Evaluating the association between longitudinal exposure to a PFAS mixture and adolescent cardiometabolic risk in the HOME Study

Elvira S Fleury; Jordan R Kuiper; Jessie P Buckley; George D Papandonatos; Kim M Cecil; Aimin Chen; Charles B Eaton; Heidi J Kalkwarf; Bruce P Lanphear; Kimberly Yolton; Joseph M Braun

doi:10.1097/EE9.0000000000000289

Evaluating the association between longitudinal exposure to a PFAS mixture and adolescent cardiometabolic risk in the HOME Study

Environ Epidemiol. 2024 Jan 12;8(1):e289. doi: 10.1097/EE9.0000000000000289. eCollection 2024 Feb.

Authors

Affiliations

¹ Department of Epidemiology, Brown University, Providence, RI.
² Department of Environmental and Occupational Health, The George Washington University Milken Institute School of Public Health, Washington, D.C.
³ Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.
⁴ Department of Biostatistics, Brown University, Providence, RI.
⁵ Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH.
⁶ Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
⁷ Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI.
⁸ Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH.
⁹ Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada.

Abstract

Background: Exposure to per- and polyfluoroalkyl substances (PFAS) throughout gestation and childhood may impact cardiometabolic risk.

Methods: In 179 HOME Study participants (Cincinnati, OH; recruited 2003-2006), we used latent profile analysis to identify two distinct patterns of PFAS exposure from serum concentrations of four PFAS measured at birth and ages 3, 8, and 12 years. We assessed the homeostatic model of insulin resistance, triglycerides-to-high-density lipoprotein cholesterol ratio, leptin-to-adiponectin ratio, systolic blood pressure, visceral fat, and hemoglobin A1c levels at age 12 years. We used multivariable linear regression to assess the association of membership in the longitudinal PFAS mixture exposure group with a summary measure of overall cardiometabolic risk and individual components.

Results: One PFAS exposure profile (n = 66, 39%) had higher geometric means of all PFAS across all visits than the other. Although adjusted associations were null in the full sample, child sex modified the association of longitudinal PFAS mixture exposure group with overall cardiometabolic risk, leptin-to-adiponectin ratio, systolic blood pressure, and visceral fat (interaction term P values: 0.02-0.08). Females in the higher exposure group had higher cardiometabolic risk scores (ß = 0.43; 95% CI = -0.08, 0.94), systolic blood pressures (ß = 0.6; 95% CI = 0.1, 1.1), and visceral fat (ß = 0.44; 95% CI = -0.13, 1.01); males had lower cardiometabolic risk scores (ß = -0.52; 95% CI = -1.06, -0.06), leptin-to-adiponectin ratios (ß = -0.7; 95% CI = -1.29, -0.1), systolic blood pressures (ß = -0.14; 95% CI = -0.7, 0.41), and visceral fat (ß = -0.52; 95% CI = -0.84, -0.19).

Conclusions: Exposure to this PFAS mixture throughout childhood may have sex-specific effects on adolescent cardiometabolic risk.

Keywords: Adolescents; Cardiometabolic risk; Chemical mixture; Latent profile analysis; polyfluoroalkyl substances.

Abstract

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