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Americans with high exposure to one specific perfluoroalkyl substance (PFAS) are more likely to have hyperlipidemia—high cholesterol and other dysregulated lipid levels, a major risk factor for cardiovascular disease, reports a study in the February Journal of Occupational and Environmental Medicine.

Led by Weilong Xing, PhD, and Lei Wang, PhD, of Nanjing Institute of Environmental Sciences, China, the researchers explored the association between serum PFAS levels and hyperlipidemia. Nine kinds of PFAS were measured in samples from 1,600 US adults from a nationally representative study (NHANES 2017-2018). 

Nearly 57% of participants were classified as having hyperlipidemia. Of the nine PFAs studied, eight were detected in more than 85% of subjects. 

Adults with hyperlipidemia had elevated levels of one kind of PFAS: serum monomethyl branched isomers of perfluorooctane sulfonate (Sm-PFOS). After adjustment for potential confounding factors, hyperlipidemia risk was about 41% to 57% higher for participants in the two highest categories (quartiles) of Sm-PFOS.

On further analysis by age, the association between Sm-PFOS and hyperlipidemia was significant only in participants younger than 60 years. In that age group, participants in the highest category of Sm-PFOS were 81% more likely to have hyperlipidemia.

Used in an extensive array of products, PFAS are "environmentally daunting" chemicals that have been linked to several adverse health effects. Previous research has shown potential effects of PFAS exposure on lipid levels; the new epidemiologic study is the first to show a significant association with hyperlipidemia on the population level.

While the findings show a positive association between PFOS and hyperlipidemia, the authors emphasize that further studies would be needed to show a causal relationship. Dr. Xing and colleagues conclude: "Given the ubiquitous presence of PFOS in various environmental media and its negative serum lipid disturbing effect, monitoring of PFAS exposure should raise concern and stricter management of PFAS-containing products is warranted."