{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:10:02Z","timestamp":1785435002704,"version":"3.56.0"},"reference-count":76,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["U24A20766"],"award-info":[{"award-number":["U24A20766"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"award":["U24A20766"],"award-info":[{"award-number":["U24A20766"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017691","name":"Guangxi Key Research and Development Plan","doi-asserted-by":"publisher","award":["GUIKEAB24010219"],"award-info":[{"award-number":["GUIKEAB24010219"]}],"id":[{"id":"10.13039\/501100017691","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the National Key Research and Development Program of China","award":["2023YFC3905203"],"award-info":[{"award-number":["2023YFC3905203"]}]},{"name":"Science and Technology Planning Projects of Guangdong Province","award":["2025A0505020035"],"award-info":[{"award-number":["2025A0505020035"]}]},{"name":"Open Project of State Key Laboratory of Respiratory Disease","award":["SKLRD-OP-202402"],"award-info":[{"award-number":["SKLRD-OP-202402"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxics"],"abstract":"<jats:p>Widespread exposure to per- and polyfluoroalkyl substances (PFAS) is a growing public health concern, but its link to muscle damage remains largely unexplored. As PFAS exposure is associated with liver dysfunction, which is an established risk factor for muscle damage, we examined their associations and potential mediating pathways. A total of 1261 participants were recruited from Guangdong province, China, from November 2018 to August 2019 and examined for muscle mass, strength, serum PFAS levels, and biomarkers of liver function. The key results demonstrated significant positive associations between serum PFAS exposure and sarcopenia risk. Specifically, a per ln ng\/mL increase in linear perfluorooctane sulfonate (PFOS), branch PFOS, and perfluorooctanoic acid (PFOA) was associated with adjusted odds ratios of 2.32 (95% CI: 1.77 to 3.00), 2.18 (95% CI: 1.67 to 2.90) and 3.01 (95% CI: 1.96 to 4.70), respectively. Analysis of PFAS mixtures via the BKMR model revealed a linear dose\u2013response relationship of sarcopenia, with PFOS and PFOA being the primary contributor. Importantly, mediation analyses showed that liver function biomarkers served as significant mediators of the PFAS\u2013sarcopenia association. Notably, liver synthesis function markers (albumin and globin) mediated a substantial proportion of the association, ranging from 3.48% to 82.42%, whereas liver injury markers (aspartate aminotransferase and gamma-glutamyl transferase) accounted for only 1.54% to 15.44%. This study underscores the need to be aware of the increased risk of muscle damage associated with PFAS exposure, which may primarily operate through liver function abnormalities.<\/jats:p>","DOI":"10.3390\/toxics14060478","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T11:25:31Z","timestamp":1780399531000},"page":"478","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exposure to Per- and Polyfluoroalkyl Substances and the Risk of Sarcopenia: The Mediating Role of Serum Albumin"],"prefix":"10.3390","volume":"14","author":[{"given":"Mingkun","family":"Sun","sequence":"first","affiliation":[{"name":"Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chu","family":"Chu","sequence":"additional","affiliation":[{"name":"Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Zhao","sequence":"additional","affiliation":[{"name":"Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9816-1379","authenticated-orcid":false,"given":"Zhengmin","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1162-8824","authenticated-orcid":false,"given":"Mario","family":"Schootman","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, University of Arkansas for Medical Sciences, Springdale, AR 72762, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0558-8731","authenticated-orcid":false,"given":"Stephen","family":"McMillin","sequence":"additional","affiliation":[{"name":"School of Social Work, Saint Louis University, Saint Louis, MO 63103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxiang","family":"Dong","sequence":"additional","affiliation":[{"name":"Thornlea Secondary School, York Region District School Board, 8075 Bayview Avenue, Thornhill, ON L3T 4N4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenwen","family":"Bao","sequence":"additional","affiliation":[{"name":"Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8191-635X","authenticated-orcid":false,"given":"Muhammad","family":"Amjad","sequence":"additional","affiliation":[{"name":"Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haseeb","family":"Moryani","sequence":"additional","affiliation":[{"name":"Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"eabg9065","DOI":"10.1126\/science.abg9065","article-title":"Per- and polyfluoroalkyl substances in the environment","volume":"375","author":"Evich","year":"2022","journal-title":"Science"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Panieri, E., Baralic, K., Djukic-Cosic, D., Buha Djordjevic, A., and Saso, L. 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