Association between per- and polyfluoroalkyl substances exposure and blood pressure: From epidemiological evidence to mechanistic insights

Exposure to per- and polyfluoroalkyl substances (PFASs) is associated with hypertension, potentially involving inflammation; however, the specific correlations and mechanisms remain unclear. This study included 2801 adults from Hebei Province, China. We employed multiple linear regression and quanti...

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Main Authors: Ziwen An, Yayuan Mei, Zhenzhen Tan, Zexuan Jiang, Xiuli Zeng, Longfei Li, Zheyuan Liu, Haiyan Shi, Jing Li, Wenjing Duan, Yiming Zhu, Mingmei Guo, Yi Liu, Ang Li, Huicai Guo
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Ecotoxicology and Environmental Safety
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Online Access:http://www.sciencedirect.com/science/article/pii/S0147651325012333
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author Ziwen An
Yayuan Mei
Zhenzhen Tan
Zexuan Jiang
Xiuli Zeng
Longfei Li
Zheyuan Liu
Haiyan Shi
Jing Li
Wenjing Duan
Yiming Zhu
Mingmei Guo
Yi Liu
Ang Li
Huicai Guo
author_facet Ziwen An
Yayuan Mei
Zhenzhen Tan
Zexuan Jiang
Xiuli Zeng
Longfei Li
Zheyuan Liu
Haiyan Shi
Jing Li
Wenjing Duan
Yiming Zhu
Mingmei Guo
Yi Liu
Ang Li
Huicai Guo
author_sort Ziwen An
collection DOAJ
description Exposure to per- and polyfluoroalkyl substances (PFASs) is associated with hypertension, potentially involving inflammation; however, the specific correlations and mechanisms remain unclear. This study included 2801 adults from Hebei Province, China. We employed multiple linear regression and quantile g-computation models to examine the effects of plasma PFASs on systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP). Stratified analyses identified susceptible populations. Restricted cubic splines (RCS) explored dose-response relationships, and receiver operating characteristic (ROC) analysis evaluated the ability of blood pressure indicators to differentiate PFASs concentrations. Mediation analysis investigated the role of inflammatory cells, while bioinformatics analyses explored potential mechanisms. Specifically, PFOA was positively correlated with DBP (0.45 %, 95 % CI: 0.08 %, 0.82 %) and MAP (0.35 %, 95 % CI: 0.02 %, 0.68 %), while a positive association was found between PFDA and DBP (0.37 %, 95 % CI: 0.01 %, 0.73 %). In subgroup analyses, stronger correlations were found in more susceptible groups; for example, 6:2 Cl-PFESA was positively correlated with SBP (0.71 %, 95 % CI: 0.14 %, 1.29 %) in smokers. A monotonic dose-response relationship was observed for PFOA and MAP. ROC analysis indicated that DBP effectively distinguished PFOA and PFDA concentrations. Mediation analysis found monocyte percentages and the lymphocyte/monocyte ratio, as significant mediators in the PFASs-blood pressure relationship. Bioinformatics suggested that inflammation mediated by pattern recognition receptors (PPRs), particularly Macrophage-induced type C lectin (Mincle), may be a potential mechanism. PFASs, especially PFOA and PFDA, have significant hypertensive effects, with inflammation mediated by PPRs likely serving as a molecular mechanism.
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spelling doaj-art-b44ef9849c4f4bb4bec3dcfdc3808c262025-08-24T05:11:18ZengElsevierEcotoxicology and Environmental Safety0147-65132025-09-0130311888810.1016/j.ecoenv.2025.118888Association between per- and polyfluoroalkyl substances exposure and blood pressure: From epidemiological evidence to mechanistic insightsZiwen An0Yayuan Mei1Zhenzhen Tan2Zexuan Jiang3Xiuli Zeng4Longfei Li5Zheyuan Liu6Haiyan Shi7Jing Li8Wenjing Duan9Yiming Zhu10Mingmei Guo11Yi Liu12Ang Li13Huicai Guo14Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR ChinaBig Data Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, 56 Nanlishi Road, Xicheng District, Beijing 100045, PR ChinaDepartment of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR China; Postdoctoral Station of Pharmaceutical Sciences, Hebei Medical University, Shijiazhuang 050017, PR ChinaDepartment of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR ChinaDepartment of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR ChinaDepartment of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR ChinaDepartment of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR ChinaDepartment of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR ChinaDepartment of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR ChinaDepartment of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR ChinaDepartment of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR ChinaDepartment of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR ChinaDepartment of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR ChinaDepartment of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Shijiazhuang, 050017, China; Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, Hebei 050017, PR China; Correspondence to: Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Shijiazhuang, 050017, PR China.Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR China; Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, Hebei 050017, PR China; The Key Laboratory of Neural and Vascular Biology, Ministry of Education, Shijiazhuang, Hebei 050017, PR China; Correspondence to: Department of Toxicology, School of Public Health, Hebei Medical University, 361 East Zhongshan Road, Shijiazhuang, Hebei 050017, PR China.Exposure to per- and polyfluoroalkyl substances (PFASs) is associated with hypertension, potentially involving inflammation; however, the specific correlations and mechanisms remain unclear. This study included 2801 adults from Hebei Province, China. We employed multiple linear regression and quantile g-computation models to examine the effects of plasma PFASs on systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP). Stratified analyses identified susceptible populations. Restricted cubic splines (RCS) explored dose-response relationships, and receiver operating characteristic (ROC) analysis evaluated the ability of blood pressure indicators to differentiate PFASs concentrations. Mediation analysis investigated the role of inflammatory cells, while bioinformatics analyses explored potential mechanisms. Specifically, PFOA was positively correlated with DBP (0.45 %, 95 % CI: 0.08 %, 0.82 %) and MAP (0.35 %, 95 % CI: 0.02 %, 0.68 %), while a positive association was found between PFDA and DBP (0.37 %, 95 % CI: 0.01 %, 0.73 %). In subgroup analyses, stronger correlations were found in more susceptible groups; for example, 6:2 Cl-PFESA was positively correlated with SBP (0.71 %, 95 % CI: 0.14 %, 1.29 %) in smokers. A monotonic dose-response relationship was observed for PFOA and MAP. ROC analysis indicated that DBP effectively distinguished PFOA and PFDA concentrations. Mediation analysis found monocyte percentages and the lymphocyte/monocyte ratio, as significant mediators in the PFASs-blood pressure relationship. Bioinformatics suggested that inflammation mediated by pattern recognition receptors (PPRs), particularly Macrophage-induced type C lectin (Mincle), may be a potential mechanism. PFASs, especially PFOA and PFDA, have significant hypertensive effects, with inflammation mediated by PPRs likely serving as a molecular mechanism.http://www.sciencedirect.com/science/article/pii/S0147651325012333Per- and polyfluoroalkyl substancesBlood pressureBioinformaticsPattern recognition receptors
spellingShingle Ziwen An
Yayuan Mei
Zhenzhen Tan
Zexuan Jiang
Xiuli Zeng
Longfei Li
Zheyuan Liu
Haiyan Shi
Jing Li
Wenjing Duan
Yiming Zhu
Mingmei Guo
Yi Liu
Ang Li
Huicai Guo
Association between per- and polyfluoroalkyl substances exposure and blood pressure: From epidemiological evidence to mechanistic insights
Ecotoxicology and Environmental Safety
Per- and polyfluoroalkyl substances
Blood pressure
Bioinformatics
Pattern recognition receptors
title Association between per- and polyfluoroalkyl substances exposure and blood pressure: From epidemiological evidence to mechanistic insights
title_full Association between per- and polyfluoroalkyl substances exposure and blood pressure: From epidemiological evidence to mechanistic insights
title_fullStr Association between per- and polyfluoroalkyl substances exposure and blood pressure: From epidemiological evidence to mechanistic insights
title_full_unstemmed Association between per- and polyfluoroalkyl substances exposure and blood pressure: From epidemiological evidence to mechanistic insights
title_short Association between per- and polyfluoroalkyl substances exposure and blood pressure: From epidemiological evidence to mechanistic insights
title_sort association between per and polyfluoroalkyl substances exposure and blood pressure from epidemiological evidence to mechanistic insights
topic Per- and polyfluoroalkyl substances
Blood pressure
Bioinformatics
Pattern recognition receptors
url http://www.sciencedirect.com/science/article/pii/S0147651325012333
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