Perfluoroalkyl substances are inversely associated with coronary heart disease in adults with diabetes

Abstract

Aims-Perfluoroalkyl substances (PFAS) are environmentally and biologically persistent synthetic environmental contaminants linked to adverse health outcomes. Though null to modest inverse relationships between PFAS and coronary heart disease (CHD) have been reported, studies regarding relationships in high risk populations such as those with diabetes are sparse. We investigated the relationship of PFAS with CHD in persons with diabetes. Methods-Data on 5,270 adults, aged ≥20 years, with diabetes were obtained from the C8 Health Project. Four PFAS were investigated separately: perfluorohexane sulfonate (PFHxS), perfluoroctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), and perfluoronanaoic acid (PFNA). Results-In logistic regression analyses adjusting for age, sex, diabetes duration, BMI, smoking, lipids, WBC, CRP, eGFR, uric acid, hemoglobin and iron, all PFAS were inversely associated with CHD, ORs (95% CIs

Perfluoroalkyl substances and likelihood of stroke in persons with and without diabetes

“…Moreover, the association of PFAS other than PFOA with stroke has been little explored, and no studies have yet examined the potential modifying effect of diabetes, a major risk factor for stroke. 21,22 We have recently observed inverse relationships between PFAS and coronary heart disease that was more pronounced among those with diabetes 16 and between PFAS and kidney function and chronic kidney disease that was significantly stronger in those with diabetes. 23 Using the C8 Health Project population, we examined the relationship of serum PFAS with stroke and the potential modifying influence of diabetes in a large sample of Appalachian adults, a population with among the highest rates of both diabetes and stroke in the United States.…”

“…[11][12][13][14] Mixed results have been observed for the relationship of PFAS with ischemic heart disease, with null 8,15 to inverse relationships observed. 16 For cerebrovascular disease, specifically stroke, two studies have examined the relationship of the PFAS perfluorooctanoic acid (PFOA) in worker populations, with one study observing an apparent protective relationship for stroke mortality 17 and the other suggesting a positive relationship. 18 A third study examined the relationship of PFOA with stroke in a combined population-based and worker cohort and also found mixed results, with prospective data suggesting a non-significant inverse relationship, but retrospective data suggesting a positive relationship with stroke incidence.…”

Associations between Per- and Polyfluoroalkyl Substances (PFAS) and Cardiometabolic Biomarkers in Adults of Czechia: The Kardiovize Study

“…In a previous study from Italy, including 15,876 young adults aged 20–39 years, PFNA (0.53–0.58) was negatively associated with BMI [ 30 ]. Although the mechanisms by which PFAS may decrease the odds of certain biomarkers are unknown, the inverse association observed in this study may contemplate the anti-inflammatory and/or reduced insulin resistance effects of certain PFAS, as well as their potentially high oxygen-carrying capacity [ 33 ]. The PFAS structural similarity to fatty acids makes them increase the expression of genes involved in fatty acid oxidation in vitro [ 34 ], which could improve insulin sensitivity, stimulating free fatty acid storage and the use of glucose rather than fatty acids as an energy substrate [ 35 , 36 ].…”

“…The PFAS structural similarity to fatty acids makes them increase the expression of genes involved in fatty acid oxidation in vitro [ 34 ], which could improve insulin sensitivity, stimulating free fatty acid storage and the use of glucose rather than fatty acids as an energy substrate [ 35 , 36 ]. Anti-inflammatory effects could be mediated by the activation of peroxisome proliferator-activated receptors (PPARs), which have anti-atherosclerotic properties, such as the suppression of vascular inflammation and oxidative stress [ 33 ].…”

Integrative omics analysis reveals the protective role of vitamin C on perfluorooctanoic acid-induced hepatoxicity

“…Perfluorooctanoic acid (PFOA), a common component of industrial and consumer products including food-containing and food-associated materials is frequently detected in humans [1] . Several population studies reveal its presence in human serum [2] , [3] , with cross-sectional studies linking it to human health problems such as metabolic, liver, coronary, immune system, and bone diseases [4] , [5] , [6] , [7] , [8] . As a detoxification venue, the liver is a reported PFOA target and a major site for PFOA accumulation [9] .…”