Serum albumin mediates the effect of multiple per- and polyfluoroalkyl substances on serum lipid levels

Fan, Yun; Li, Xiuzhu; Xu, Qiaoqiao; Zhang, Yuqing; Xu, Yang; Han, Xiumei; Du, Guizhen; Xia, Yankai; Wang, Xinru; Lu, Chuncheng

doi:10.1016/j.envpol.2020.115138

Cited by 41 publications

(20 citation statements)

References 59 publications

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“…Nevertheless, it is worth noting that the associations were largely consistent among nationwide representative samples in the U.S. National Health and Nutrition Examination Survey (NHANES) at the lower range of PFAS exposures. 43 , 47 Publication bias was also spotted in a few PFAS–lipid associations, although results from the trim-and-fill analysis did not support the notion that the publication bias might explain our findings.…”

Section: Discussioncontrasting

confidence: 55%

Associations between Per- and Polyfluoroalkyl Substances Exposures and Blood Lipid Levels among Adults—A Meta-Analysis

Liu

Zhu

Wang

et al. 2023

Environ Health Perspect

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Section: Discussioncontrasting

confidence: 55%

Associations between Per- and Polyfluoroalkyl Substances Exposures and Blood Lipid Levels among Adults—A Meta-Analysis

Liu

Zhu

Wang

et al. 2023

Environ Health Perspect

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“…These findings are supported by previous studies reporting associations between single PFAS biomarkers with serum lipids levels. 36 , 37 PFAS exposure has also been linked to having less inflammation as measured by C-reactive protein. 40 , 41 Some previous studies have found null associations between individual PFAS and blood pressure.…”

Section: Discussionmentioning

confidence: 99%

“…Covariates were selected based on previous studies as well as on a directed acyclic graph (DAG; Figure S1), 35 – 37 and included sex, age (in years), race/ethnicity (using categories prespecified by the NHANES, 45 including Mexican American, other Hispanic, non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, other/multiple race) as a proxy for racism/structural inequity, 46 ratio of family income to poverty, and body mass index (BMI, in kilograms per meter squared). The family income-to-poverty ratio was calculated by dividing reported family income by poverty guidelines established by the Department of Health and Human Services.…”

Section: Methodsmentioning

confidence: 99%

“…Serum lipids were chosen because serum PFAS concentrations have consistently been associated with higher lipid levels. 35 – 37 We included blood pressure because there have been mixed findings of associations between PFAS concentrations and blood pressure. 38 , 39 Last, studies have found inverse associations of PFAS concentrations with C-reactive protein and that PFAS exposure can suppress immune responses.…”

Section: Introductionmentioning

confidence: 99%

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Developing an Exposure Burden Score for Chemical Mixtures Using Item Response Theory, with Applications to PFAS Mixtures

Liu

Kuiper

Chen

et al. 2022

Environ Health Perspect

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Background: There are few existing methods to quantify total exposure burden to chemical mixtures, independent of a health outcome. A summary metric could be advantageous for use in biomonitoring, risk assessment, health risk calculators, and mediation models. Objective: We developed a novel exposure burden score method for chemical mixtures, applied it to estimate exposure burden to per- and polyfluoroalkyl substances (PFAS) mixtures, and estimated associations of PFAS burden scores with cardio-metabolic outcomes in the general U.S. population. Methods: We applied item response theory (IRT) to biomonitoring data from 1,915 children and adults 12–80 years of age in the 2017–2018 National Health and Examination Survey to quantify a latent PFAS burden score, using serum concentrations of eight measured PFAS biomarkers, each considered an “item.” The premise of IRT is that through using both information about a participant’s concentration of an individual PFAS biomarker, as well as their exposure patterns for the PFAS mixture, we can estimate the participant’s latent PFAS exposure burden, independent of a health outcome. We used linear regression to estimate associations of the PFAS burden score with cardio-metabolic outcomes and compared our findings to results using summed PFAS concentrations as the exposure metric. Results: PFAS burden scores and summed PFAS concentrations had moderate-high correlation ( ). Isomers of PFOS [ -perfluorooctane sulfonic acid ( -PFOS) and perfluoromethylheptane sulfonic acid isomers (Sm-PFOS)] were the most informative to the PFAS burden scores. PFAS burden scores and summed PFAS concentrations were both significantly associated with cardio-metabolic outcomes, but associations were generally closer to the null for summed PFAS concentrations vs. the PFAS burden score. Adjusted associations (95% CIs) with total cholesterol (in milligrams per deciliter) were 8.6 (95% CI: 5.2, 11.9) and 2.4 (95% CI: 0.5, 4.2) per interquartile range increase in the PFAS burden score and summed concentrations, respectively. Sensitivity analyses showed similar associations with cardio-metabolic outcomes when only a subset of PFAS biomarkers was used to estimate PFAS burden. In a validation study, associations between PFAS burden scores and cholesterol were consistent with primary analyses but null when using summed PFAS concentrations. Discussion: IRT offers a straightforward way to include exposure biomarkers with low detection frequencies and can reduce exposure measurement error. Further, IRT enables comparisons of exposure burden to chemical mixtures across studies even if they did not measure the exact same set of chemicals, which supports harmonization across studies and consortia. We provide an accompanying PFAS burden calculator ( https://pfasburden.shinyapps.io/app_pfas_burden/ ), enabling res...

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“…Taken together, this suggests that using a mixture IRT scoring approach for PFAS burden may have increased sensitivity to detecting health effects. Previous studies have reported associations between single PFAS analytes with serum lipids. , Some previous studies have found null associations between individual PFAS and blood pressure, , while others have found significant positive associations of PFAS with systolic and diastolic blood pressure …”

Section: Discussionmentioning

confidence: 97%

Toward Advancing Precision Environmental Health: Developing a Customized Exposure Burden Score to PFAS Mixtures to Enable Equitable Comparisons Across Population Subgroups, Using Mixture Item Response Theory

Liu,

Feuerstahler,

Chen

et al. 2023

Environ. Sci. Technol.

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Quantifying a person's cumulative exposure burden to per-and polyfluoroalkyl substances (PFAS) mixtures is important for risk assessment, biomonitoring, and reporting of results to participants. However, different people may be exposed to different sets of PFASs due to heterogeneity in the exposure sources and patterns. Applying a single measurement model for the entire population (e.g., by summing concentrations of all PFAS analytes) assumes that each PFAS analyte is equally informative to PFAS exposure burden for all individuals. This assumption may not hold if PFAS exposure sources systematically differ within the population. However, the sociodemographic, dietary, and behavioral characteristics that underlie systematic exposure differences may not be known, or may be due to a combination of these factors. Therefore, we used mixture item response theory, an unsupervised psychometrics and data science method, to develop a customized PFAS exposure burden scoring algorithm. This scoring algorithm ensures that PFAS burden scores can be equitably compared across population subgroups. We applied our methods to PFAS biomonitoring data from the United States National Health and Nutrition Examination Survey (2013−2018). Using mixture item response theory, we found that participants with higher household incomes had higher PFAS burden scores. Asian Americans had significantly higher PFAS burden compared with non-Hispanic Whites and other race/ethnicity groups. However, some disparities were masked when using summed PFAS concentrations as the exposure metric. This work demonstrates that our summary PFAS burden metric, accounting for sources of exposure variation, may be a more fair and informative estimate of PFAS exposure.

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Serum albumin mediates the effect of multiple per- and polyfluoroalkyl substances on serum lipid levels

Cited by 41 publications

References 59 publications

Associations between Per- and Polyfluoroalkyl Substances Exposures and Blood Lipid Levels among Adults—A Meta-Analysis

Associations between Per- and Polyfluoroalkyl Substances Exposures and Blood Lipid Levels among Adults—A Meta-Analysis

Developing an Exposure Burden Score for Chemical Mixtures Using Item Response Theory, with Applications to PFAS Mixtures

Toward Advancing Precision Environmental Health: Developing a Customized Exposure Burden Score to PFAS Mixtures to Enable Equitable Comparisons Across Population Subgroups, Using Mixture Item Response Theory

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