An exposome atlas of human serum reveals risk of chronic diseases

Although adverse environmental exposures are considered to be a major cause to chronic diseases, current studies have provided limited knowledge on real-world chemical exposures and related risks. Here, we collected serum samples from 5696 healthy people and patients, including 12 chronic diseases in China, and completed serum biomonitoring containing 267 chemicals using gas and liquid chromatography-tandem mass spectrometry. 74 high-frequently detected exposures were used for exposure characterization and risk analysis. Results showed that region was the most critical factor influencing human exposure levels, followed by age. Hyperlipidemia was associated with the maximum number of exposures. Organochlorine pesticides and perfluoroalkyl substances were associated with multiple chronic diseases, and some of them exceed the exposure reference values. Mixture effect models showed significant risk effects of exposure on hyperlipidemia, metabolic syndrome and hyperuricemia. Overall, this study provided a comprehensive human serum exposure atlas and its disease risk, which could guide subsequent more in-depth cause-and-effect studies between environmental exposures and human health.