Non-monotonic Association Between Chlorinated Polyfluorinated Ether Sulfonic Acids Exposure and the Risk of Overweight/Obesity Status in Adults

Chu Chu, Qiu Ling Fang, Xin Xin Cui, Peng Xin Dong, Zhengmin Qian, Stephen Edward McMillin, Steven W. Howard, Yan Qiu Ou, Qing Qing Li, Lu Yin Wu, Li Xia Liang, Shuang Jian Qin, Xiao Wen Zeng, Li Wen Hu, Ming Deng Xiang, Guang Hui Dong, Xiao Miao Zhao

Research output: Contribution to journalArticlepeer-review

Abstract

Chlorinated polyfluorinated ether sulfonic acids (Cl-PFESAs, including 6:2 Cl-PFESA and 8:2 Cl-PFESA), one of poly- and perfluoroalkyl substances (PFAS), used as perfluorooctane sulfonate (PFOS) alternatives in electroplating industry. Evidence in vivo and in vitro indicates that Cl-PFESAs might disrupt lipid metabolism. However, the association between Cl-PFESAs exposure and the prevalence of overweight/obesity in human is unknown. We conducted a cross-sectional study to investigate associations of serum 6:2 Cl-PFESA and 8:2 Cl-PFESA exposure with overweight/obesity status in adults. We quantified four perfluoroalkyl substances (PFAS), including 6:2 Cl-PFESA, 8:2 Cl-PFESA, PFOS, and perfluorooctanoic acid (PFOA) in 1275 Chinese adults from the Isomers of C8 Health Project in China study. Characteristics of participants were gathered from interviewer-administered questionnaires and anthropometric measurements. We classified overweight/obesity based on body mass index (BMI) according to WHO. Participants were categorized into normal weight group (BMI < 25 kg/m2) and overweight/obesity group (BMI ≥ 25 kg/m2). The detection proportion of 6:2 Cl-PFESA was 100% among the participants in this study. Adjusted for potential confounders, BMI in the second quartile of each ln-ng/mL greater concentration of 6:2 Cl-PFESA and 8:2 Cl-PFESA was 0.45 [95% confidence interval (CI): 0.08, 0.82], and 0.39 (95% CI:0.03, 0.76) significantly higher than the lowest quartile, respectively. Cl-PFESAs displayed inverted U-shaped associations with the risk of overweight/obesity, and the inflection point of 6:2 Cl-PFESA and 8:2 Cl-PFESA was 1.80 ng/mL, 0.01 ng/mL, respectively. For example, The risk of overweight/obesity increased (OR= 1.94; 95%CI: 1.24, 3.01) until around 1.80 ng/mL of predicted 6:2 Cl-PFESA concentration and then decreased (OR= 0.69; 95%CI: 0.39, 1.21). PFOS was associated with waist circumference (WC) but not BMI in each quartile. For PFOA, the associations with outcomes were linearly positive (P for trend < 0.05). This study reports the first observations on non-monotonic associations between serum 6:2 Cl-PFESA and 8:2 Cl-PFESA concentrations and the prevalence of overweight/obesity in adults. Our findings suggest that Cl-PFESAs may have endocrine disrupting characteristics, and this exposure-outcome association is a challenge for risk assessment of Cl-PFESAs. But more epidemiological investigations are required to confirm the observed associations.

Original languageEnglish (US)
Pages (from-to)539-549
Number of pages11
JournalExposure and Health
Volume15
Issue number3
DOIs
StatePublished - Sep 2023

All Science Journal Classification (ASJC) codes

  • Water Science and Technology
  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

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