Cross-Sectional Associations of Plasma Per- and Polyfluoroalkyl Substances with Lipid Profile among Pre-Diabetic Adults-Report from the Diabetes Prevention Program

摘要

Per- and polyfluoroalkyl substances (PFASs) may interfere with lipid regulation but most previous studies examined occupational cohorts or general populations but not those with high metabolic risks. Among 957 adults in the Diabetes Prevention Program, we measured plasma concentrations of 6 PFASs and lipoproteins at recruitment (1996-1999) and examined their cross-sectional associations using linear regression adjusting for potential confounding by demographic and lifestyle variables. We excluded 69 participants taking lipid lowering medications or had missing values. Plasma PFAS for the 888 participants were comparable to those reported in NHANES 1999-2000. 59.3% of participants had total cholesterol above 200mg/dL. Median levels of several lipid were higher in the 4th compared to the 1st quartile of summed PFASs. Specifically, median total cholesterol was 4.2% (95% CI: 0.9-7.6%) or 8.5mg/dL higher in the 4th comparing to the 1st quartile; 14.6% (95% CI: 4.7-24.5%) for triglycerides (21.2 mg/dL); 5.9% (95% CI: 1.4-10.3%) for non-HDL (5.9 mg/dL); 6.1% (95% CI: 1.1-11.1%) for HDL/Total Cholesterol ratio (0.3); and 14.9% (95% CI: 5.2-24.7%) for vLDL (4.3 mg/dL). We also observed positive associations of perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonic acid (PFHxS), and perfluorononanoic acid (PFNA) with total cholesterol, non-HDL, and very low-density LDL (vLDL). We found negative associations for PFOA with LDL particle size and N-ethyl-perfluorooctane sulfonamide acetic acid (EtFOSAA) with HDL. In this pre-diabetic population, higher plasma PFAS levels were cross-sectionally associated with higher blood lipids. Positive associations of PFOS and PFOA with total cholesterol were consistent with previous studies. This study added new findings for EtFOSAA, N-Methyl-perfluorooctane sulfonamide acetic acid, non-HDL, vLDL, and LDL particle size which are clinically relevant lipid parameters.