Associations between both legacy and alternative per- and polyfluoroalkyl substances and glucose-homeostasis: The Isomers of C8 health project in China,Environment International

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Associations between both legacy and alternative per- and polyfluoroalkyl substances and glucose-homeostasis: The Isomers of C8 health project in China
Environment International ( IF 11.8 ) Pub Date : 2021-10-05 , DOI: 10.1016/j.envint.2021.106913
Yun-Ting Zhang ₁ , Mohammed Zeeshan ₁ , Fan Su ₁ , Zheng-Min Qian ₂ , Sarah Dee Geiger ₃ , Stephen Edward McMillin ₄ , Zhi-Bin Wang ₅ , Peng-Xin Dong ₆ , Yan-Qiu Ou ₇ , Shi-Min Xiong ₈ , Xu-Bo Shen ₈ , Pei-En Zhou ₁ , Bo-Yi Yang ₁ , Chu Chu ₁ , Qing-Qing Li ₁ , Xiao-Wen Zeng ₁ , Wen-Ru Feng ₉ , Yuan-Zhong Zhou ₈ , Guang-Hui Dong ₁

Affiliation

Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63104, USA.
Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA.
School of Social Work, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63103, USA.
Department of Environmental Health Sciences, Laboratory of Human Environmental Epigenomes, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Nursing College, Guangxi Medical University, Nanning 530021, China.
Department of Epidemiology, Guangdong Cardiovascular Institute, WHO Collaborating Center for Research and Training in Cardiovascular Diseases, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
School of Public Health, Zunyi Medical University, Zunyi 563060, China.
Department of Environmental Health, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.

Background

Epidemiological studies on the associations of legacy per- and polyfluoroalkyl substances (PFASs) and glucose homeostasis remain discordant. Understanding of PFAS alternatives is limited, and few studies have reported joint associations of PFASs and PFAS alternatives.

Objectives

To investigate associations of novel PFAS alternatives (chlorinated perfluoroalkyl ether sulfonic acids, Cl-PFESAs and perfluorobutanoic acid, PFBA) and two legacy PFASs (Perfluorooctanoic acid, PFOA and perfluorooctane sulfonate, PFOS) with glucose-homeostasis markers and explore joint associations of 13 legacy and alternative PFASs with the selected outcomes.

Methods

We used cross-sectional data of 1,038 adults from the Isomers of C8 Health Project in China. Associations of PFASs and PFAS alternatives with glucose-homeostasis were explored in single-pollutant models using generalized linear models with natural cubic splines for PFASs. Bayesian Kernel Machine Regression (BKMR) models were applied to assess joint associations of exposures and outcomes. Sex-specific analyses were also conducted to evaluate effect modification.

Results

After adjusting for confounders, both legacy (PFOA, PFOS) and alternative (Cl-PFESAs and PFBA) PFASs were positively associated with glucose-homeostasis markers in single-pollutant models. For example, in the total study population, estimated changes with 95% confidence intervals (CI) of fasting glucose at the 95th percentile of 6:2Cl-PFESA and PFOS against the thresholds were 0.90 (95% CI: 0.59, 1.21) and 0.44 (95% CI: 0.26, 0.62). Positive joint associations were found in BKMR models with 6:2Cl-PFESA contributing most. Sex-specific associations existed in both single- and multi-pollutant models.

Conclusions

Legacy and alternative PFASs were positively associated with glucose-homeostasis markers. 6:2Cl-PFESA was the primary contributor. Sex-specific associations were also identified. These results indicate that joint associations and effect modification should be considered in risk assessment. However, further studies are recommended to strengthen our findings and to elucidate the mechanisms of action of legacy and alternative PFASs.

更新日期：2021-10-06

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