Abstract
BackgroundStudies exploring the associations between perfluoroalkyl acids (PFAAs) and type 2 diabetes mellitus (T2DM) are rather limited and have reported conflicting results. All studies to date, including prospective ones, have relied on a single blood sample to study this association. Similarly, studies investigating how T2DM status may influence the longitudinal changes in PFAA concentrations have not been previously performed. As PFAA concentrations in humans have changed considerably over the last two decades, and as individuals diagnosed with T2DM usually undergo lifestyle changes that could influence these concentrations, a single blood sample may not necessarily reflect the life-time exposure to PFAA concentrations. Hence, repeated measurements from the same individuals will extend our understanding of how PFAAs are associated with T2DM. The present study, therefore, aimed to explore associations between pre- and post-diagnostic PFAA blood profiles and T2DM and assess factors associated with longitudinal changes in PFAAs in T2DM cases and controls. MethodsQuestionnaire data and blood samples from women participating in the Norwegian Women and Cancer study were used to conduct a nested case-control study among 46 T2DM cases matched to 85 non-diabetic controls. PFAAs were measured in blood samples collected prior to (2001/02) and after (2005/6) T2DM diagnosis. We investigated the association between PFAAs and incident and prevalent T2DM using conditional logistic regression. We assessed the longitudinal changes in PFAA concentrations within and between matched cases and controls using t-tests and linear regression models. ResultsWe observed no significant associations between pre-diagnostic PFAA concentrations and T2DM incidence. Similar results were observed for the post-diagnostic PFAA concentrations and T2DM prevalence. Decrease over time in PFAA concentrations were observed for PFOA and ∑PFOS concentrations, whereas increase over time were observed for PFNA, PFDA and PFUnDA concentrations. Longitudinal trends in PFAA concentrations among T2DM cases were similar to the changes observed in controls. ConclusionsThe study did not find evidence of association between PFAAs and incident or prevalent T2DM. The longitudinal changes in PFAAs concentrations were not influenced by T2DM status.
Highlights
The prevalence of type 2 diabetes mellitus (T2DM), a metabolic condition characterized by elevated blood glucose levels, has increased alarmingly worldwide and accounts for 90% of all diabetes (Saeedi et al, 2019)
type 2 diabetes mel litus (T2DM), previous studies have shown that dietary factors as sociated with increased risk for T2DM are linked with other unhealthy lifestyle factors which showed highly significant associations with T2DM, such as physical inactivity and increased body mass index (BMI) (Aune et al, 2009; Bellou et al, 2018; Imamura et al, 2015)
In contrast to our results, positive, significant associations between pre-diagnostic perfluorooctanoic acid (PFOA) concentrations (3rd vs. 1st tertile odds ratios (ORs): 1.54, 95% confidence interval (CI): 1.04, 2.28), perfluorooctane sulfonate (PFOS) concentrations (3rd vs. 1st tertile OR: 1.62, 95% CI: 1.09, 2.41), and incident T2DM were reported by a re cent, prospective, nested case-control study (n = 1586, 793 T2DM cases) conducted among women from the United States Nurses Health Study II
Summary
The prevalence of type 2 diabetes mellitus (T2DM), a metabolic condition characterized by elevated blood glucose levels, has increased alarmingly worldwide and accounts for 90% of all diabetes (Saeedi et al, 2019). Studies exploring the associations between perfluoroalkyl acids (PFAAs) and type 2 diabetes mel litus (T2DM) are rather limited and have reported conflicting results. Studies investigating how T2DM status may influence the longitudinal changes in PFAA concentrations have not been previously performed. The present study, aimed to explore associations between pre- and post-diagnostic PFAA blood profiles and T2DM and assess factors associated with longitudinal changes in PFAAs in T2DM cases and controls. We investigated the association between PFAAs and incident and prevalent T2DM using conditional lo gistic regression. Results: We observed no significant associations between pre-diagnostic PFAA concentrations and T2DM in cidence. Similar results were observed for the post-diagnostic PFAA concentrations and T2DM prevalence. Longitudinal trends in PFAA concentrations among T2DM cases were similar to the changes observed in controls. The longitudinal changes in PFAAs concentrations were not influenced by T2DM status
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