Early-life associations between per- and polyfluoroalkyl substances and serum lipids in a longitudinal birth cohort

Abstract

BACKGROUND AND AIM: Exposures to per- and polyfluoroalkyl substances (PFASs) may affect metabolic outcomes, including serum lipid concentrations. However, few studies have evaluated potential associations between PFASs and lipids longitudinally. In this study we estimated associations between PFAS and lipid concentrations at birth and at several points in childhood and identified sensitive periods of exposure. METHODS: This study included 490 children from a prospective cohort in the Faroe Islands. Concentrations of five PFASs were measured in serum collected at birth and ages 18 months, 5 years and 9 years. Serum lipid concentrations were measured at birth, 18 months and 9 years. We estimated associations between PFAS and lipid concentrations and evaluated possible effect modification by sex. We further tested whether PFAS associations with age-9 lipids varied by exposure period using multiple informant models of repeated PFAS exposures. RESULTS:Childhood PFAS exposures were positively associated with lipids at age 9. Increases in age-9 concentrations of perfluorodecanoic acid (PFDA), perfluorononanoic acid (PFNA) and perfluorooctanesulfonic acid (PFOS) were positively associated with total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). For example, a doubling of PFDA at age nine was associated with a 0.19 mmol/L increase in TC (95% CI: 0.07, 0.32), a 0.10 mmol/L increase in HDL-C (95% CI: 0.05, 0.15) and a 0.12 mmol/L increase in LDL-C (95% CI: 0.02, 0.22). We found significant differences in estimated effects by sex, with stronger positive associations between PFASs and TC and LDL-C in girls, and stronger positive associations with HDL-C in boys. Exposure period was a significant modifier of PFAS effects in multiple informant models. CONCLUSIONS:These findings suggest that childhood PFAS exposures may be associated with elevated serum lipid concentrations. This is a public health concern, as a detrimental lipid profile in childhood is a risk factor for later development of hyperlipidemia and cardiovascular disease. KEYWORDS: Chemical exposures, Children's environmental health, Endocrine disrupting chemicals, Obesity and metabolic disorders, PFAS