环境与职业医学2025，Vol.42Issue(8)：900-907,8.DOI:10.11836/JEOM25008
全氟化合物暴露与人群血清超敏C反应蛋白的关联:基于美国国家健康与营养调查数据库
Association between per-and polyfluoroalkyl substances and serum high-sensitivity C-reactive protein levels:Based on the National Health and Nutrition Examination Survey
摘要
Abstract
[Background]High-sensitivity C-reactive protein(hs-CRP)is a sensitive biomarker for cardiovas-cular disease(CVD)and can independently predict the risk of cardiovascular events.Although the association between per-and polyfluoroalkyl substances(PFAS)exposure and CVD risk has been widely reported,studies on the association between hs-CRP and PFAS remain limited. [Objective]To investigate the association between PFAS and hs-CRP levels,to provide a scientific basis for early identification and prevention of environment-related cardiovascular events. [Methods]This study utilized data from the National Health and Nutrition Examination Survey(NHANES)database(2015-2018).Based on predefined inclusion and exclusion criteria,a total of 3219 participants were included for subsequent analysis.Five PFAS with detection rates exceeding 90%were selected as exposure factors and log-transformed(lnPFAS)for subsequent analysis,including perfluorohexane sulfonic acid(PFHxS),perfluorononanoic acid(PFNA),perfluorooctanoic acid(PFOA),perfluorooctane sulfonic acid(PFOS),and perfluo-rodecanoic acid(PFDA).After selecting potential confounders through a change-in-estimate approach,logistic regression was employed to examine the effects of individual PFAS on serum hs-CRP level.Additionally,quantile g-computation and Bayesian kernel machine re-gression(BKMR)were applied to assess the combined effects of PFAS mixtures on hs-CRP. [Results]The study included 3219 participants with a mean age of(50.4±17.6)years,of whom 1554(48.28%)were male.The median concentrations of the five PFAS compounds were:1.20 ng·mL-1(PFHxS),0.50 ng·mL-1(PFNA),1.50 ng·mL-1(PFOA),5.20 ng·mL-1(PFOS),and 0.20 ng·mL-1(PFDA).The Wilcoxon rank-sum tests revealed statistically significant differences between the elevated serum hs-CRP(≥2 mg·L-1)and normal(<2 mg·L-1)groups for all five PFAS compounds(PFHxS:P=0.005;PFNA:P=0.009;PFOA:P<0.001;PFOS:P<0.001;PFDA:P<0.001).After adjusting for potential confounders,the analysis of individual PFAS exposure demonstrated significant negative associations between serum hs-CRP levels and both ln-PFOS(OR:0.87;95%CI:0.79,0.96;P=0.0036)and lnPFDA(OR:0.78;95%CI:0.71,0.86;P<0.001).The joint effect analysis using quantile g-computation revealed an overall inverse association between PFAS mixtures and hs-CRP,with lnPFDA emerging as a primary contributor;an similar association was observed in males,but not significant in females.Further evaluation through BKMR showed that when PFAS mixture concentrations reached or exceeded P70,their combined effect on hs-CRP became significantly lower than when all PFAS concentrations were at P50,establishing a clear negative dose-response rela-tionship. [Conclusion]The mixed exposure to PFAS showed a significant negative joint effect on serum hs-CRP levels,with PFDA being the key component contributing to this combined effect.Future prospective cohort studies are warranted to further validate these findings and elucidate the underlying mechanisms involved.关键词
全氟化合物/全氟辛酸/全氟辛烷磺酸/全氟癸酸/超敏C反应蛋白/分位数g计算/贝叶斯核机回归Key words
per-and polyfluoroalkyl substances/perfluorooctanoic acid/perfluorooctane sulfonic acid/perfluorodecanoic acid/high-sensi-tivity C-reactive protein/quantile g-computation/Bayesian kernel machine regression分类
预防医学引用本文复制引用
马爽,张倩,段慧荣,殷金珠,王彤,高倩..全氟化合物暴露与人群血清超敏C反应蛋白的关联:基于美国国家健康与营养调查数据库[J].环境与职业医学,2025,42(8):900-907,8.基金项目
国家自然科学基金项目(82204163,82373692) （82204163,82373692）
山西省基础研究计划资助项目(202203021212382) （202203021212382）
山西省神经疾病防治研究委级重点实验室项目(TMSYSKF2023004) （TMSYSKF2023004）
