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Wu Y, Cheng Z, Zhang W, Yin C, Sun J, Hua H, Long X, Wu X, Wang Y, Ren X, Zhang D, Bai Y, Li Y, Cheng N. Association between per- and poly-fluoroalkyl substances and nonalcoholic fatty liver disease: A nested case-control study in northwest China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 350:123937. [PMID: 38631453 DOI: 10.1016/j.envpol.2024.123937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 03/19/2024] [Accepted: 04/05/2024] [Indexed: 04/19/2024]
Abstract
Per- and poly-fluoroalkyl substances (PFAS) have been reported to have hepatotoxic effects. However, it is unclear whether they are linked to non-alcoholic fatty liver disease (NAFLD). This nested case-control study focused on the epidemiological links between PFAS and the prevalence of NAFLD. We selected 476 new cases of NAFLD and 952 age- and sex-matched controls from the Jinchang cohort population between 2014 and 2019. Serum concentrations of PFAS were measured using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Only PFAS with a detection rate of ≥90 % were included for analysis, which included PFPeA, PFOA, PFNA, PFHxS, PFOS, and 9Cl-PF3ONS. The relationship between single and co-exposure to PFAS and the occurrence of NAFLD was evaluated using conditional logistic regression, Quantile g-computation (QgC), and Bayesian kernel machine regression (BKMR) model. Logistic regression indicated that PFPeA, PFOA, and 9Cl-PF3ONS were positive correlation with the incidence of NAFLD after adjusting for confounders, with odds ratios (OR) and 95 % confidence interval (CI) of 3.13 (95 % CI: 2.53, 3.86), 1.39 (95 % CI: 1.12, 1.73), and 1.41 (95 % CI: 1.20, 1.66), respectively. PFNA, PFHxS, and PFOS were nonlinearly and negatively associated with the incidence of NAFLD, with OR (95 % CI) of 0.53 (0.46, 0.62), 0.83 (0.73, 0.95), and 0.52 (0.44, 0.61), respectively. QgC showed a significant joint effect of PFAS mixture on NAFLD onset (OR: 1.52, 95 % CI: 1.24, 1.88). BKMR showed a weak positive trend between PFAS mixtures and NAFLD incidence. Positive correlations were primarily driven by PFPeA and 9Cl-PF3ONS, while negative correlations were mainly influenced by PFNA and PFOS. The BKMR model also suggested that there was an interaction between PFOS and PFNA and other four PFAS compounds. In conclusion, our findings suggest that individual and co-exposure to PFAS is associated with a risk of NAFLD onset.
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Affiliation(s)
- Yuanqin Wu
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Zhiyuan Cheng
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, PR China
| | - Wei Zhang
- Basic Medical College, Lanzhou University, Lanzhou, Gansu, PR China
| | - Chun Yin
- Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang, Gansu, PR China
| | - Jianyun Sun
- Physical and Chemical Laboratory, Center for Disease Control and Prevention of Gansu, PR China
| | - Honghao Hua
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Xianzhen Long
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Xijiang Wu
- Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang, Gansu, PR China
| | - Yufeng Wang
- Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang, Gansu, PR China
| | - Xiaoyu Ren
- Basic Medical College, Lanzhou University, Lanzhou, Gansu, PR China
| | - Desheng Zhang
- Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang, Gansu, PR China
| | - Yana Bai
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Yongjun Li
- Physical and Chemical Laboratory, Center for Disease Control and Prevention of Gansu, PR China
| | - Ning Cheng
- Basic Medical College, Lanzhou University, Lanzhou, Gansu, PR China.
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Liu Y, Zhang H, Xu F, Zhang X, Zhao N, Ding L. Associations between serum per- and polyfluoroalkyl substances as mixtures and lipid levels: A cross-sectional study in Jinan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 923:171305. [PMID: 38423340 DOI: 10.1016/j.scitotenv.2024.171305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/24/2024] [Accepted: 02/25/2024] [Indexed: 03/02/2024]
Abstract
Per- and polyfluoroalkyl substances (PFASs) are known to be linked with dyslipidemia. Between March and June 2022, we collected 575 fasting serum samples from individuals without occupational exposure in Jinan, China. Eighteen PFASs were analyzed using UHPLC-Orbitrap MS. Multiple linear regression (MLR), Bayesian kernel machine regression (BKMR), and Quantile g-computation (QGC) models were utilized to assess the effects of both individual PFAS and PFAS mixtures on serum lipid levels, including triglycerides (TG), cholesterol (CHO), high-density lipoprotein (HDL), and low-density lipoprotein (LDL). The PFAS mixture, composed of perfluoroheptanoic acid (PFHpA), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA), perfluorododecanoic acid (PFDoDA), perfluorotridecanoic acid (PFTrDA), perfluorohexane sulfonate (PFHxS), perfluoroheptane sulfonic acid (PFHpS), perfluorooctane sulfonate (PFOS), and 6:2 chlorinated polyfluoroalkyl ether sulfonate (6:2 Cl-PFESA), showed a positive association with CHO and LDL levels, while no distinct trend was noted in HDL and TG levels about changes in PFAS mixtures levels in BKMR and QGC models, adjusted for gender, age, BMI, occupation, and educational level. The effects of individual PFASs on lipid levels were in general consistent across MLR, BKMR and QGC models. PFUnDA and PFTrDA demonstrated greater impacts on blood lipid levels compared to other PFAS, albeit with varied directional effects. Age-stratified analysis revealed PFAS mixture effect was more pronounced in participants aged higher than 40. No obvious trend in lipid levels with changes in PFAS mixture levels in participants with age ranged from 18 to 40, while positive association between PFAS mixture and CHO and LDL was detected in participants aged higher than 40.
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Affiliation(s)
- Yi Liu
- School of Public Health, Shandong University, Jinan 250012, China
| | - Haoyu Zhang
- Environmental Research Institute, Shandong University, Qingdao 266237, China
| | - Fei Xu
- Environmental Research Institute, Shandong University, Qingdao 266237, China
| | - Xiaozhen Zhang
- School of environmental science and engineering, Shandong University, Qingdao 266237, China
| | - Nan Zhao
- School of environmental science and engineering, Shandong University, Qingdao 266237, China
| | - Lei Ding
- Environmental Research Institute, Shandong University, Qingdao 266237, China.
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Park YT, Chung EY, Chae CH, Lee YH. Association between serum perfluoroalkyl substances concentrations and non-alcoholic fatty liver disease among Korean adults: a cross-sectional study using the National Environmental Health Survey cycle 4. Ann Occup Environ Med 2024; 36:e10. [PMID: 38872635 PMCID: PMC11168940 DOI: 10.35371/aoem.2024.36.e10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/20/2024] [Accepted: 03/28/2024] [Indexed: 06/15/2024] Open
Abstract
Background Perfluoroalkyl substances (PFAS) are widely used in industry and daily life due to their useful properties. They have a long half-life, accumulate in the body, and there is evidence that they are associated with biomarkers of lipid metabolism and liver damage. This may suggest non-alcoholic fatty liver disease (NAFLD) caused by PFAS. However, since there has been no study analyzing the relationship between PFAS and NAFLD in the entire population in Korea. We sought to confirm the relationship between serum PFAS concentration and NAFLD prevalence in Korean adults using the Korean National Environmental Health Survey (KoNEHS) cycle 4. Methods The study was conducted on 2,529 subjects in 2018-2019 among KoNEHS participants. For the diagnosis of NAFLD, the hepatic steatosis index (HSI) was used, and the geometric mean and concentration distribution of serum PFAS were presented. Logistic regression was performed to confirm the increase in the risk of NAFLD due to changes in PFAS concentration, and the odds ratio and 95% confidence interval (CI) were calculated. Results In both adjusted and unadjusted models, an increased odds ratio was observed with increasing serum concentrations of total PFAS and perfluorooctane sulfonate (PFOS) in the non-obese group. In the adjusted model, the odds ratios for serum total PFAS and PFOS were 6.401 (95% CI: 1.883-21.758) and 7.018 (95% CI: 2.688-18.319). Conclusions In this study, a higher risk of NAFLD based on HSI was associated with serum total PFAS, PFOS in non-obese group. Further research based on radiological or histological evidence for NAFLD diagnosis and long-term prospective studies are necessary. Accordingly, it is necessary to find ways to reduce exposure to PFAS in industry and daily life.
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Affiliation(s)
- Yong Tae Park
- Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Eui Yup Chung
- Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Chang Ho Chae
- Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Young Hoon Lee
- Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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Li R, Zhang Z, Xuan Y, Wang Y, Zhong Y, Zhang L, Zhang J, Chen Q, Yu S, Yuan J. HNF4A as a potential target of PFOA and PFOS leading to hepatic steatosis: Integrated molecular docking, molecular dynamic and transcriptomic analyses. Chem Biol Interact 2024; 390:110867. [PMID: 38199259 DOI: 10.1016/j.cbi.2024.110867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/30/2023] [Accepted: 01/08/2024] [Indexed: 01/12/2024]
Abstract
Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) are indeed among the most well known and extensively studied Per- and polyfluoroalkyl substances (PFASs), and increasing evidence confirm their effects on human health, especially liver steatosis. Nonetheless, the molecular mechanisms of their initiation of hepatic steatosis is still elusive. Therefore, potential targets of PFOA/PFOS must be explored to ameliorate its adverse consequences. This research aims to investigate the molecular mechanisms of PFOA and PFOS-induced liver steatosis, with emphasis on identifying a potential target that links these PFASs to liver steatosis. The potential target that causes PFOA and PFOS-induced liver steatosis have been explored and determined based on molecular docking, molecular dynamics (MD) simulation, and transcriptomics analysis. In silico results show that PFOA/PFOS can form a stable binding conformation with HNF4A, and PFOA/PFOS may interact with HNF4A to affect the downstream conduction mechanism. Transcriptome data from PFOA/PFOS-induced human stem cell spheres showed that HNF4A was inhibited, suggesting that PFOA/PFOS may constrain its function. PFOS mainly down-regulated genes related to cholesterol synthesis while PFOA mainly up-regulated genes related to fatty acid β-oxidation. This study explored the toxicological mechanism of liver steatosis caused by PFOA/PFOS. These compounds might inhibit and down-regulate HNF4A, which is the molecular initiation events (MIE) that induces liver steatosis.
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Affiliation(s)
- Rui Li
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, PR China
| | - Zijing Zhang
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, PR China
| | - Yuxin Xuan
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, PR China
| | - Yulu Wang
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, PR China
| | - Yuyan Zhong
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, PR China
| | - Lingyin Zhang
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, PR China
| | - Jinrui Zhang
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, PR China
| | - Qian Chen
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, PR China
| | - Shuling Yu
- Key Laboratory of Natural Medicine and Immune-Engineering of Henan Province, Henan University, Kaifeng, Henan, 475004, PR China
| | - Jintao Yuan
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, PR China.
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Pavan A, Cendron L, Di Nisio A, Pedrucci F, Sabovic I, Scarso A, Ferlin A, Angelini A, Foresta C, De Toni L. In vitro binding analysis of legacy-linear and new generation-cyclic perfluoro-alkyl substances on sex hormone binding globulin and albumin, suggests low impact on serum hormone kinetics of testosterone. Toxicology 2023; 500:153664. [PMID: 37931871 DOI: 10.1016/j.tox.2023.153664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/08/2023]
Abstract
In humans, serum testosterone (T) is largely bound to the sex hormone binding globulin (SHBG) and human serum albumin (hSA), resulting in a 2-3 % of unbound or "free" active quote (FT). Endocrine-disrupting chemicals, including perfluoro-alkyl substances (PFAS), are recognized to interfere with the hormonal axes, but the possible impact on the FT quote has not been addressed so far. Here we investigated the possible competition of two acknowledged PFAS molecules on T binding to SHBG and hSA. In particular, perfluoro-octanoic acid (PFOA) and acetic acid, 2,2-difluoro-2-((2,2,4,5-tetrafluoro-5(trifluoromethoxy)-1,3-dioxolan-4-yl)oxy)-ammonium salt (1:1) (C6O4) were used as, respectively, legacy-linear and new-generation-cyclic PFASs. Human recombinant SHBG 30-234 domain (SHBG30-234), produced in HEK293-F cells, and delipidated recombinant hSA were used as in vitro protein models. Isothermal Titration Calorimetry (ITC) and tryptophan fluorescence quencing (TFQ) were used to evaluate the binding modes of T and PFAS to SHBG30-234 and hSA. ITC revealed the binding of T to SHBG30-234 with a Kd of 44 ± 2 nM whilst both PFOA and C6O4 showed no binding activity. Results were confirmed by TFQ, since only T modified the fluorescence profile of SHBG30-234. In hSA, TFQ confirmed the binding of T on FA6 site of the protein. A similar binding mode was observed for PFOA but not for C6O4, as further verified by displacement experiments with T. Although both PFASs were previously shown to bind hSA, only PFOA is predicted to possibly compete with T for the binding to hSA. However, on the base of the binding stoichiometry and affinity of PFOA for hSA, this appears unlikely at the blood concentrations of the chemical documented to date.
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Affiliation(s)
- Angela Pavan
- Department of Biology, University of Padova, Padova, Italy
| | - Laura Cendron
- Department of Biology, University of Padova, Padova, Italy
| | - Andrea Di Nisio
- Deparment of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Padova, Italy
| | - Federica Pedrucci
- Deparment of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Padova, Italy
| | - Iva Sabovic
- Deparment of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Padova, Italy
| | - Alessandro Scarso
- Department of Molecular Sciences and Nanosystems, Università Ca' Foscari Venezia, Venezia, Italy
| | - Alberto Ferlin
- Deparment of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Padova, Italy
| | - Alessandro Angelini
- Department of Molecular Sciences and Nanosystems, Università Ca' Foscari Venezia, Venezia, Italy; European Centre for Living Technology (ECLT), Ca' Bottacin, Venice, Italy
| | - Carlo Foresta
- Deparment of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Padova, Italy.
| | - Luca De Toni
- Deparment of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Padova, Italy
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Yun J, Kwon SC. The Association of Perfluoroalkyl Substance Exposure and a Serum Liver Function Marker in Korean Adults. TOXICS 2023; 11:965. [PMID: 38133366 PMCID: PMC10748130 DOI: 10.3390/toxics11120965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/22/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Abstract
Perfluoroalkyl substances (PFAS), widely used throughout industry and daily life, are currently one of the environmental pollutants garnering the most attention worldwide. Recently, environmental pollutants have had a high profile as one of the main causes of chronic liver disease, such as non-alcoholic fatty liver disease. Research on PFAS is actively underway. Although Korea has a remarkably high prevalence of chronic liver disease, and it continues to increase, only a few studies have revealed the relationship between PFAS and liver disease. In addition, regulations on PFAS in Korea are delayed compared to developed countries, such as Europe and the United States, and public interest is insufficient compared to others. Therefore, we would like to investigate the exposure of Koreans to PFAS in the blood and examine the relationship between these substances and markers of liver function (AST, ALT, and GGT). This study was based on the results of the Korean National Environmental Health Survey (KoNEHS) 2018–2020 (Cycle 4), and a total of 2961 subjects were selected. The concentration of PFAS in the blood of Korean adults was measured to be significantly higher based on the geometric mean compared to the results of recently investigated American adults based on the National Health and Nutrition Examination Survey (NHANES, 2017-2018). A multivariable linear regression analysis adjusted for age, sex, body mass index (BMI), smoking status, alcohol intake, and regular exercise was performed to examine changes in three liver function markers as the serum PFAS concentration increased. We found that some of the five PFAS (PFOA, PFOS, PFHxS, PFNA, and PFDeA) were significantly associated with increased liver enzymes. It is necessary to recognize the threat of PFAS to the human body and to discuss regulations and alternatives in earnest. Continuous follow-up studies are required through a well-designed cohort.
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Affiliation(s)
| | - Soon-Chan Kwon
- Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, Cheonan 31151, Republic of Korea;
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Ducatman A, Tan Y, Nadeau B, Steenland K. Perfluorooctanoic Acid (PFOA) Exposure and Abnormal Alanine Aminotransferase: Using Clinical Consensus Cutoffs Compared to Statistical Cutoffs for Abnormal Values. TOXICS 2023; 11:toxics11050449. [PMID: 37235263 DOI: 10.3390/toxics11050449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/03/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFASs) including perfluorooctanoic acid (PFOA) are ubiquitous environmental contaminants. Prior analysis in the large "C8 Health Project" population defined abnormal alanine aminotransferase (ALT) with statistically derived cutoffs (>45 IU/L in men, >34 IU/L in women). OBJECTIVE To explore the degree to which PFOA was associated with modern, clinically predictive ALT biomarker cutoffs in obese and nonobese participants, excluding those with diagnosed liver disease. METHODS We reevaluated the relationship of serum PFOA to abnormal ALT using predictive cutoff recommendations including those of the American College of Gastroenterology (ACG). Evaluations modeled lifetime cumulative exposure and measured internal PFOA exposure. RESULTS ACG cutoff values (≥34 IU/L for males, ≥25 IU/L for females) classified 30% of males (3815/12,672) and 21% of females (3359/15,788) above ALT cutoff values. Odds ratios (OR) for above cutoff values were consistently associated with modeled cumulative and measured serum PFOA. Linear trends were highly significant. ORs by quintile showed near monotonic increases. Trends were stronger for the overweight and obese. However, all weight classes were affected. CONCLUSION Predictive cutoffs increase the OR for abnormal ALT results. Obesity increases ORs, yet association with abnormal ALT pertains to all weight classes. The results are discussed in context of current knowledge about the health implications of PFOA hepatotoxicity.
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Affiliation(s)
- Alan Ducatman
- School of Public Health, West Virginia University, Morgantown, WV 26506-9190, USA
| | - Youran Tan
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Brian Nadeau
- Department of Gastroenterology, William Beaumont Hospital, Royal Oak, MI 48173, USA
| | - Kyle Steenland
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
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