Xiao Fang, Yang Ming, Lv Junli, Li Jing, Guo Mingmei, Duan WenJing, Li Haoran, An Ziwen, Su Zhengyi, Li Ang, Liu Yi, Lu Jingchao, Guo Huicai
Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, China.
Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China.
J Environ Sci (China). 2025 Sep;155:773-785. doi: 10.1016/j.jes.2024.06.026. Epub 2024 Jun 28.
Previous studies have suggested that abnormal hepatobiliary system function may contribute to poor prognosis in patients with acute coronary syndrome (ACS) and that abnormal hepatobiliary system function may be associated with per- and polyfluoroalkyl substances (PFAS) exposure. However, there is limited evidence for this association in cardiovascular subpopulations, particularly in the ACS patients. Therefore, we performed this study to evaluate the association between plasma PFAS exposure and hepatobiliary system function biomarkers in patients with ACS. This study included 546 newly diagnosed ACS patients at the Second Hospital of Hebei Medical University, and data on 15 hepatobiliary system function biomarkers were obtained from medical records. Associations between single PFAS and hepatobiliary system function biomarkers were assessed using multiple linear regression models and restricted cubic spline model (RCS), and mixture effects were assessed using the Quantile g-computation model. The results showed that total bile acids (TBA) was negative associated with perfluorohexane sulfonic acid (PFHxS) (-7.69 %, 95 % CI: -12.15 %, -3.01 %). According to the RCS model, linear associations were found between TBA and PFHxS (P for overall = 0.003, P for non-linear = 0.234). We also have observed the association between between PFAS congeners and liver enzyme such as aspartate aminotransferase (AST) and α-l-Fucosidase (AFU), but it was not statistically significant after correction. In addition, Our results also revealed an association between prealbumin (PA) and PFAS congeners as well as mixtures. Our findings have provided a piece of epidemiological evidence on associations between PFAS congeners or mixture, and serum hepatobiliary system function biomarkers in ACS patients, which could be a basis for subsequent mechanism studies.
先前的研究表明，肝胆系统功能异常可能导致急性冠状动脉综合征（ACS）患者预后不良，且肝胆系统功能异常可能与全氟和多氟烷基物质（PFAS）暴露有关。然而，在心血管亚人群中，尤其是ACS患者中，这一关联的证据有限。因此，我们开展了本研究，以评估ACS患者血浆PFAS暴露与肝胆系统功能生物标志物之间的关联。本研究纳入了河北医科大学第二医院546例新诊断的ACS患者，并从病历中获取了15种肝胆系统功能生物标志物的数据。使用多元线性回归模型和受限立方样条模型（RCS）评估单一PFAS与肝胆系统功能生物标志物之间的关联，并使用分位数g计算模型评估混合效应。结果显示，总胆汁酸（TBA）与全氟己烷磺酸（PFHxS）呈负相关（-7.69%，95%CI：-12.15%，-3.01%）。根据RCS模型，发现TBA与PFHxS之间存在线性关联（总体P=0.003，非线性P=0.234）。我们还观察到PFAS同系物与肝酶如天冬氨酸转氨酶（AST）和α-L-岩藻糖苷酶（AFU）之间的关联，但校正后无统计学意义。此外，我们的结果还揭示了前白蛋白（PA）与PFAS同系物以及混合物之间的关联。我们的研究结果为ACS患者中PFAS同系物或混合物与血清肝胆系统功能生物标志物之间的关联提供了一项流行病学证据，可为后续的机制研究提供依据。
