Prenatal exposure to per- and polyfluoroalkyl substances and early childhood adiposity and cardiometabolic health in the Healthy Start study

• Published in: International Journal of Obesity Vol. 48; no. 2; pp. 276 - 283
• Main Authors: Starling, Anne P., Friedman, Chloe, Boyle, Kristen E., Adgate, John L., Glueck, Deborah H., Allshouse, William B., Calafat, Antonia M., Bloemsma, Lizan D., Dabelea, Dana
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.02.2024; Nature Publishing Group
• Subjects: 692/308/174; 692/499; Adipose tissue; Adiposity; Bayes Theorem; Bayesian analysis; Biomarkers; Body composition; Body fat; Body mass index; Body size; Body weight; Caprylates; Cardiovascular Diseases - chemically induced; Child; Child, Preschool; Childhood; Children; Environmental Pollutants; Epidemiology; Evaluation; Exposure; Female; Fluorocarbons; Health Promotion and Disease Prevention; Humans; Internal Medicine; Lipids; Mathematical models; Medicine; Medicine & Public Health; Metabolic Diseases; Mixtures; Pediatric Obesity - chemically induced; Pediatric Obesity - epidemiology; Perfluoroalkyl & polyfluoroalkyl substances; Perfluorochemicals; Perfluorooctanoic acid; Plethysmography; Pregnancy; Prenatal experience; Prenatal exposure; Prenatal Exposure Delayed Effects - chemically induced; Public Health; Regression analysis; Regression models; Serum lipids
• ISSN: 0307-0565; 1476-5497; 1476-5497
• DOI: 10.1038/s41366-023-01420-3

Background/Objectives Observational and experimental studies have suggested that prenatal exposure to per- and polyfluoroalkyl substances (PFAS) can increase childhood adiposity and cardiometabolic disruption. However, most previous studies have used weight-based measures that cannot distinguish between fat mass and lean mass. We evaluated associations of prenatal PFAS exposure with precisely measured body composition and cardiometabolic biomarkers in early childhood. Subjects 373 eligible mother-infant pairs in the Healthy Start longitudinal cohort. Methods We used multiple linear regression and Bayesian kernel machine regression models to estimate associations between five PFAS in maternal mid-pregnancy serum, and early childhood adiposity via air displacement plethysmography. Secondary outcomes included body mass index, waist circumference, and fasting serum lipids, glucose, insulin and adipokines. Models were adjusted for potential confounders and effect modification by child sex was evaluated. Results The median age of children at assessment was 4.6 years. Prenatal concentration of perfluorooctanoate (PFOA) was positively associated with percent fat mass (0.89% per log 2 -unit increase, 95% CI: 0.15, 1.64), while perfluorononanoate (PFNA) was positively associated with fat mass index and body mass index. Cardiometabolic markers in blood were generally not associated with prenatal PFAS in this population. Mixture models confirmed the importance of PFNA and PFOA in predicting percent fat mass, while PFNA was most important for fat mass index, body mass index, and waist circumference. There were no significant effects of the five PFAS as a mixture, potentially due to opposing effects of different PFAS. Conclusions Our results agree with previous studies showing that prenatal serum concentrations of certain PFAS are positively associated with early childhood adiposity. Notably, associations were stronger for measures incorporating precisely measured fat mass compared to measures of body size or weight. Early life increases in adiposity may precede the development of adverse cardiometabolic health outcomes in children exposed to PFAS during gestation.