早期暴露多氟烷基化合物與兒童肥胖關係的橫斷性研究

Abstract

本研究深入探討兒童暴露多氟烷基物質（PFAS）與肥胖及脂質代謝的交互關係。PFAS 是一人造化合物，因其防水、防油等穩定之性質而被廣泛應用，且因其在環境中的持久性和對健康的潛在危害而受到關注。本研究旨在探索傳統與新型PFAS 化合物如何影響兒童脂質代謝和體態組成。 本研究利用台灣出生群組研究 II（Taiwan Birth Penal Study II）在 2018 年收集的兒童樣本，我們分析了 595 名兒童（平均年齡 7.84 歲）的血清中 17 種長短鏈PFAS 的濃度、體態組成及血液生化數據，並發現這些 PFAS 的檢出率普遍高於50%，突顯出這些化合物在兒童群體中的普遍存在。進一步的線性迴歸分析揭示，部分長鏈 PFAS（如 PFOA 和 PFOS）與膽固醇濃度呈現顯著的正相關，但不同的PFAS 結果並不一致，例如較高的 PFNA 暴露與皮膚褶皺厚度成負相關，但在 6:2 PAP 卻成正相關，這表明不同 PFAS 化合物可能對體態組成和脂質代謝產生不同的影響，顯示出不同 PFAS 化合物對健康影響的差異性。此外，本研究特別採用了Quantile-Base G Computation 計算法來評估混合 PFAS 的健康風險，以克服過去研究在處理混合污染物共線性及交互作用時的限制。分析結果表明，PFAS 混合物與總膽固醇、高密度膽固醇和低密度膽固醇之間存在正相關，且在肥胖及正常體重的兒童族群中結果一致。另外一個發現是相較於傳統 PFAS，短鏈 PFAS（如 PFBA）的貢獻性在加權指數上顯著增加。然而 PFAS 混合物濃度與體態組成、甘油三酸酯、脂聯素和瘦素等其他血脂標記的相關性則不顯著。 總結來說，本研究為 PFAS 暴露與兒童肥胖和脂質代謝之間的複雜關係提供了新的視角，除了支持之前的觀點，即 PFAS 暴露會干擾脂質代謝，同時也強調了未來研究者應更關注短鏈 PFAS 對人體健康可能的影響。

This study delves into the interplay between children''s exposure to Perfluoroalkyl Substances (PFAS) and its associations with obesity and lipid metabolism. PFAS, synthetic compounds known for their stable, water- and oil-repellent properties, are widely used and have raised concerns due to their persistence in the environment and potential health hazards. The aim of this research is to explore how traditional and novel PFAS compounds affect children''s lipid metabolism and body composition, addressing a gap in this field. Utilizing data from the Taiwan Birth Panel Study II collected in 2018, we analyzed serum concentrations of 17 types of long- and short-chain PFAS in 595 children (average age 7.84 years), along with their body composition and biochemical blood markers. Our findings indicate a detection rate of these PFAS exceeding 50% among the children, highlighting their prevalent presence. Further linear regression analysis revealed that certain long-chain PFAS (such as PFOA and PFOS) were positively correlated with cholesterol levels. However, the impacts of different PFAS varied, for instance, higher exposure to PFNA was negatively correlated with skinfold thickness, while a positive correlation was observed with 6:2 PAP, suggesting diverse effects of various PFAS on body composition and lipid metabolism. A notable aspect of this study was the application of the Quantile-Based G Computation method to assess the health risks of mixed PFAS exposure, overcoming limitations of previous research in handling collinearity and interactions of mixed pollutants. The results indicated a positive correlation between PFAS mixtures and total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL), consistent across both obese and normal-weight child populations. Another key finding was the increased significance of short-chain PFAS (like PFBA) in weighted indices compared to traditional PFAS. However, no significant correlations were observed between PFAS mixture concentrations and body composition, triglycerides, adiponectin, or leptin levels. In conclusion, this study provides new insights into the complex relationship between PFAS exposure, child obesity, and lipid metabolism. It not only supports previous views that PFAS exposure disrupts lipid metabolism but also emphasizes the need for future research to focus more on the potential health impacts of short-chain PFAS.