Abstract TU150: Associations of Per- and Polyfluoroalkyl Substances with Cardiovascular Risk in Midlife Women and the Potential Protective Role of Dietary Fiber

Abstract

Background: Per- and polyfluoroalkyl substances (PFAS) are persistent chemicals with widespread human exposure and reported links to dyslipidemia. PFAS bioaccumulation may accelerate after menopause, yet the cardiovascular effects of PFAS in midlife women are understudied. Potential dietary strategies to reduce PFAS burden are also poorly understood. Methods: We analyzed data from 54 women aged 19-59, spanning pre-, peri-, and post-menopause. Serum concentrations of 13 PFAS, CVD risk factors (blood pressure, body mass index, glucose, and lipids), and vascular measures (flow-mediated dilation [FMD] and pulse wave velocity [PWV]) were assessed. In a subset of 29 women, dietary fiber and folate intakes were estimated from dietary records. Multivariable linear regression models estimated associations of PFAS with cardiovascular outcomes, and of dietary factors with PFAS concentrations. Results: Among the six PFAS compounds detected in >70% of samples, perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) had the highest concentrations. Exposures were generally higher in postmenopausal than premenopausal women. Although not statistically significant, ΣPFAS and PFOS were positively associated with total cholesterol, LDL cholesterol, and triglycerides, and inversely associated with HDL cholesterol. Associations of PFAS with FMD were weak and non-significant. Most PFAS compounds were linked to slightly higher PWV, particularly ΣPFAS and PFOS. Folate showed modest, nonsignificant associations with PFAS, whereas soluble fiber was inversely associated with 5 of 6 compounds. Conclusion: These exploratory results suggest that PFAS could adversely influence lipid profile and vascular function in women. Increased soluble fiber intake may reduce PFAS burden. Larger studies are warranted to confirm these findings.