Associations between Per- and Polyfluoroalkyl Substances (PFAS) and Cardiometabolic Biomarkers in Adults of Czechia: The Kardiovize Study

Neto, Geraldo A. Maranhão; Polcrová, Anna; Pospíšilová, Anna; Bláha, Luděk; Klánová, Jana; Bobák, Martin; González-Rivas, Juan P.

doi:10.3390/ijerph192113898

Cited by 5 publications

(10 citation statements)

References 34 publications

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“…Some studies report that the body burden of some PFAS is associated with higher body mass index, larger waist circumference, and higher fat mass. [47][48][49] Three studies have reported negative associations between PFAS body burden and body size characteristics. 47,50,51 Moreover, several studies have reported no associations between PFAS body burden and body size.…”

Section: Obesitymentioning

confidence: 99%

“…[47][48][49] Three studies have reported negative associations between PFAS body burden and body size characteristics. 47,50,51 Moreover, several studies have reported no associations between PFAS body burden and body size. [52][53][54][55][56] To date, epidemiological studies do not support consistent associations between PFAS and obesity.…”

Section: Obesitymentioning

confidence: 99%

“…85 Analysis in the Kardiovize Study (Czechia, 479 participants) showed that PFOA (but not PFNA, PFDA, or PFOS) was associated with increased systolic and diastolic blood pressures. 47 Two overlapping analyses of the Isomers of C8 Health Project (China) participants also have examined the associations between PFAS, including isomers of PFOS and pressure. 86,87 In females, PFOA, PFNA, linear-PFOS, and branched-PFOS were associated with increased systolic pressure; PFNA, linear-PFOS, and branched-PFOS also were associated with increased diastolic pressure.…”

Section: Blood Pressure and Hypertensionmentioning

confidence: 99%

“…115 Analysis in the Kardiovize Study (Czechia, 479 participants) showed that PFOA and PFOS were associated with increased total cholesterol, but PFOA also was associated with higher LDL-C, while PFOS was associated with increased HDL-C. 47 In contrast, PFDA was associated with lower total serum cholesterol. 47 No PFAS (PFOA, PFNA, PFHxS, or PFOS) was associated with triglycerides. 47 A limited analysis within the EuroMix study (Norway, 127 participants) reported that PFNA (but no other PFAS) was linked to increased HDL-C, and PFOA (but no other PFAS) was associated with a decrease in triglycerides.…”

Section: Dyslipidemia and Atherosclerosismentioning

confidence: 99%

“…117 It is important to note that although uncommon and typically in small studies with lower exposures, some studies reported completely null associations between PFOA, PFNA, PFDA, PFNA, PFHxS, or PFOS and total cholesterol or LDL-C. 53,55,90,[116][117][118] Rarely, PFASs were reported to be associated with a decrease in cholesterol. 47 Few studies have specifically examined the association between PFAS and overt atherosclerosis, coronary artery disease, or acute coronary syndromes (Table 5; Figure ). A single case-control study (China, 355 cases and controls) investigated the association between NASEM PFAS and acute coronary syndromes, demonstrating increased risk associated with higher serum concentrations of PFOA, PFUnDA, and PFOS.…”

Section: Dyslipidemia and Atherosclerosismentioning

confidence: 99%

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Perfluoroalkyl/Polyfluoroalkyl Substances: Links to Cardiovascular Disease Risk

Schlezinger,

Gokce

2024

Circulation Research

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Conservative estimates by the World Health Organization suggest that at least a quarter of global cardiovascular diseases are attributable to environmental exposures. Associations between air pollution and cardiovascular risk have garnered the most headlines and are strong, but less attention has been paid to other omnipresent toxicants in our ecosystem. Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are man-made chemicals that are extensively used in industrial and consumer products worldwide and in aqueous film-forming foam utilized in firefighting. As such, our exposure to PFAS is essentially ubiquitous. Given the long half-lives of these degradation-resistant chemicals, virtually, all people are carrying a body burden of PFAS. Health concerns related to PFAS are growing such that the National Academies of Sciences, Engineering and Medicine has recommended standards for clinical follow-up of individuals with high PFAS blood levels, including prioritizing screening for dyslipidemia. The link between PFAS and dyslipidemia has been extensively investigated, and evidence for associations is compelling. However, dyslipidemia is not the only cardiovascular risk factor with which PFAS is associated. Here, we review the epidemiological evidence for links between PFAS of concern identified by the National Academies of Sciences, Engineering and Medicine and risk factors for cardiovascular disease, including overweight/obesity, glucose intolerance, hypertension, dyslipidemia, and hyperuricemia. Moreover, we review the potential connections of PFAS with vascular disease and atherosclerosis. While observational data support associations between the National Academies of Sciences, Engineering and Medicine PFAS and selected cardiac risk factors, additional research is needed to establish causation and better understand how exposure to PFAS leads to the development of these conditions.

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Section: Obesitymentioning

confidence: 99%

Section: Obesitymentioning

confidence: 99%

Section: Blood Pressure and Hypertensionmentioning

confidence: 99%

Section: Dyslipidemia and Atherosclerosismentioning

confidence: 99%

Section: Dyslipidemia and Atherosclerosismentioning

confidence: 99%

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Perfluoroalkyl/Polyfluoroalkyl Substances: Links to Cardiovascular Disease Risk

Schlezinger,

Gokce

2024

Circulation Research

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Hepatic injury and metabolic perturbations in mice exposed to perfluorodecanoic acid revealed by metabolomics and lipidomics

Sun,

He,

Chen

et al. 2025

Ecotoxicology and Environmental Safety

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A systems toxicology approach for identification of disruptions in cholesterol homeostasis after aggregated exposure to mixtures of perfluorinated compounds in humans

Westerhout,

den Heijer-Jordaan,

Princen

et al. 2024

Toxicological Sciences

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Per- and polyfluoroalkyl substances (PFAS) are used in various household and industrial products. In humans, positive associations were reported between PFAS, including perfluorsulfonic acid and perfluorooctanoic acid, and cholesterol, a cardiometabolic risk factor. Animal studies show the opposite. Human-centered approaches are needed to better understand the effects of PFAS mixtures on cholesterol. Here, a systems toxicology approach is described, using a gene-centered cholesterol biokinetic model. PFAS exposure-gene expression relations from published data were introduced into the model. An existing PFAS physiologically based kinetic model was augmented with lung and dermal compartments and integrated with the cholesterol model to enable exposure-effect modelling. The final model was populated with data reflecting lifetime mixture exposure from: tolerable weekly intake values (TWI); the environment; high occupational exposures (ski waxing, PFAS industry). Results indicate that low level exposures (TWI, environmental), did not change cholesterol. In contrast, occupational exposures clearly resulted in internal PFAS exposure and disruption of cholesterol homeostasis, largely in line with epidemiological observations. Despite model limitations (e.g. dynamic range, directionality), changes in cholesterol homeostasis were predicted for ski waxers, hitherto unknown from epidemiological studies. Here, future studies involving lipid metabolism could improve risk assessment. Impact statement Using a human-centered computational approach, the effects of aggregated lifetime PFAS exposure on cholesterol homeostasis clearly distinguished background exposures versus high occupational exposures, and helped to identify occupational subgroups at potential risk. The approach may help to develop human-based quantitative health risk assessment approaches for PFAS, unlikely to be achieved by animal and epidemiological studies alone.

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Associations between Per- and Polyfluoroalkyl Substances (PFAS) and Cardiometabolic Biomarkers in Adults of Czechia: The Kardiovize Study

Cited by 5 publications

References 34 publications

Perfluoroalkyl/Polyfluoroalkyl Substances: Links to Cardiovascular Disease Risk

Perfluoroalkyl/Polyfluoroalkyl Substances: Links to Cardiovascular Disease Risk

Hepatic injury and metabolic perturbations in mice exposed to perfluorodecanoic acid revealed by metabolomics and lipidomics

A systems toxicology approach for identification of disruptions in cholesterol homeostasis after aggregated exposure to mixtures of perfluorinated compounds in humans

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