Association of Prenatal Exposure to Persistent Organic Pollutants and Childhood Lipid Levels: The Rhea Birth Cohort (Greece)

Abstract

BACKGROUND AND AIM: Lipid disorders in childhood are associated with an earlier onset and greater risk of cardiovascular disease in adulthood. Prenatal exposure to persistent organic pollutants (POPs) has been linked to cardiometabolic risk factors in childhood, but there are limited studies evaluating the persistence of these associations into early adolescence. We assessed the impact of in-utero exposure to POPs on lipid profiles during childhood in the RHEA birth cohort in Greece. METHODS: Maternal serum concentrations of several polychlorinated biphenyls (PCBs), dichlorodiphenyldichloroethene (DDE), and hexachlorobenzene (HCB) were measured in first trimester. We measured triglycerides (TG), total cholesterol (TC), HDL- and LDL-cholesterol at 4, 6, and 11 years. Generalized estimating equations and multivariate regression models assessed the associations with repeated and single time-point measures, respectively. We also tested effect modification by sex. RESULTS: We did not find any strong evidence of lipid levels at age-four being associated to prenatal POPs exposure. DDE exposure in the third tertile (>2846 ng/mL) was associated with higher TC (β= 8.01 mg/dL, 95% CI:1.66, 14.36), HDL (β= 3.25 mg/dL, 95% CI: 0.04, 6.46) and LDL (β= 6.29 mg/dL, 95% CI: 0.78, 11.79). HCB in the second tertile (69 – 102.5 ng/mL) was associated with lower TC (β= -7.27mg/dL, 95% CI: -13.36, -1.19) and HDL (β= -3.34 mg/dL, 95% CI: -6.40, -0.27). We observed strong negative associations between all POPs and age-six TG levels. Similarly, HCB and PCB118 were associated with lower TC and LDL levels at 11 years. In GEE models of repeated outcome measures DDE was associated with higher TC and HDL levels. No clear differences by sex were observed. CONCLUSIONS: Our data indicate that in utero exposures to POPs may be associated with changes in child circulating lipids. These findings require further exploration in other settings and larger cohorts. KEYWORDS: prenatal, POPs, lipids, children