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Niu Z, Duan Z, He W, Chen T, Tang H, Du S, Sun J, Chen H, Hu Y, Iijima Y, Han S, Li J, Zhao Z. Kidney function decline mediates the adverse effects of per- and poly-fluoroalkyl substances (PFAS) on uric acid levels and hyperuricemia risk. JOURNAL OF HAZARDOUS MATERIALS 2024; 471:134312. [PMID: 38640681 DOI: 10.1016/j.jhazmat.2024.134312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 03/30/2024] [Accepted: 04/14/2024] [Indexed: 04/21/2024]
Abstract
Previous studies indicated per- and poly-fluoroalkyl substances (PFAS) were related to uric acid and hyperuricemia risk, but evidence for the exposure-response (E-R) curves and combined effect of PFAS mixture is limited. Moreover, the potential mediation effect of kidney function was not assessed. Hence, we conducted a national cross-sectional study involving 13,979 US adults in NHANES 2003-2018 to examine the associations of serum PFAS with uric acid and hyperuricemia risk, and the mediation effects of kidney function. Generalized linear models and E-R curves showed positive associations of individual PFAS with uric acid and hyperuricemia risk, and nearly linear E-R curves indicated no safe threshold for PFAS. Weighted quantile sum regression found positive associations of PFAS mixture with uric acid and hyperuricemia risk, and PFOA was the dominant contributor to the adverse effect of PFAS on uric acid and hyperuricemia risk. Causal mediation analysis indicated significant mediation effects of kidney function decline in the associations of PFAS with uric acid and hyperuricemia risk, with the mediated proportion ranging from 19 % to 57 %. Our findings suggested that PFAS, especially PFOA, may cause increased uric acid and hyperuricemia risk increase even at low levels, and kidney function decline plays a crucial mediation effect.
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Affiliation(s)
- Zhiping Niu
- Department of Environmental Health, School of Public Health, NHC Key Laboratory of Health Technology Assessment, Key Laboratory of Public Health Safety of the Ministry of Education, Fudan University, Shanghai 200032, China
| | - Zhizhou Duan
- Preventive Health Service, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, 152 Aiguo Road, Nanchang, Jiangxi, China
| | - Weixiang He
- Department of Urology, Xijing Hospital, The Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, China
| | - Tianyi Chen
- Department of Environmental Health, School of Public Health, NHC Key Laboratory of Health Technology Assessment, Key Laboratory of Public Health Safety of the Ministry of Education, Fudan University, Shanghai 200032, China
| | - Hao Tang
- Department of Environmental Health, School of Public Health, NHC Key Laboratory of Health Technology Assessment, Key Laboratory of Public Health Safety of the Ministry of Education, Fudan University, Shanghai 200032, China
| | - Shuang Du
- Department of Environmental Health, School of Public Health, NHC Key Laboratory of Health Technology Assessment, Key Laboratory of Public Health Safety of the Ministry of Education, Fudan University, Shanghai 200032, China
| | - Jin Sun
- Department of Environmental Health, School of Public Health, NHC Key Laboratory of Health Technology Assessment, Key Laboratory of Public Health Safety of the Ministry of Education, Fudan University, Shanghai 200032, China
| | - Han Chen
- Department of Environmental Health, School of Public Health, NHC Key Laboratory of Health Technology Assessment, Key Laboratory of Public Health Safety of the Ministry of Education, Fudan University, Shanghai 200032, China
| | - Yuanzhuo Hu
- Department of Environmental Health, School of Public Health, NHC Key Laboratory of Health Technology Assessment, Key Laboratory of Public Health Safety of the Ministry of Education, Fudan University, Shanghai 200032, China
| | - Yuka Iijima
- Department of Clinical Medicine, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Shichao Han
- Department of Urology, Xijing Hospital, The Fourth Military Medical University, 127 West Changle Road, Xi'an 710032, China.
| | - Jiufeng Li
- Department of Environmental Health, School of Public Health, NHC Key Laboratory of Health Technology Assessment, Key Laboratory of Public Health Safety of the Ministry of Education, Fudan University, Shanghai 200032, China.
| | - Zhuohui Zhao
- Department of Environmental Health, School of Public Health, NHC Key Laboratory of Health Technology Assessment, Key Laboratory of Public Health Safety of the Ministry of Education, Fudan University, Shanghai 200032, China; Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai 200030, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai 200438, China; WMO/IGAC MAP-AQ Asian Office Shanghai, Fudan University, Shanghai 200438, China.
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