Data_Sheet_1_Exposure to per- and polyfluoroalkyl substances is associated with impaired cardiovascular health: a cross-sectional study.docx

BackgroundPer- and polyfluoroalkyl substance (PFAS) exposure and cardiovascular disease are controversial. We aimed to assess the association between serum PFAS exposure and cardiovascular health (CVH) in U.S. adults.
MethodsWe analyzed serum PFAS concentration data of U.S. adults reported in the National Health and Nutrition Examination Survey (NHANES) study (2005–2018). We employed two weighted logistic regression models and a restricted cubic spline (RCS) to examine the association between each PFAS and impaired CVH (defined as moderate and low CVH). Quantile g-computation (Qgcomp) and weighted quantile sum (WQS) analysis were used to estimate the effects of mixed exposures to PFASs on impaired CVH.
ResultsPFAS were associated with an increased risk of impaired CVH (ORPFNA: 1.40, 95% CI: 1.09, 1.80; ORPFOA: 1.44, 95% CI: 1.10, 1.88; ORPFOS: 1.62, 95% CI: 1.25, 2.11). PFOA and PFOS exhibited nonlinear relationships with impaired CVH. Significant interactions were observed for impaired CVH between race/ethnicity and PFHxS (p = 0.02), marital status and PFOA (p = 0.03), and both marital status and race/ethnicity with PFOS (p = 0.01 and p = 0.02, respectively). Analysis via WQS and Qgcomp revealed that the mixture of PFAS was positively associated with an increased risk of impaired CVH.
ConclusionPFNA, PFOA, and PFOS exposure are associated with an increased risk of impaired CVH in U.S. adults. Race/ethnicity and marital status may influence CVH. Reducing PFAS exposure could alleviate the burden of disease associated with impaired CVH.

研究背景：全氟和多氟烷基物质（Per- and polyfluoroalkyl substance, PFAS）暴露与心血管疾病的关联尚存争议。本研究旨在评估美国成年人血清PFAS暴露水平与心血管健康（cardiovascular health, CVH）之间的关联。
研究方法：本研究分析了2005-2018年美国国家健康与营养检查调查（National Health and Nutrition Examination Survey, NHANES）中报告的美国成年人血清PFAS浓度数据。本研究采用两种加权逻辑回归模型与限制性立方样条（restricted cubic spline, RCS），探究单种PFAS与心血管健康受损（定义为中等及低水平CVH）的关联；同时采用分位数g计算（quantile g-computation, Qgcomp）与加权分位数和（weighted quantile sum, WQS）分析，评估PFAS混合暴露对心血管健康受损的影响。
研究结果：PFAS暴露与心血管健康受损风险升高显著相关（PFNA的比值比（Odds Ratio, OR）：1.40，95%置信区间（Confidence Interval, CI）：1.09~1.80；PFOA的OR：1.44，95%CI：1.10~1.88；PFOS的OR：1.62，95%CI：1.25~2.11）。PFOA与PFOS与心血管健康受损呈非线性关联。本研究观察到种族/族裔与PFHxS（p=0.02）、婚姻状况与PFOA（p=0.03）、婚姻状况及种族/族裔与PFOS（分别为p=0.01与p=0.02）之间对心血管健康受损存在显著交互作用。通过WQS与Qgcomp分析发现，PFAS混合物与心血管健康受损风险升高呈正相关。
研究结论：美国成年人的PFNA、PFOA及PFOS暴露与心血管健康受损风险升高显著相关。种族/族裔与婚姻状况可能对CVH存在影响。降低PFAS暴露或可缓解与心血管健康受损相关的疾病负担。