Early life exposure to per- and polyfluoroalkyl substances and mid-childhood lipid and alanine aminotransferase levels

Environ Int. 2018 Feb;111:1-13. doi: 10.1016/j.envint.2017.11.008. Epub 2017 Nov 20.


Background: Growing evidence suggests that exposure to per- and polyfluoroalkyl substances (PFASs) may disrupt lipid homeostasis and liver function, but data in children are limited.

Objective: We examined the association of prenatal and mid-childhood PFAS exposure with lipids and alanine aminotransferase (ALT) levels in children.

Methods: We studied 682 mother-child pairs from a Boston-area pre-birth cohort. We quantified PFASs in maternal plasma collected in pregnancy (median 9.7weeks gestation, 1999-2002) and in child plasma collected in mid-childhood (median age 7.7years, 2007-2010). In mid-childhood we also measured fasting total (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and ALT. We then derived low-density lipoprotein cholesterol (LDL-C) from TC, HDL-C, and TG using the Friedewald formula.

Results: Median (interquartile range, IQR) perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA), and perfluorodecanoate (PFDeA) concentrations in child plasma were 6.2 (5.5), 4.3 (3.0), and 0.3 (0.3) ng/mL, respectively. Among girls, higher child PFOS, PFOA, and PFDeA concentrations were associated with detrimental changes in the lipid profile, including higher TC and/or LDL-C [e.g., β per IQR increment in PFOS=4.0mg/dL (95% CI: 0.3, 7.8) for TC and 2.6mg/dL (-0.5, 5.8) for LDL-C]. However, among both boys and girls, higher plasma concentrations of these child PFASs were also associated with higher HDL-C, which predicts better cardiovascular health, and slightly lower ALT, which may indicate better liver function. Prenatal PFAS concentrations were also modestly associated with improved childhood lipid and ALT levels.

Conclusions: Our data suggest that prenatal and mid-childhood PFAS exposure may be associated with modest, but somewhat conflicting changes in the lipid profile and ALT levels in children.

Keywords: Childhood; Lipids; Liver function; Per- and polyfluoroalkyl substances; Pregnancy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Alanine Transaminase / blood*
  • Alkanesulfonic Acids / blood*
  • Caprylates / blood*
  • Child
  • Cohort Studies
  • Decanoic Acids / blood*
  • Environmental Exposure
  • Environmental Pollutants / blood
  • Female
  • Fluorocarbons / blood*
  • Humans
  • Lipids / blood*
  • Male
  • Maternal-Fetal Exchange
  • Pregnancy
  • Young Adult


  • Alkanesulfonic Acids
  • Caprylates
  • Decanoic Acids
  • Environmental Pollutants
  • Fluorocarbons
  • Lipids
  • perfluorodecanoic acid
  • perfluorooctanoic acid
  • perfluorooctane sulfonic acid
  • Alanine Transaminase