Levels of serum per- and polyfluoroalkyl substances and association with dyslipidemia in the Korean population

By Kangyeon Park, Da-An Huh, Lita Kim, Yun-Hee Choi, Jiyoun Lee, Se Hyun Hwang, Hyeon Jeong Choi, Woohyun Lim, and Kyong Whan Moon
Ecotoxicol Environ Saf
July 7, 2025
DOI: 10.1016/j.ecoenv.2025.118633

Per- and polyfluoroalkyl substances (PFAS) are primarily used in coatings for cookware and waterproof clothing, and can enter the body through contaminated food or water, potentially acting as endocrine disruptors. Epidemiological studies have reported associations between PFAS and dyslipidemia; however, these studies have mainly been conducted in Western and other countries. Due to genetic differences and weak regulations in East Asia compared to Western countries, there is a need for studies on the health impact on this population. This cross-sectional study analyzed the association between serum PFAS levels and dyslipidemia in Korean adults. The data were from 2975 participants from the cycle 4 of Korean National Environmental Health Survey conducted between 2018 and 2020. We performed general linear regression, robust Poisson regression, and Bayesian kernel machine regression to analyze the association between the five PFAS and dyslipidemia. All five PFAS were detected in over 99.8 % of the study participants, with geometric mean concentrations as follows: perfluorooctanoic acid (PFOA) = 6.4 ng/mL, perfluorooctane sulfonic acid (PFOS) = 15 ng/mL, perfluorohexane sulfonic acid (PFHxS) = 4.2 ng/mL, perfluorononanoic acid (PFNA) = 2.1 ng/mL, and perfluorodecanoic acid (PFDeA) = 0.91 ng/mL. This study confirmed positive associations between PFOA, PFHxS, PFNA, PFDeA, and low-density lipoprotein cholesterol (LDL), as well as a positive association between PFOA, PFNA, and PFDeA and the prevalence of high total cholesterol (TC). Further, an analysis stratified by sex revealed a positive association between PFOA and high-density lipoprotein cholesterol (HDL) in men. The PFAS mixture was associated with lipid profiles (TC, HDL, and LDL) in the general population of Korean adults, which emphasizes the need to strengthen PFAS regulations.

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