Background: Perfluorooctanoate (PFOA) has been used extensively in the manufacture of both commercial and household products. PFOA serum concentrations have been associated with adverse health effects, including lower body mass in children and infants.
Objective: To determine if there is an association between serum PFOA concentration and body mass, serum insulin and lipid profile in exposed young girls.
Methods: We conducted a cross-sectional study of PFAS environmental biomarkers and insulin resistance in 6 to 8 year-old girls from Greater Cincinnati (n=353). In 2004-2006, blood samples were obtained to measure polyfluoroalkyl substances (PFAS), fasting insulin, glucose and lipids. Clinical exams included anthropometric measurements and pubertal maturation staging. Linear regression and mediation analyses, specifically structural equation modeling (SEM), were used to determine the strength and direction of the relationships between PFAS, pubertal maturation status, body mass index (BMI), cholesterol and insulin resistance.
Results: The median PFOA (7.7ng/ml) was twice the National Health and Nutrition Examination Survey (2005-2006). Only PFOA, a PFAS sub-species, showed statistically significant relationships with the outcomes. In regression models, PFOA was associated with decreased BMI and waist-to-height ratio (p=0.0008; p=0.0343), HDL-cholesterol (p=0.0046) and had a borderline inverse association with the HOMA Index of insulin resistance (p=0.0864). In SEM, PFOA retained an inverse relationship with BMI (p<0.0001) but the relationships with HOMA and HDL-cholesterol were no longer statistically significant. Pubertal initiation (Tanner breast or pubic stage 2 or greater) and BMI were associated with increased HOMA Index (p<0.0001).
Conclusions: These findings suggest PFOA exposure in young girls affects both BMI and ultimately insulin resistance. In mediation analysis with puberty in the model, the direct effects of PFOA on insulin resistance and were reduced.
Keywords: Children; Cholesterol; Insulin resistance; Perfluorooctanoate; Structural equation modeling.
Copyright © 2019 Elsevier Inc. All rights reserved.
Conflict of interest statement
COMPETING FINANCIAL INTERESTS
Authors have no conflicts of interest to report.
Perfluorooctanoate and changes in anthropometric parameters with age in young girls in the Greater Cincinnati and San Francisco Bay Area.Int J Hyg Environ Health. 2019 Aug;222(7):1038-1046. doi: 10.1016/j.ijheh.2019.07.002. Epub 2019 Jul 9. Int J Hyg Environ Health. 2019. PMID: 31300293
Association of Pubertal Development With Adiposity and Cardiometabolic Health in Girls and Boys-Findings From the Generation XXI Birth Cohort.J Adolesc Health. 2019 Oct;65(4):558-563. doi: 10.1016/j.jadohealth.2019.05.014. Epub 2019 Jul 31. J Adolesc Health. 2019. PMID: 31377165
[Visceral adiposity and its association with serum lipids in female obese teenagers].Rev Med Chil. 2007 Mar;135(3):294-300. doi: 10.4067/s0034-98872007000300003. Epub 2007 Apr 26. Rev Med Chil. 2007. PMID: 17505574 Spanish.
PFOA is associated with diabetes and metabolic alteration in US men: National Health and Nutrition Examination Survey 2003-2012.Sci Total Environ. 2018 Jun 1;625:566-574. doi: 10.1016/j.scitotenv.2017.12.186. Epub 2017 Dec 30. Sci Total Environ. 2018. PMID: 29291571
Sexual dimorphisms in the associations of BMI and body fat with indices of pubertal development in girls and boys.J Clin Endocrinol Metab. 2014 Aug;99(8):E1519-29. doi: 10.1210/jc.2014-1384. Epub 2014 Apr 29. J Clin Endocrinol Metab. 2014. PMID: 24780051 Free PMC article.
- P30 ES013508/ES/NIEHS NIH HHS/United States
- UL1 RR026314/RR/NCRR NIH HHS/United States
- U01 ES019453/ES/NIEHS NIH HHS/United States
- T32 GM063483/GM/NIGMS NIH HHS/United States
- U01 ES012770/ES/NIEHS NIH HHS/United States