Table 2.
Multivariable-adjusted prospective associations between baseline PFAS plasma concentrations and subsequent risk of cardiovascular disease (CVD) in 1,528 men and women from two pooled Swedish cohorts, estimated using conditional logistic regression—PFHpA and PFOA results are from the 60YO cohort alone.
| Exposure categories | Pooled cohorts () | |||||
|---|---|---|---|---|---|---|
| OR of incident CVD (95% CI) | ||||||
| Case/control () | Median (IQR) (mmol/L)a | Model 1 | Model 2 | Model 3 | Model 4 | |
| Tertile 1 | 270/278 | (, ) | 1.00 | 1.00 | 1.00 | 1.00 |
| Tertile 2 | 253/275 | (, 0.10) | 0.94 (0.74, 1.20) | 1.03 (0.79, 1.34) | 1.01 (0.77, 1.31) | 1.05 (0.81, 1.37) |
| Tertile 3 | 176/276 | 3.46 (2.09, 5.70) | 0.64 (0.49, 0.82) | 0.70 (0.53, 0.93) | 0.68 (0.51, 0.90) | 0.73 (0.55, 0.97) |
| 1-SD log | — | — | 0.95 (0.92, 0.98) | 0.97 (0.93, 1.00) | 0.96 (0.93, 0.99) | 0.97 (0.94, 1.00) |
| PFHxS | ||||||
| Tertile 1 | 244/277 | 1.73 (1.44, 1.95) | 1.00 | 1.00 | 1.00 | 1.00 |
| Tertile 2 | 237/276 | 2.52 (2.32, 2.74) | 0.98 (0.76, 1.25) | 0.95 (0.72, 1.24) | 0.92 (0.70, 1.20) | 0.96 (0.73, 1.26) |
| Tertile 3 | 218/276 | 4.97 (3.20, 11.1) | 0.87 (0.67, 1.13) | 0.96 (0.72, 1.28) | 0.94 (0.70, 1.25) | 0.99 (0.74, 1.32) |
| 1-SD log | — | — | 0.93 (0.84, 1.04) | 0.95 (0.85, 1.06) | 0.94 (0.84, 1.06) | 0.96 (0.85, 1.07) |
| PFHpA b | ||||||
| Tertile 1 | 153/132 | 0.03 (0.02, 0.03) | 1.00 | 1.00 | 1.00 | 1.00 |
| Tertile 2 | 120/130 | 0.06 (0.05, 0.07) | 0.79 (0.56, 1.12) | 0.69 (0.46, 1.03) | 0.64 (0.42, 0.97) | 0.68 (0.45, 1.02) |
| Tertile 3 | 120/131 | 0.13 (0.10, 0.18) | 0.78 (0.55, 1.11) | 0.75 (0.50, 1.11) | 0.68 (0.45, 1.03) | 0.72 (0.48, 1.08) |
| 1-SD log | — | — | 0.93 (0.81, 1.08) | 0.95 (0.81, 1.12) | 0.94 (0.79, 1.11) | 0.95 (0.80, 1.12) |
| PFOS | ||||||
| Tertile 1 | 250/278 | 12.9 (10.0, 17.3) | 1.00 | 1.00 | 1.00 | 1.00 |
| Tertile 2 | 228/276 | 21.9 (17.1, 25.7) | 0.89 (0.70, 1.15) | 0.92 (0.70, 1.21) | 0.86 (0.65, 1.14) | 0.95 (0.73, 1.26) |
| Tertile 3 | 221/275 | 32.3 (24.8, 38.9) | 0.87 (0.67, 1.13) | 0.90 (0.68, 1.20) | 0.87 (0.65, 1.16) | 0.94 (0.71, 1.26) |
| 1-SD log | — | — | 0.89 (0.80, 0.99) | 0.91 (0.81, 1.03) | 0.89 (0.79, 1.01) | 0.93 (0.82, 1.05) |
| PFOA b | ||||||
| Tertile 1 | 135/131 | 3.41 (2.66, 3.94) | 1.00 | 1.00 | 1.00 | 1.00 |
| Tertile 2 | 142/131 | 5.25 (4.82, 5.70) | 1.05 (0.76, 1.45) | 1.14 (0.78, 1.65) | 1.03 (0.70, 1.50) | 1.17 (0.80, 1.70) |
| Tertile 3 | 116/131 | 7.63 (6.88, 9.18) | 0.84 (0.58, 1.20) | 0.90 (0.60, 1.37) | 0.81 (0.52, 1.24) | 0.93 (0.61, 1.42) |
| 1-SD log | — | — | 0.90 (0.77, 1.04) | 0.91 (0.77, 1.08) | 0.87 (0.73, 1.04) | 0.92 (0.77, 1.09) |
| PFNA | ||||||
| Tertile 1 | 260/279 | 0.51 (0.40, 0.60) | 1.00 | 1.00 | 1.00 | 1.00 |
| Tertile 2 | 234/276 | 0.81 (0.71, 0.93) | 0.89 (0.71, 1.13) | 0.88 (0.68, 1.14) | 0.83 (0.64, 1.08) | 0.88 (0.68, 1.14) |
| Tertile 3 | 205/274 | 1.28 (1.11, 1.55) | 0.80 (0.62, 1.02) | 0.91 (0.69, 1.20) | 0.87 (0.66, 1.14) | 0.93 (0.71, 1.23) |
| 1-SD log | — | — | 0.87 (0.78, 0.96) | 0.91 (0.81, 1.02) | 0.89 (0.79, 1.00) | 0.92 (0.82, 1.03) |
| PFDA | ||||||
| Tertile 1 | 256/285 | 0.20 (0.15, 0.26) | 1.00 | 1.00 | 1.00 | 1.00 |
| Tertile 2 | 254/269 | 0.31 (0.25, 0.38) | 1.02 (0.80, 1.29) | 1.17 (0.90, 1.52) | 1.13 (0.87, 1.47) | 1.19 (0.92, 1.55) |
| Tertile 3 | 189/275 | 0.52 (0.45, 0.66) | 0.73 (0.56, 0.95) | 0.81 (0.61, 1.08) | 0.78 (0.58, 1.04) | 0.86 (0.64, 1.15) |
| 1-SD log | — | — | 0.83 (0.75, 0.93) | 0.89 (0.79, 1.00) | 0.87 (0.77, 0.98) | 0.90 (0.80, 1.02) |
| PFUnDA | ||||||
| Tertile 1 | 288/294 | 0.16 (0.13, 0.19) | 1.00 | 1.00 | 1.00 | 1.00 |
| Tertile 2 | 236/260 | 0.27 (0.24, 0.31) | 0.89 (0.70, 1.13) | 0.99 (0.76, 1.29) | 0.99 (0.76, 1.28) | 1.01 (0.78, 1.32) |
| Tertile 3 | 175/275 | 0.48 (0.40, 0.60) | 0.61 (0.47, 0.79) | 0.76 (0.57, 1.02) | 0.73 (0.54, 0.97) | 0.80 (0.59, 1.07) |
| 1-SD log | — | — | 0.79 (0.71, 0.88) | 0.86 (0.76, 0.97) | 0.84 (0.74, 0.95) | 0.87 (0.77, 0.99) |
Note: Adjusted ORs (95% CIs) of incident CVD (myocardial infarction or stroke) are presented according to the PFAS tertiles as well as by 1-SD increment in natural log-transformed plasma PFAS concentrations (ng/mL). Model 1: adjusted for matching factors (sex, age, sampling date). Model 2: additionally adjusted for education, BMI, diabetes, hypertension, family history of CVD, smoking habits, physical activity, and healthy diet score. Model 3: additionally adjusted for LDL (19 observations deleted due to missing LDL). Model 4: additionally adjusted for HDL and triglycerides. Individual PFAS were standardized (rescaled with and ) and summed (). —, not applicable; 60YO, Cohort of 60-year-olds; BMI, body mass index; CI, confidence interval; CVD, cardiovascular disease; HDL, high-density lipoprotein; IQR, interquartile range; LDL, low-density lipoprotein; OR, odds ratio; PFAS, per- and polyfluoroalkyl substances; PFDA, perfluorodecanoic acid; PFHpA, perfluoroheptanoic acid; PFHxS, perfluorohexane sulfonic acid; PFNA, perfluorononanoic acid; PFOA, perfluorooctanoic acid; PFOS, perfluorooctane sulfonate; PFUnDA, perfluoroundecanoic acid; SD, standard deviation; SMC-C, Swedish Mammography Cohort-Clinical cohort.
The score are standardized values.
Estimated from the 60YO cohort alone.