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Outline
To investigate the associations between single and mixed exposure to per- and polyfluoroalkyl substances (PFAS) and the metabolic score for insulin resistance (METS-IR), and to explore the modifying effects of sex, age, and body mass index (BMI).
Data on serum concentrations of perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), and METS-IR were obtained from 2 345 participants aged 20-80 years in the National Health and Nutrition Examination Survey (NHANES) 2013—2018. We employed weighted linear regression and restricted cubic splines to examine linear and nonlinear associations of single PFAS exposure with METS-IR. The joint effects and key driver components of PFAS mixtures were assessed using weighted quantile sum regression, quantile g-computation, and Bayesian kernel machine regression. Subgroup analyses were conducted to assess potential effect modification by sex, age, and BMI.
All five PFAS were inversely associated with METS-IR, with PFHxS exhibiting a nonlinear relationship with METS-IR (qnonlinear=0.021). A higher mixed PFAS exposure index was inversely associated with METS-IR (β^=-0.329, 95% CI: -0.583~-0.08, P=0.001), with PFDA being the primary driver (w=0.625). The mixture effect was significant in males, the elderly, and individuals with obesity (all q<0.05).
PFAS exposure is inversely associated with METS-IR, with PFDA being the key component driving the joint effect. Future prospective cohort studies are needed to validate these findings and elucidate the underlying mechanisms.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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