Serum perfluoroalkyl substances in relation to lipid metabolism in Chinese pregnant women
Introduction
Perfluoroalkyl substances (PFASs) are a class of highly stable man-made organic compounds with an aliphatic carbon backbone and all hydrogen atoms being substituted by fluorine atom (Zeng et al., 2015). PFASs have been widely used in the past several decades and are detected in a variety of environmental and biological media (Sunderland et al., 2019). Lipids are a large group of compounds, such as fatty acids, glycerolipids, and sterol lipids, which play a key role in maintaining normal human physiological functions (Shamim et al., 2018). Lipid metabolism is known to be associated with cardiovascular illness and sub-health status (Manandhar et al., 2017). However, PFASs have been reported to possibly affect lipid metabolism by multiple mechanisms, such as disruption of thyroid or estrogen functions (Kim et al., 2018; Sunderland et al., 2019; Ding et al., 2020), activation of metabolic receptors (peroxisome proliferator-activated receptor α (PPARα)), and interaction with constitutive activated receptor (CAR), pregnane X receptors (PXR) and liver X receptors (LXR) (Bijland et al., 2011). Moreover, the structural resemblance of PFASs to natural fatty acids may directly cause disorders in lipid regulation (Nelson et al., 2010).
For pregnant women, maternal hyperlipidemia is related to enhanced oxidative stress and adipocytokines have effects on fetal growth (Herrera and Ortega-Senovilla, 2010). Elevated plasma triglycerides (TG) was reported to be associated with various adverse consequences, including endothelial damage, preeclampsia and pregnancy-induced hypertension (Kaaja, 2011). Elevated total cholesterol (TC) was found to be associated with preeclampsia (Spracklen et al., 2014). Currently, seven epidemiological studies of general population or of children (Nelson et al., 2010; Wang et al., 2012; Fu et al., 2014; Zeng et al., 2015; Li et al., 2020; Lin et al., 2020; Liu et al., 2020) found that PFASs exposure was associated with blood lipid levels, including TC and TG. However, only four studies investigated the relationship between PFAS and lipid metabolism in pregnant women, which were conducted in Denmark (Skuladottir et al., 2015), Spain (Matilla-Santander et al., 2017), Norway (Starling et al., 2014) and the U.S. (Spratlen et al., 2020). These studies reported that exposure to PFASs was associated to one or more lipids during pregnancy, but the results were inconsistent.
Multiple factors might influence the effects of exposure to PFASs on lipid metabolism during pregnancy including diet pattern, exposure level of PFASs or genetic background (Ordovas and Corella, 2005; Zili, 2017). So far, to our best knowledge, there have been no relevant studies conducted among Chinese pregnant women. In the current study, we investigated 436 pregnant women in Tangshan City, North China, and measured the serum levels of 11 PFASs and four lipids (TC, TG, high-density lipoprotein (HDL), and low-density lipoprotein (LDL)) to determine their associations.
Section snippets
Study population
A cohort of pregnant women was established in Tangshan City of Hebei province in North China between September 2013 and December 2014. Detailed information has been described elsewhere (Wang et al., 2018a). The inclusion criteria were healthy pregnant women aged 20–40 years in the early term of pregnancy (5–15 gestational weeks). Pregnant women who took lipid control drugs or had serious metabolic or immune diseases, including diabetes mellitus, chronic hypertension, systemic lupus
Results
Table 1 shows the detection rates and median concentrations of PFASs in 436 pregnant women. The detection rates were all higher than 70% for PFOS, PFOA, PFHxS, PFUdA, PFNA, PFDA and PFHpS with a median concentration of 6.78, 5.41, 0.33, 0.51, 1.34, 1.03 and 0.22 ng/mL, respectively. Other four PFASs (PFDoA, PFBS, PFHxA and PFHpA) had a detection rate less than 20% and were not analyzed further. PFASs were highly correlated with each other indicated by the Pearson correlation coefficients except
Discussion
We prospectively explored the associations between serum PFASs levels and lipids in Chinese pregnant women. Some serum PFASs in the early term of pregnancy were found to be associated with serum TC, HDL, LDL or LDL/HDL in the late term. These findings suggested that exposure to PFASs might affect the lipid metabolism during pregnancy.
The concentrations of PFASs and lipids in our study population were comparable to those from previous studies (Jiang et al., 2014; Wang et al., 2019; Zhang et al.,
Conclusion
The current study prospectively explored the associations between serum concentrations of serum PFASs and lipids in Chinese pregnant women. Serum PFHxS, PFUdA, PFOA, PFNA and PFDA were found to be associated with serum lipids and some associations showed a non-monotonic trend. Exposure to PFASs may influence lipid metabolisms during pregnancy and more studies are needed to confirm the associations.
Credit author statement
Jiaqi Yang, Writing - original draft, Validation. Hexing Wang, Writing - review & editing, Methodology. Hongyi Du, Linji Xu, Shuping Liu, Jianping Yi, Project administration. Hongji Fang, Minghui Han, Visualization. Yue Chen, Writing - review & editing. Qingwu Jiang, Supervision. Gengsheng He, Funding acquisition, Supervision.
Declaration of competing interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgments
This study was supported by the Ministry of Science and Technology of the People’s Republic of China (No. 2017YFC1600500), the Project of Shanghai Municipal Commission of Health and Family Planning Foundation (No. 201740113), National Natural Science Foundation of China (No.81773413) and the key research project of National Natural Science Foundation of China (No. 21537001).
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2022, Ecotoxicology and Environmental SafetyCitation Excerpt :Another example is PFHxS, the main hazardous substance detected in our investigation (median concentration = 0.10 ng/mL). We compared our results with the values reported in studies conducted in Hebei, China (median concentration = 0.42 ng/mL) (Yang et al., 2021), the USA (median concentration = 0.40 ng/mL) (Eick et al., 2021) and Canada (median concentration = 0.44 ng/mL) (Workman et al., 2019). A similar result was obtained for the association of the PFDoA concentration (median = 0.11 ng/mL) with PPH in our investigation.
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2022, Journal of Hazardous MaterialsCitation Excerpt :From acute toxicological testing on animals, and ecological toxicity studies, it is well known now that dysregulated lipid metabolism is one of the most common outcomes of PFAS exposure, among other adverse health effects (Sinclair et al., 2020). Previous research (Eriksen et al., 2013; Starling et al., 2014) and multiple recent human biomonitoring studies coupled with targeted metabolomics showed strong correlations between the PFAS serum/plasma concentration and altered lipid homeostasis (Canova et al., 2020; Chen et al., 2020; Yang et al., 2020). Perturbed lipid metabolism upon exposure to PFAS has also been recently reported in Daphnia magna (Seyoum et al., 2020), and Atlantic cod (Gadus morhua) (Dale et al., 2020).
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2021, Ecotoxicology and Environmental SafetyCitation Excerpt :All of them found a positive association of one or more of the analyzed PFAS with TC. Only two studies (Starling et al., 2014; Yang et al., 2020), examined the association with HDL-C and LDL-C. None of these studies of pregnant women was focused on highly exposed population.
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These authors contributed equally to this work.