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.
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The authors thank all of participants in this study. The research was funded by National Key Research and Development Program of China [No. 2018YFE0106900], National Natural Science Foundation of China [No.82173471; No.82003409; No.82073503; No.M-0420; No.81903287; No. 81950410633], Fundamental Research Funds for the Central Universities [19ykjc01], Natural Science Foundation of Guangdong Province [No. 2021A1515012212; No. 2021A151011754; No. 2021B1515020015; No. 2020A1515011131; No. 2019A050510017; No. 2018B05052007; No. 2017A090905042], Science and Technology Program of Guangzhou [No. 201807010032; No. 201803010054; No. 201903010023], the Guangdong Basic and Applied Basic Research Foundation [2020B1515020001].
Funding was provided by National Key Research and Development Program of China (Grant No. 2018YFE0106900), National Natural Science Foundation of China (Grant Nos. 82173471, 82003409, 82073503, M-0420, 81903287, 81950410633), Fundamental Research Funds for Central Universities (19ykjc01) Natural Science Foundation of Guangdong Province (Grant Nos. 2021A1515012212, 2021A151011754, 2021B1515020015, 2020A1515011131, 2019A050510017, 2018B05052007, 2017A090905042), Science and Technology Program of Guangzhou (Grant No. 201807010032, 201803010054, 201903010023), the Guangdong Basic and Applied Basic Research Foundation (Grant No. 2020B1515020001).
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Chu, C., Fang, QL., Cui, XX. et al. Non-monotonic Association Between Chlorinated Polyfluorinated Ether Sulfonic Acids Exposure and the Risk of Overweight/Obesity Status in Adults. Expo Health 15, 539–549 (2023). https://doi.org/10.1007/s12403-022-00506-z