背景:全氟烷基和多氟烷基物质(PFAS)的不良代谢健康影响的证据正在增加。然而,PFAS对心血管疾病的影响仍存在争议。本荟萃分析旨在分析PFAS对卒中风险的影响。
背景:搜索了截至2022年11月1日发表的研究,这些研究报告了中风与暴露于四种主要PFAS(全氟辛酸[PFOA],全氟辛烷磺酸[全氟辛烷磺酸],全氟壬酸[PFNA],和全氟己烷磺酸[PFHxS])。根据纽卡斯尔-渥太华量表进行数据提取和质量评估。
■本系统综述包括四项研究。在荟萃分析中,将每个血清PFAS中每1个对数单位增量的卒中事件的多变量校正比值比(ORs)合并。卒中发生的风险与PFOA无显著相关性,全氟辛烷磺酸,或PFNA暴露(PFOA:合并比值比[OR]=1.001,95%置信区间[CI]=0.975-1.028,p=0.934;PFOS:合并OR=0.994,95%CI=0.972-1.017,p=0.601;PFNA:合并OR=1.016,95%CI=0.920-1.123,p=0.752),而与PFHxS暴露相关的中度风险较低,无统计学意义(合并OR=0.953,95%CI=0.908-1.001,p=0.054).PFOA,全氟辛烷磺酸,PFNA暴露显示出中性关联,而PFHxS可能与卒中风险呈负相关.因此,这一发现应谨慎解释。有必要对PFAS混合物进行进一步的前瞻性观察性研究分析。
BACKGROUND: Evidence of the adverse metabolic health effects of perfluoroalkyl and polyfluoroalkyl substances (PFAS) is increasing. However, the impact of PFAS on cardiovascular diseases remains controversial. This meta-analysis aimed to analyze the impact of PFAS on the stroke risk.
BACKGROUND: Databases were searched for studies published up to November 1, 2022, which report the association between stroke and exposure to at least one of four main PFAS (perfluorooctanoic acid [PFOA], perfluorooctanesulfonic acid [PFOS], perfluorononanoic acid [PFNA], and perfluorohexane sulfonic acid [PFHxS]). Data extraction and quality assessment were performed according to the Newcastle-Ottawa scale.
UNASSIGNED: Four studies were included in this systematic review. Multivariate adjusted odds ratios (ORs) for incident stroke per 1-log unit increment in each serum PFAS were combined in the meta-analysis. The risk of development of stroke was not significantly associated with PFOA, PFOS, or PFNA exposure (PFOA: pooled odds ratio [OR]=1.001, 95 % confidence interval [CI]=0.975-1.028, p=0.934; PFOS: pooled OR=0.994, 95 % CI=0.972-1.017, p=0.601; PFNA: pooled OR=1.016, 95 % CI=0.920-1.123, p=0.752), whereas a moderately lower risk was associated with PFHxS exposure without statistical significance (pooled OR=0.953, 95 % CI=0.908-1.001, p=0.054). PFOA, PFOS, and PFNA exposure showed a neutral association, while PFHxS showed a possible inverse association with the risk of stroke. Therefore, this finding should be interpreted with caution. Further prospective observational studies with PFAS mixture analyses are warranted.