Per- and polyfluoroalkyl substances are linked to incident primary dyslipidaemia: A prospective study from Chinese...

This study aimed to explore the single and mixed effects of per- and polyfluoroalkyl substances (PFAS) on incident primary dyslipidaemia (PD). We further evaluated the interactions between PFAS and other environmental factors. After a 3-year follow-up of 11,843 government employees, 490 were newly diagnosed with PD, and 490 healthy controls were matched based on age, sex, and study location. Six serum PFAS were detected using ultra-high-pressure liquid chromatography-tandem mass spectrometry. Individual air-pollutant exposure, demographic characteristics, lifestyles and other clinical indicators were obtained from environmental monitoring station data, questionnaires, laboratory, or physical examinations. Logistic regression was performed to analyse the single exposure of PFAS and the interactions. The weighted quantile sum (WQS) model was employed to assess the effect of PFAS mixtures. The serum perfluorooctane sulfonate (PFOS) was higher in PD group than in controls. Serum PFOS concentrations demonstrated monotonic increasing trend with PD incidence risk (OR = 1.33, 95 %CI: 1.01-1.74), and the risk of PD increased by 52 % in the high-concentration group (≥ 29.4 ng/mL) (OR = 1.52, 95 %CI: 1.01-2.30) than the low-concentration group. The WQS model demonstrated a 27 % increment in risk per quartile increase (OR = 1.27, 95 %CI: 1.00-1.62), with PFOS dominating the weight allocation (54.43 %). An antagonistic effect between serum PFOS exposure and aquatic product intake (P_interaction = 0.009) was observed. Our findings revealed a PFAS mixture exposure on increased incident PD risks and identified PFOS > 29.4 ng/mL as a potentially hazardous substance while aquatic product intake seems to partially attenuate its risk.