PFOA levels [95% CI = (-0.031, -0.001), = 0.040] and blood manganese levels [95% CI = (-0.009, -0.002), = 0.004] increased. Similarly, lumbar spine bone density decreased as the blood manganese levels [95% CI = (-0.011, -0.002), = 0.009] increased. In the female group, total bone density decreased as the serum PFNA levels [95% CI = (-0.039, 0.000), = 0.048] increased. As shown in the BKMR model, the joint effects of pollutant mixtures, including Mn, were negatively associated with both the lumbar spine and total BMD. Among the pollutants analyzed, Mn appeared to be the primary contributor to this negative association.
This study suggests that exposure to certain PFASs and heavy metals may be associated with poor bone health. Childhood and adolescence are crucial stages for bone development, and improper exposure to PFASs and heavy metals during these stages could potentially jeopardize future bone health, consequently raising the risk of osteoporosis in adulthood.
目前关于儿童和青少年时期接触全氟和多氟烷基物质（PFAS）/重金属与骨骼健康之间的相关性的研究有限。鉴于它们作为内分泌干扰物的作用，我们使用来自国家健康和营养检查调查（NHANES）的代表性样本，研究了六种 PFAS 和三种重金属与儿童和青少年骨矿物质密度（BMD）之间的关系。
本研究纳入了 622 名 12-19 岁的参与者。使用线性回归分析研究单一污染物与腰椎和总 BMD 的关系。此外，还应用贝叶斯核机器回归（BKMR）模型来评估多种 PFAS 和重金属暴露对腰椎和总 BMD 的联合影响。
男性和女性参与者的血清全氟辛酸（PFOA）、全氟辛烷磺酸（PFOS）、全氟己烷磺酸（PFHxS）、血铅（Pb）和血锰（Mn）浓度存在统计学差异（均<0.05）。单暴露研究表明，Mn 与腰椎 BMD 和总 BMD 呈负相关。多变量线性回归模型显示，在男性组中，随着血 PFOA 水平[95%置信区间（CI）=（-0.031，-0.001），=0.040]和血 Mn 水平[95% CI=（-0.009，-0.002），=0.004]的增加，总骨密度降低。同样，随着血 Mn 水平[95% CI=（-0.011，-0.002），=0.009]的增加，腰椎骨密度降低。在女性组中，随着血清 PFNA 水平[95% CI=（-0.039，0.000），=0.048]的增加，总骨密度降低。如 BKMR 模型所示，污染物混合物（包括 Mn）的联合效应与腰椎和总 BMD 呈负相关。在所分析的污染物中，Mn 似乎是这种负相关的主要贡献者。
本研究表明，接触某些 PFAS 和重金属可能与骨骼健康不良有关。儿童和青少年时期是骨骼发育的关键阶段，在此期间不当暴露于 PFAS 和重金属可能会危及未来的骨骼健康，从而增加成年后患骨质疏松症的风险。
