Exposures to perfluoroalkyl substances (PFAS) have shown positive associations with serum lipids in previous studies. While many studies on lipids investigated associations with perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA), there are only a few studies regarding other PFAS, such as perfluorohexane sulfonic acid (PFHxS). The purpose of the current study is to investigate if associations with serum lipids were present, not only for serum PFOS and PFOA, but also for PFHxS, and if the associations with PFAS remained also in a comparison based only on residency in areas with contrasting exposure to PFAS. 1945 adults aged 20–60 were included from Ronneby, Sweden, a municipality where one out of two waterworks had been heavily contaminated from aqueous fire-fighting foams, and from a nearby control area. The exposure was categorized based on either been living in areas with contrasting PFAS exposure or based on the actual serum PFAS measurements. Regression analyses of serum lipids were fitted against serum PFAS levels, percentile groups, smooth splines and between exposed and reference areas, adjusting for age, sex and BMI. Drinking water contamination caused high serum levels of PFOS (median 157 ng/ml) and PFHxS (median 136 ng/ml) and PFOA (median 8.6 ng/ml). These serum PFAS levels in the exposed groups were 5 to 100-fold higher than in the controls. In this population with mixed PFAS exposure, predominantly PFOS and PFHxS, PFAS exposure were positively associated with serum lipids. This was observed both when quantifying exposure as contrast between exposed and controls, and in terms of serum PFAS. Due to high correlations between each PFAS, we cannot separate them. In conclusion, the present study provides further evidence of a causal association between PFAS and serum lipids, especially for PFHxS.

中文翻译：

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饮用水受污染的瑞典成年人群中全氟烷基物质与血清脂质之间的关联。


先前的研究显示，接触全氟烷基物质 (PFAS) 与血脂呈正相关。虽然许多关于脂质的研究调查了与全氟辛烷磺酸 (PFOS) 和全氟辛酸 (PFOA) 的关联，但只有少数研究涉及其他 PFAS，例如全氟己烷磺酸 (PFHxS)。本研究的目的是调查是否存在与血清脂质的关联，不仅是血清 PFOS 和 PFOA，还包括 PFHxS，以及在仅基于对比暴露地区的居住情况的比较中，与 PFAS 的关联是否仍然存在到 PFAS。 1945 名 20-60 岁的成年人被纳入瑞典龙讷比市和附近控制区，该市有二分之一的自来水厂受到含水消防泡沫的严重污染。根据是否居住在 PFAS 暴露对比区域或根据实际血清 PFAS 测量值对暴露进行分类。根据血清 PFAS 水平、百分位组、平滑样条以及暴露区域和参考区域之间的情况，对血清脂质进行回归分析，并根据年龄、性别和 BMI 进行调整。饮用水污染导致 PFOS（中位值 157 ng/ml）、PFHxS（中位值 136 ng/ml）和 PFOA（中位值 8.6 ng/ml）的血清水平升高。暴露组的血清 PFAS 水平比对照组高 5 至 100 倍。在混合 PFAS 暴露（主要是 PFOS 和 PFHxS）的人群中，PFAS 暴露与血清脂质呈正相关。在将暴露量化为暴露与对照之间的对比时，以及在血清 PFAS 方面，都观察到了这一点。由于每种 PFAS 之间的高度相关性，我们无法将它们分开。 总之，本研究提供了 PFAS 与血脂（尤其是 PFHxS）之间因果关系的进一步证据。