Lind, PM; Salihovic, S; van Bavel, B; Lind, L
BACKGROUND AND OBJECTIVE: During recent years, some persistent organic pollutants (POPs) have been linked to atherosclerosis. One group of POPs, the poly- and perfluoroalkyl substances (PFASs) have not been investigated with regard to atherosclerotic plaques.
METHODS: Carotid artery atherosclerosis was assessed by ultrasound in 1016 subjects aged 70 years in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. Eight PFASs were detected in >75% of participants' plasma by ultra-performance liquid chromatography coupled to tandem mass spectrometry (UPLC-MS/MS).
RESULTS: No significant linear associations were observed between the PFASs and intima-media thickness (IMT), or the echogenicity in the intima-media complex (IM-GSM, a marker of lipid infiltration in the artery) when men and women were analyzed together. Neither was occurrence of carotid plaques related to PFASs levels. However, highly significant interactions were observed between some PFASs and sex regarding both IM-GSM and plaque prevalence. Perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), and perfluoroundecanoic acid (PFUnDA), were all related to IM-GSM in a positive fashion in women (p=0.002-0.003), while these relationships were negative in men. The levels of PFUnDA were significantly related to carotid plaque in women (OR 1.59, 95%CI 1.03-2.43, p=0.03), but not in men (OR 0.93, 95%CI 0.62-1.42, p=0.75).
CONCLUSIONS: In this cross-sectional study, a pronounced gender difference was observed regarding associations between some PFASs, especially the long-chain PFUnDA, and markers of atherosclerosis, with more pronounced relationships found in women. These findings suggest a sex-specific role for PFASs in atherosclerosis.
Pollution Abstracts; Environment Abstracts; AMS Artery Measurement Software; CV cardiovascular; HRGC/ HRMS high-resolution mass spectrometry; IM-GSM grey scale median of the carotid artery intima-media complex; IMT intima media thickness; L-PFOS linear isomer of perfluorooctane sulfonic acid; PIVUS Prospective Investigation of the Vasculature in Uppsala Seniors; PCBs polychlorinated biphenyls; PFASs per- and polyfluoroalkyl substances; PFCAs perfluoroalkyl carboxylic acids; PFDA perfluorodecanoic acid; PFDS perfluorodecane sulfonic acid; PFHpA perfluoroheptanoic acid; PFHxS perfluorohexane sulfonic acid; PFNA perfluorononanoic acid; PFOSA perfluorooctane sulfonamide; PFUnDA perfluoroundecanoic acid; POPs persistent organic pollutants; UPLC-MS/MS ultra-performance liquid chromatography coupled to tandem mass spectrometry; Atherosclerosis; Atherosclerotic plaques; Poly- and perfluoroalkyl substances (PFASs); Liquid chromatography; Infiltration; Persistent organic pollutants; Sweden, Uppsala; Mass spectrometry; ENA 09:Land Use & Planning; P 6000:TOXICOLOGY AND HEALTH