Oxidative stress mediates the association between brominated flame retardants and hyperlipidemia in US adults

Brominated flame retardants (BFRs) are classified as persistent organic pollutants (POPs), and studies suggest that exposure to POPs may contribute to the development of metabolic diseases. However, the specific link between single and mixed BFRs and hyperlipidemia remains unclear, as does the potential mediating role of oxidative stress in this relationship. We conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2016, encompassing 6800 participants, to investigate the association between BFRs and hyperlipidemia. Our findings from weighted multiple logistic regression models suggest that PBB153 and PBDE28 are significantly associated with hyperlipidemia. Furthermore, both the weighted quantile sum (WQS) regression model and the quantile g-computation (QGcomp) model demonstrated a positive association between mixed BFRs exposure and hyperlipidemia. Additionally, we revealed positive associations between individual and combined BFRs and levels of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C). Furthermore, the oxidative stress marker γ-glutamyltransferase (GGT) plays a mediating role in the relationship between BFRs and hyperlipidemia, TC and TG. Our study concludes that BFRs are associated with an increased prevalence of hyperlipidemia and lipid levels, with oxidative stress likely acting as a mediator in this process.