Per- and polyfluoroalkyl substance concentrations during pregnancy and post-pregnancy biomarkers of cardiometabolic health in Project Viva

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OPS 20: Chemicals, biomarkers, omics, Room 110, Floor 1, August 27, 2019, 4:30 PM - 5:30 PM Background/Aim: Per- and polyfluoroalkyl substances (PFAS) are persistent chemicals linked to weight gain and type 2 diabetes. We tested whether PFAS concentrations during pregnancy are associated with postpartum biomarkers of cardiometabolic disease. Methods: We studied 1,631 women recruited 1999-2002 in the Project Viva cohort with pregnancy (median 9.7 weeks, range 4.8-21.4) plasma measurements of 6 PFAS, including perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and 2-(N-ethyl-perfluorooctane sulfonamide) acetic acid (Et-PFOSA-AcOH). PFAS were log2-transformed. At 3 years post-pregnancy we measured anthropometry and, in a subset, serum biomarkers including sex hormone binding globulin (SHBG), interleukin-6 (IL-6), and hemoglobin A1c (HbA1c). We excluded women who were pregnant within the last 6 months (n=193); the analysis sample was n=831 after loss to follow-up. We used multivariable regression, adjusting for age, pre-pregnancy body mass index, marital status, race/ethnicity, education, income, smoking, and parity. We multiply imputed missing covariates and adjusted for loss to follow-up using inverse probability of censoring weights. Results: PFAS exposure was associated with greater triceps skinfold thickness (0.69 [95%CI: 0.10, 1.28] mm per doubling in PFOS and 0.72 [95%CI: 0.06, 1.38] mm per doubling of PFOA) and greater subscapular skinfold thickness (0.53 [95%CI: -0.03, 1.09] mm per doubling in PFOS and 0.42 [95%CI: 0.02, 0.82] mm per doubling of Et-PFOSA-AcOH). PFAS were also associated with greater mid-upper arm circumference (0.27 [95%CI: -0.01, 0.54] cm per doubling of PFOA and 0.18 [95%CI: -0.01, 0.36] cm per doubling of Et-PFOSA-AcOH) and greater waist circumference (0.55 [95%CI: 0.06, 1.05] cm per doubling in Et-PFOSA-AcOH). Finally, each doubling of Et-PFOSA-AcOH was associated with lower log-SHBG (-0.06 mg/L [95%CI: -0.11, -0.00]), higher log-IL-6 (0.11 pg/mL [95%CI: 0.04, 0.18]) and higher HbA1c (0.030% [95%CI: 0.01, 0.05]). Conclusions: Though effect sizes are small, the direction of associations taken together suggests PFAS exposure is associated with an unfavorable cardiometabolic profile.