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. 2019 Aug;127(8):87006.
doi: 10.1289/EHP4918. Epub 2019 Aug 21.

Per- And Polyfluoroalkyl Substance Plasma Concentrations and Bone Mineral Density in Midchildhood: A Cross-Sectional Study (Project Viva, United States)

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Free PMC article

Per- And Polyfluoroalkyl Substance Plasma Concentrations and Bone Mineral Density in Midchildhood: A Cross-Sectional Study (Project Viva, United States)

Rachel Cluett et al. Environ Health Perspect. .
Free PMC article

Abstract

Background: Identifying factors that impair bone accrual during childhood is a critical step toward osteoporosis prevention. Exposure to per- and polyfluoroalkyl substances (PFASs) has been associated with lower bone mineral density, but data are limited, particularly in children.

Methods: We studied 576 children in Project Viva, a Boston-area cohort of mother/child pairs recruited prenatally from 1999 to 2002. We quantified plasma concentrations of several PFASs and measured areal bone mineral density (aBMD) by dual-energy X-ray absorptiometry (DXA) in midchildhood. We used linear regression to examine associations between plasma concentrations of individual PFASs and aBMD z-score. We used weighted quantile sum (WQS) regression to examine the association of the PFAS mixture with aBMD z-score. All models were adjusted for maternal age, education, annual household income, census tract median household income, and child age, sex, race/ethnicity, dairy intake, physical activity, and year of blood draw.

Results: Children were [[Formula: see text]] [Formula: see text] of age. The highest PFAS plasma concentrations were of perfluorooctanesulfonic acid (PFOS) {median [interquartile range (IQR)]: 6.4 (5.6) ng/mL} and perfluorooctanoic acid (PFOA) [median (IQR): 4.4 (3.2) ng/mL]. Using linear regression, children with higher plasma concentrations of PFOA, PFOS, and perfluorodecanoate (PFDA) had lower aBMD z-scores [e.g., [Formula: see text]: [Formula: see text]; 95% confidence interval (CI): [Formula: see text], [Formula: see text] per doubling of PFOA]. The PFAS mixture was negatively associated with aBMD z-score ([Formula: see text]: [Formula: see text]; 95% CI: [Formula: see text], [Formula: see text] per IQR increment of the mixture index).

Conclusions: PFAS exposure may impair bone accrual in childhood and peak bone mass, an important determinant of lifelong skeletal health. https://doi.org/10.1289/EHP4918.

Figures

Figure 1 is a graphical representation plotting change in aBMD z-score per doubling of PFAS concentration (95 percent confidence interval) (y-axis) across PFASs, namely, PFOA, PFOS, PFDA, PFHxS, MeFOSAA, and PFNA (x-axis).
Figure 1.
Single-per- and polyfluoroalkyl substance (PFAS) models showing adjusted associations of individual PFAS plasma concentrations with areal bone mineral density (aBMD) z-score. Note: Adjusted for maternal age, education, census tract median household income, individual household income, and child age, sex, race/ethnicity, year of blood draw, dairy intake, and physical activity. n=531 for all single-PFAS models. CI, confidence interval; PFOA, perfluorooctanoic acid; PFOS, perfluorooctanesulfonic acid; PFDA, perfluorodecanoate; PFHxS, perfluorohexane sulfonate; MeFOSAA, 2-(N-methyl-perfluorooctane sulfonamide) acetate; PFNA, perfluorononanoate.
Figure 2 is a graphical representation plotting change in aBMD z-score per doubling of PFAS concentration (95 percent confidence interval) (y-axis) across PFASs, namely, PFOA, PFOS, PFDA, PFHxS, MeFOSAA, and PFNA (x-axis).
Figure 2.
Multi-per- and polyfluoroalkyl substance (PFAS) model showing adjusted associations of PFAS plasma concentrations with areal bone mineral density (aBMD) z-score. Note: Adjusted for maternal age, education, census tract median household income, individual household income, and child age, sex, race/ethnicity, year of blood draw, dairy intake, and physical activity. n=531. CI, confidence interval; PFOA, perfluorooctanoic acid; PFOS, perfluorooctanesulfonic acid; PFDA, perfluorodecanoate; PFHxS, perfluorohexane sulfonate; MeFOSAA - 2-(N-methyl-perfluorooctane sulfonamide) acetate; PFNA, perfluorononanoate.

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