Associations of per- and polyfluoroalkyl substances with risk for depressive disorder: mixtures approach

Abstract

Abstract Per-and polyfluoroalkyl substances (PFAS) are shown to have adverse health effects on brain function, but epidemiological evidence for associations between mixture PFAS exposure and depressive disorder risk is inconclusive. The objective of this study was to assess the association between co-exposure to PFAS concentrations and depressive disorder. The study included a subsample of 1948 individuals aged 20–80 in the National Health and Nutrition Examination Survey (NHANES) between 2013 and 2018. The weighted quantile sum regression (WQS), Quantile g-computation (QG-C), and Bayesian kernel machine regression (BKMR) were constructed to estimate the overall and individual effects of PFAS exposure on depressive disorder risk. A total of 3788 adult participants were enrolled from NHANES. The WQS model found that mixed exposure to per- and polyfluoroalkyl substances was significantly negatively associated with the risk of depressive disorder (WQSPFASβ=-0.25; 95%CI: -0.11, -0.39) after adjusting for various covariates The BKME results showed a significant reduction in the risk of depressive disorder with increasing total levels of the PFAS mixture, of which PFNA played the most important role. In qgcomp, a substantial negative correlation between PFAS and depressive disorder was identified (difference in risk for depression per quartile increase =-0.25; 95% CI: -0.13, -0.38). These findings suggested that PFAS mixture exposure in the US population may have a negative effect on the risk of depressive disorder.