Periods of Susceptibility: Exposure to Per- and Polyfluoroalkyl Substances and Children’s Body Composition

Abstract

Background/Aim: Some epidemiological studies suggest that per- and polyfluoroalkyl substances (PFAS) exposure may increase adiposity and obesity risk in children. However, we are unaware of any studies extending these findings into adolescence or identifying potential periods of heightened susceptibility. Thus, we estimated associations of five repeated measures of pre- and postnatal PFAS exposure with body composition in adolescence.Methods: We studied 212 mother-offspring pairs from the HOME Study, a prospective pregnancy and birth cohort study that enrolled pregnant women in Cincinnati, OH from 2003-2006. We quantified serum perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA), perfluorononanoate (PFNA), and perfluorohexane sulfonate (PFHxS) concentrations in mothers at ~16 weeks gestation and their children at birth and ages 3, 8, and 12 years. At 12 years, we assessed children’s adiposity using anthropometry and dual X-ray absorptiometry (DXA). We used multiple informant models to estimate covariate-adjusted associations of ln-transformed PFAS with adiposity measures for each exposure period, and tested the difference in these associations.Results: Prenatal serum concentrations of all four PFAS were positively associated with body fat, but there was no clear pattern for postnatal PFAS exposures. For instance, each ln-transformed increase in prenatal PFOA and PFHxS was associated with higher android (PFOA: β=1.9%, 95%CI: 0.0, 3.8; PFHxS: β=2.0%, 95%CI: 0.2, 3.9) and visceral fat percent (PFOA: β=1.9%, 95%CI: -0.2, 3.9; PFHxS: β=2.4%, 95%CI: 0.5, 4.4). Associations were generally stronger for central adiposity measures compared to peripheral ones. In multipollutant models, prenatal PFOA and PFHxS were more strongly associated with body fat than PFOS and PFNA. We observed evidence suggesting that prenatal PFOA was more strongly associated with greater adiposity in girls, but not boys.Conclusions: Prenatal, but not postnatal, serum concentrations of PFAS, particularly PFOA and PFHxS, were positively associated with measures of central body fat in adolescence.