Understanding the Impact of Perfluorinated Compounds on Cardiovascular Diseases and Their Risk Factors: A Meta-Analysis Study

Siti Suhana Abdullah Soheimi,Siti Hamimah Sheikh Abdul Kadir,Effendi Ibrahim,Amirah Abdul Rahman,Normala Abd Latip

doi:10.3390/ijerph18168345

Abstract

Perfluorinated compounds (PFCs) are non-biodegradable synthetic chemical compounds that are widely used in manufacturing many household products. Many studies have reported the association between PFCs exposure with the risk of developing cardiovascular diseases (CVDs). However, those reports are still debatable, due to their findings. Thus, this review paper aimed to analyse the association of PFCs compound with CVDs and their risk factors in humans by systematic review and meta-analysis. Google Scholar, PubMed and ScienceDirect were searched for PFCs studies on CVDs and their risk from 2009 until present. The association of PFCs exposure with the prevalence of CVDs and their risk factors were assessed by calculating the quality criteria, odds ratios (ORs), and 95% confidence intervals (CIs). CVDs risk factors were divided into serum lipid profile (main risk factor) and other known risk factors. The meta-analysis was then used to derive a combined OR test for heterogeneity in findings between studies. Twenty-nine articles were included. Our meta-analysis indicated that PFCs exposure could be associated with CVDs (Test for overall effect: = 2.2, p = 0.02; Test for heterogeneity: I2 = 91.6%, CI = 0.92–1.58, p < 0.0001) and their risk factors (Test for overall effect: = 4.03, p < 0.0001; Test for heterogeneity: I2 = 85.8%, CI = 1.00–1.14, p < 0.0001). In serum lipids, total cholesterol levels are frequently reported associated with the exposure of PFCs. Among PFCs, perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) exposure increased the risk of CVDs than other types of PFCs. Although the risk of PFOA and PFOS were positively associated with CVDs and their risk factors, more observational studies shall be carried out to identify the long-term effects of these contaminants in premature CVDs development in patients.

Highlights

From the meta-analysis, Perfluorinated compounds (PFCs) exposure to humans might contribute to the cardiovascular diseases (CVDs) development (Figure 2), with strong evidence indicating the association of PFCs exposure with their risk factors (Figure 3)
Hutcheson et al report that the risk of getting stroke is not associated with PFCs exposure, yet the study did not demonstrate whether PFCs increases the risk of stroke, the population studied in the report is larger compared to others (50-fold population differences) which might contribute to the insignificant findings
Our synthesis of adequately designed studies showed a significant association of PFCs exposure with CVDs and their risk factors among children and adults

Summary

Introduction

Licensee MDPI, Basel, Switzerland.Attribution (CC BY) license (https://creativecommons.org/licenses/by/ 4.0/).Perfluorinated compounds are synthetic chemicals produced by 3M companies since the 1940s. PFCs consist of at least one perfluoroalkyl moiety (Cn F2n+ 1) attached to one or more hydrophilic head groups [1]. PFCs are used in manufacturing products, such as non-sticky kitchenware [2], stain-resistant household products, waterproof clothing, mattresses [3] and food packaging [2]. Other than that, they are used in electronics, automotive, aerospace and firefighting materials [1,3]. PFOA, PFHxS and PFOS are among

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