Objectives The relationship between per- and polyfluoroalkyl substances (PFAS) and osteoarthritis (OA) remains unclear. This study aims to assess the association analyzing data from the NHANES 2003–2018 cycles. Methods Weighted multiple logistic regression and mixture analysis models were employed to evaluate the relationship between PFAS exposure and OA risk, with subgroup analyses conducted by age and sex. Mediation model was used to examine the potential mediating effect on the association between PFAS exposure and OA risk. Additionally, several sensitivity analyses were conducted. Results The study included 9584 participants, of whom 1042 had OA. Weighted logistic regression analysis showed a significant negative association between serum concentrations of perfluorooctanoic acid, perfluorooctane sulfonic acid, perfluorodecanoic acid, perfluoroundecanoic acid, and OA risk, with this association being more pronounced in individuals aged 60 and older. In the mixture analysis models, mixed exposure to PFAS was also negatively associated with OA risk; this correlation was significant in the population aged over 60. Sensitivity analysis results were similar. Additionally, mediation analysis did not find a significant mediating effect. Conclusions Exposure to PFAS is negatively associated with OA risk, with this association being significant in individuals aged 60 and older. To strengthen the current evidence, further comprehensive studies should be conducted. <Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec colname="c1" colnum="1" /> <colspec colname="c2" colnum="2" /> <tbody> <row> <entry align="left" nameend="c2" namest="c1"> Key Points • Single PFAS exposure is associated with a reduced risk of osteoarthritis. • PFAS-mixed exposure may be negatively associated with the risk of osteoarthritis. • PFAS exposure has a more significant impact on elderly osteoarthritis patients. </entry> </row> </tbody> </tgroup> </Table>

Age-specific associations between per- and polyfluoroalkyl substance exposure and osteoarthritis: a cross-sectional study

期刊论文
发表日期：

2025年12月18日

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Chang-Jie Du,
Wen-Zhuo Xu,
Jian-Wen Ye,
Yuan-Chen Zhao,
Dong-Sheng Di,
Rui-Xue Leng

摘要

Objectives

The relationship between per- and polyfluoroalkyl substances (PFAS) and osteoarthritis (OA) remains unclear. This study aims to assess the association analyzing data from the NHANES 2003–2018 cycles.

Methods

Weighted multiple logistic regression and mixture analysis models were employed to evaluate the relationship between PFAS exposure and OA risk, with subgroup analyses conducted by age and sex. Mediation model was used to examine the potential mediating effect on the association between PFAS exposure and OA risk. Additionally, several sensitivity analyses were conducted.

Results

The study included 9584 participants, of whom 1042 had OA. Weighted logistic regression analysis showed a significant negative association between serum concentrations of perfluorooctanoic acid, perfluorooctane sulfonic acid, perfluorodecanoic acid, perfluoroundecanoic acid, and OA risk, with this association being more pronounced in individuals aged 60 and older. In the mixture analysis models, mixed exposure to PFAS was also negatively associated with OA risk; this correlation was significant in the population aged over 60. Sensitivity analysis results were similar. Additionally, mediation analysis did not find a significant mediating effect.

Conclusions

Exposure to PFAS is negatively associated with OA risk, with this association being significant in individuals aged 60 and older. To strengthen the current evidence, further comprehensive studies should be conducted.

Key Points

• Single PFAS exposure is associated with a reduced risk of osteoarthritis.

• PFAS-mixed exposure may be negatively associated with the risk of osteoarthritis.

• PFAS exposure has a more significant impact on elderly osteoarthritis patients.