饮用水中的全氟和多氟烷基物质（PFAS）、妊娠糖尿病、高血压和子痫前期：一项基于全国登记的饮用水中PFAS的研究

IF 10.3 1区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Environment International Pub Date : 2025-04-01 DOI:10.1016/j.envint.2025.109415

Melle Säve-Söderbergh , Irina Gyllenhammar , Tessa Schillemans , Emelie Lindfeldt , Carolina Vogs , Carolina Donat-Vargas , Emilie Helte , Emma Ankarberg , Anders Glynn , Lutz Ahrens , Agneta Åkesson

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引用次数: 0

摘要

孕期暴露于全氟烷基和多氟烷基物质（PFAS）与糖尿病和高血压疾病之间的关联尚无确凿证据。目的：我们进行了一项全国性的基于登记的队列研究，以评估估计的孕产妇饮用水暴露与四种主要PFAS (PFAS4；全氟辛烷磺酸（PFOS）、全氟辛酸盐（PFOA）、全氟壬酸盐（PFNA）和全氟己酸盐（PFHxS）)与妊娠糖尿病（GDM）、高血压和子痫前期。材料和方法我们纳入了2012-2018年在瑞典由市政饮用水服务的大型地区分娩的未分娩妇女，在这些地区测量了原水和饮用水中的PFAS。使用单室毒性动力学模型，我们考虑了居住史、城市PFAS水浓度和特定年份母体PFAS背景血清水平，估计了妊娠期间母体血液中PFAS4的累积水平。结果和个体协变量通过注册连锁确定。比值比（OR）的平均值和95%置信区间（CI）采用logistic回归估计。结果在109,031名未生育妇女中，估计平均血清PFAS4含量为7.8 ng /mL（标准差：2.0 ng/mL），有迹象表明PFAS4与GDM呈非单调负相关，在比较极端四分位数时，多变量调整OR为0.72（95 % CI: 0.61-0.84）。每个PFAS也分别呈负相关。高血压或先兆子痫没有明显的相关性，尽管个体PFAS与高血压有显著的相关性，无论是反向（PFAS和PFHxS）还是直接（PFOS和PFNA）。结论在本研究中，我们观察到PFAS4与GDM呈非单调逆相关。一些个体PFAS也与高血压有直接或负相关关系。与暴露评估有关的局限性在解释时仍需谨慎。

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Per- and polyfluoroalkyl substances (PFAS) in drinking water, gestational diabetes mellitus, hypertension and preeclampsia: A nation-wide register-based study on PFAS in drinking water

Background

There is inconclusive evidence of associations between exposure to per- and polyfluoroalkyl substances (PFAS) and diabetes and hypertensive disorders during pregnancy.

Objectives

We conducted a nation-wide register-based cohort study to assess the associations of the estimated maternal drinking water exposure to the sum of four major PFAS (PFAS4; perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA), perfluorononanoate (PFNA) and perfluorohexanoate (PFHxS)) with gestational diabetes mellitus (GDM), hypertension and preeclampsia.

Materials and methods

We included nulliparous women giving birth in Sweden during 2012–2018 in large localities served by municipal drinking water where PFAS were measured in raw and drinking water. Using a one-compartment toxicokinetic model, we estimated cumulative maternal blood levels of PFAS4 during pregnancy considering residential history, municipal PFAS water concentration and year-specific maternal PFAS background serum levels. The outcomes and individual covariates were ascertained via register linkage. Mean values and 95% Confidence Intervals (CI) of Odds Ratios (OR) were estimated by logistic regression.

Results

Among the 109,031 nulliparous women included, with an estimated average 7.8 ng PFAS4/mL serum (standard deviation: 2.0 ng/mL), there were indications of a non-monotonic inverse association for PFAS4 and GDM, corresponding to multivariable-adjusted OR 0.72 (95 % CI: 0.61–0.84) when comparing extreme quartiles. An inverse association were also seen for each PFAS individually. No clear associations were seen for hypertension or preeclampsia, although individual PFAS indicated significant associations, both inverse (PFAS and PFHxS) and direct (PFOS and PFNA) for hypertension.

Conclusion

In the present study, we observed indications of inverse, non-monotonic associations for PFAS4 and GDM. Some individual PFAS were also associated with hypertension, both direct and inverse. The limitations linked to the exposure assessment still require caution in the interpretation.

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来源期刊

Environment International 环境科学-环境科学

CiteScore

21.90

自引率

3.40%

发文量

734

审稿时长

2.8 months

期刊介绍： Environmental Health publishes manuscripts focusing on critical aspects of environmental and occupational medicine, including studies in toxicology and epidemiology, to illuminate the human health implications of exposure to environmental hazards. The journal adopts an open-access model and practices open peer review. It caters to scientists and practitioners across all environmental science domains, directly or indirectly impacting human health and well-being. With a commitment to enhancing the prevention of environmentally-related health risks, Environmental Health serves as a public health journal for the community and scientists engaged in matters of public health significance concerning the environment.