Assessing the health risk of hyperuricemia in participants with persistent organic pollutants exposure - a systematic review and meta-analysis

Yu, Yipei; Quan, Xuyuan; Wang, Huijun; Zhang, Bing; Hou, Yan; Su, Chang

doi:10.1016/j.ecoenv.2023.114525

Cited by 7 publications

(4 citation statements)

References 21 publications

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“…Historic "long-chain" PFAS such as PFOA, PFOS, and PFHxS are consistently associated with adverse changes in a variety of human clinical biomarkers of liver toxicity and also with predictive equations for MASLD in humans. 25,42,54,55,58,70,71 There are parallel confirmatory experimental findings of consistent presence of steatosis and disruption of lipid and uric Invited Perspective. Per-and Polyfluoroalkyl Substances, Hepatotoxicity, and Liver Disease acid metabolism across species following PFAS exposure, 25,42,97,98 although reproducing the specific experimental finding of higher serum cholesterol requires attention to species, dietary conditions, and can benefit from additional investigation of 'humanized' models for energy handling.…”

Section: Mechanisms Of Pfas Hepatoxicitymentioning

confidence: 62%

“…55 PFAS internal exposures similarly affect total and LDL cholesterol, as well as uric acid including increased risk of hyperuricemia in studies of multiple populations, including children, adolescents, and adults including women during the menopausal transition. 25,42,[56][57][58][59][60][61][62][63][64] The triad of higher liver enzymes, worse lipid profiles, and higher uric acid is the pattern of biomarker elevation also seen in populations afflicted by MASLD, notably in the setting of metabolic syndrome. 65,66 (NAFLD or MASLD has also been termed toxicant-associated fatty liver disease (TAFLD) when the contributing cause may be contaminant such as PFAS.…”

Section: Introductionmentioning

confidence: 99%

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Invited Perspective. Per- and Polyfluoroalkyl Substances, Hepatotoxicity, and Liver Disease: Evidence and Clinical Responses

Ducatman,

Chatzi

2023

MRAJ

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Background: This perspective concerning hepatoxicity of per- and polyfluoroalkyl substances (PFAS) aims to provide a current understanding of the damage and reasonable clinician responses to the needs of concerned patients and affected communities. Methods: Search strategy included PFAS and the following: human liver toxicity/disease; relevant biomarkers including transaminases, lipids, uric acid; predictive equations (for liver disease), liver imaging modalities, and histologic findings. Experimental data concerning liver outcomes and disrupted hepatic metabolic pathways was also reviewed. Recommended clinical approaches to patients and communities was sought in both the National Library of Medicine and relevant organizational websites. Results: Several PFAS reliably cause adverse changes in human liver biomarkers, with strong consistency between human and experimental data. Adverse population changes include human transaminases, cholesterol and LDL cholesterol, and uric acid. This biomarker triad suggests that mechanisms and outcomes are or resemble metabolic associated steatotic liver disease, which is found across species following experimental PFAS exposure. Human imaging studies and sparse human histologic studies mostly support the inference that the toxicant damage is or resembles a pathway that can lead from steatosis to more serious stages of liver disease due to disrupted liver metabolism of fatty acids. Advice to patients and clinicians was reviewed from various agencies and nonprofits organizations including a committee of the US National Academies of Sciences, Engineering, and Medicine, and the nonprofit/university collaboration PFAS REACH. Discussion: Converging lines of evidence indict PFAS as human (and trans-species) hepatotoxins and mostly support a metabolic associated steatotic liver disease continuum as the nature of the injury. Increases in abnormal transaminases and sparser imaging and biopsy findings support that the damage is clinically important and a contributing cause of a public health problem. It is still challenging to decide which of many definitively disrupted metabolic pathways is/are most important to the injury. Many PFAS in use remain virtually unstudied, a research and public health emergency. Simple clinical responses to the concerns of the most heavily contaminated patients and communities, which are within the capabilities of most clinical offices, are reviewed.

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Section: Mechanisms Of Pfas Hepatoxicitymentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Invited Perspective. Per- and Polyfluoroalkyl Substances, Hepatotoxicity, and Liver Disease: Evidence and Clinical Responses

Ducatman,

Chatzi

2023

MRAJ

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“…As such, recent meta-analyses also support a strong association between PFOA, PFNA, PFOS, and the risk of hyperuricemia. 137,138…”

Section: Serum Uric Acid and Hyperuricemiamentioning

confidence: 99%

Perfluoroalkyl/Polyfluoroalkyl Substances: Links to Cardiovascular Disease Risk

Schlezinger,

Gokce

2024

Circulation Research

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Conservative estimates by the World Health Organization suggest that at least a quarter of global cardiovascular diseases are attributable to environmental exposures. Associations between air pollution and cardiovascular risk have garnered the most headlines and are strong, but less attention has been paid to other omnipresent toxicants in our ecosystem. Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are man-made chemicals that are extensively used in industrial and consumer products worldwide and in aqueous film-forming foam utilized in firefighting. As such, our exposure to PFAS is essentially ubiquitous. Given the long half-lives of these degradation-resistant chemicals, virtually, all people are carrying a body burden of PFAS. Health concerns related to PFAS are growing such that the National Academies of Sciences, Engineering and Medicine has recommended standards for clinical follow-up of individuals with high PFAS blood levels, including prioritizing screening for dyslipidemia. The link between PFAS and dyslipidemia has been extensively investigated, and evidence for associations is compelling. However, dyslipidemia is not the only cardiovascular risk factor with which PFAS is associated. Here, we review the epidemiological evidence for links between PFAS of concern identified by the National Academies of Sciences, Engineering and Medicine and risk factors for cardiovascular disease, including overweight/obesity, glucose intolerance, hypertension, dyslipidemia, and hyperuricemia. Moreover, we review the potential connections of PFAS with vascular disease and atherosclerosis. While observational data support associations between the National Academies of Sciences, Engineering and Medicine PFAS and selected cardiac risk factors, additional research is needed to establish causation and better understand how exposure to PFAS leads to the development of these conditions.

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“…In the contemporary industrialized society, environmental concerns such as air pollution, water pollution, and soil contamination have gained significant attention (1)(2)(3)(4). Some pollutants are metabolized because of their shorter half-lives, others, such as heavy metals, insecticides, flame retardants, persistent organic pollutants, and other endocrine-disrupting chemicals continue to accumulate in the human body and have significant and long-term effects on human health (5)(6)(7)(8). For instance, the association between heavy metals toxicity and the development of neurodegenerative diseases and various ocular pathologies has been established, while concurrent exposure to heavy metals can elevate the risk of prostate cancer and thyroid enlargement (9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

A review of common statistical methods for dealing with multiple pollutant mixtures and multiple exposures

Zhu,

Wen,

Cao

et al. 2024

Front. Public Health

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Traditional environmental epidemiology has consistently focused on studying the impact of single exposures on specific health outcomes, considering concurrent exposures as variables to be controlled. However, with the continuous changes in environment, humans are increasingly facing more complex exposures to multi-pollutant mixtures. In this context, accurately assessing the impact of multi-pollutant mixtures on health has become a central concern in current environmental research. Simultaneously, the continuous development and optimization of statistical methods offer robust support for handling large datasets, strengthening the capability to conduct in-depth research on the effects of multiple exposures on health. In order to examine complicated exposure mixtures, we introduce commonly used statistical methods and their developments, such as weighted quantile sum, bayesian kernel machine regression, toxic equivalency analysis, and others. Delineating their applications, advantages, weaknesses, and interpretability of results. It also provides guidance for researchers involved in studying multi-pollutant mixtures, aiding them in selecting appropriate statistical methods and utilizing R software for more accurate and comprehensive assessments of the impact of multi-pollutant mixtures on human health.

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Assessing the health risk of hyperuricemia in participants with persistent organic pollutants exposure - a systematic review and meta-analysis

Cited by 7 publications

References 21 publications

Invited Perspective. Per- and Polyfluoroalkyl Substances, Hepatotoxicity, and Liver Disease: Evidence and Clinical Responses

Invited Perspective. Per- and Polyfluoroalkyl Substances, Hepatotoxicity, and Liver Disease: Evidence and Clinical Responses

Perfluoroalkyl/Polyfluoroalkyl Substances: Links to Cardiovascular Disease Risk

A review of common statistical methods for dealing with multiple pollutant mixtures and multiple exposures

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