The Association of Combined Per- and Polyfluoroalkyl Substances and Metals with Allostatic Load Using Bayesian Kernel Machine Regression

Abstract

Background/Objective: This study aimed to investigate the effect of exposure to per- and polyfluoroalkyl substances (PFAS), a class of organic compounds utilized in commercial and industrial applications, on allostatic load (AL), a measure of chronic stress. PFAS, such as perfluorodecanoic acid (PFDE), perfluorononanoic acid (PFNA), perfluorooctane sulfonic acid (PFOS), perfluoroundecanoic acid (PFUA), perfluorooctanoic acid (PFOA), and perfluorohexane sulfonic acid (PFHS), and metals, such as mercury (Hg), barium (Ba), cadmium (Cd), cobalt (Co), cesium (Cs), molybdenum (Mo), lead (Pb), antimony (Sb), thallium (TI), tungsten (W), and uranium (U) were investigated. This research was performed to explore the effects of combined exposure to PFAS and metals on AL, which may be a disease mediator. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2014 were used to conduct this study on persons aged 20 years and older. A cumulative index of 10 biomarkers from the cardiovascular, inflammatory, and metabolic systems was used to calculate AL out of 10. If the overall index was ≥ 3, an individual was considered to be chronically stressed (in a state of AL). In order to assess the dose-response connections between mixtures and outcomes and to limit the effects of multicollinearity and other potential interaction effects between exposures, Bayesian kernel machine regression (BKMR) was used. Results: The most significant positive trend between mixed PFAS and metal exposure and AL was revealed by combined exposure to cesium, molybdenum, PFHS, PFNA, and mercury (posterior inclusion probabilities, PIP = 1, 1, 0.854, 0.824, and 0.807, respectively). Conclusions: Combined exposure to metals and PFAS increases the likelihood of being in a state of AL.

Association of Per- and Polyfluoroalkyl Substances with Allostatic Load Stratified by Herpes Simplex Virus 1 and 2 Exposure

“…Furthermore, the null models highlighted that individuals not exposed to PFOA, PFOS, PFNA, and PFHxS exhibited odds reductions of 79% to 97% for experiencing higher AL. This signifies that exposure to PFOA, PFOS, PFNA, and PFHxS escalates the likelihood of higher AL, affirming previous research on the deleterious effects of PFAS exposure [ 12 ].…”

“…AL relies on a complex interplay of social, physical, and environmental factors, which intricately shape an individual’s behavioral responses and systemic physiology [ 6 , 7 , 8 ], leading to aberrant alterations in normal physiological processes and maladaptation of crucial health markers [ 9 ]. Ultimately, the wear and tear over time [ 6 , 10 ] owing to AL [ 11 , 12 , 13 ] leads to weathering of the body and adverse health outcomes [ 10 ]. As such, AL serves as a mediator for several chronic diseases by acting as a crucial link between chronic stress and adverse health outcomes.…”

Association of Combined PFOA, PFOS, Metals and Allostatic Load on Hepatic Disease Risk

“…Drawing from prior research, allostatic load was measured by aggregating dysfunction across various physiological systems, including the cardiovascular system (systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides, high-density lipoprotein (HDL) cholesterol, total cholesterol, the metabolic system (albumin, body mass index (BMI), hemoglobin A1C, and creatinine clearance) and the inflammatory system, c-reactive protein (CRP) [ 5 , 34 , 35 , 36 ]. These markers were categorized into quartiles based on their distribution within the database.…”