Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

PFAS Concentrations and Cardiometabolic Traits in Highly Exposed Children and Adolescents

Version 1 : Received: 21 October 2021 / Approved: 22 October 2021 / Online: 22 October 2021 (12:07:37 CEST)

A peer-reviewed article of this Preprint also exists.

Canova, C.; Di Nisio, A.; Barbieri, G.; Russo, F.; Fletcher, T.; Batzella, E.; Dalla Zuanna, T.; Pitter, G. PFAS Concentrations and Cardiometabolic Traits in Highly Exposed Children and Adolescents. Int. J. Environ. Res. Public Health 2021, 18, 12881. Canova, C.; Di Nisio, A.; Barbieri, G.; Russo, F.; Fletcher, T.; Batzella, E.; Dalla Zuanna, T.; Pitter, G. PFAS Concentrations and Cardiometabolic Traits in Highly Exposed Children and Adolescents. Int. J. Environ. Res. Public Health 2021, 18, 12881.

Abstract

Background: Residents of a large area of North-Eastern Italy were exposed for decades to high concentrations of perfluoroalkyl and polyfluoroalkyl substances (PFAS) via drinking water. Despite the large amount of evidence in adults of a positive association between serum PFAS and metabolic outcomes, studies focusing on children and adolescents are limited. We evaluated the associations between serum PFAS concentrations and lipid profile, blood pressure and body mass index (BMI) in highly exposed adolescents and children. Methods: A cross-sectional analysis was conducted in 6669 adolescents (14-19 years) and 2693 children (8-11 years) enrolled in the health surveillance program of the Veneto Region. Non-fasting blood samples were obtained and analyzed for perfluorooctanoic acid (PFOA) perfluorooctane sulfonate (PFOS), perfluorohexanesulfonic acid (PFHxS), perfluorononanoic acid (PFNA), total cholesterol (TC) high-density lipoprotein cholesterol (HDL-C) and triglycerides. Low-density lipoprotein cholesterol (LDL-C) was calculated. Systolic and diastolic blood pressure (BP) were measured and BMI z-score accounting for age and sex was estimated. The associations between ln-transformed PFAS (and categorized into quartiles) and continuous outcomes were assessed using generalized additive models. Analyses were stratified by gender and adjusted for potential confounders. Results: Among adolescents, significant associations were detected between all investigated PFAS and TC, LDL-C, and to a fewer extent HDL-C. Among children, PFOS and PFNA had significant associations with TC, LDL-C and HDL-C, while PFOA and PFHxS had significant associations with HDL-C only. Increased serum concentrations of PFAS, particularly PFOS, were associated with decreased BMI z-score. No statistically significant associations were observed between PFAS concentrations and BP. Conclusions: Our study supports a consistent association between PFAS concentration and serum lipids, stronger for PFOS and PFNA and with a greater magnitude among children compared to adolescents, and a negative association of PFAS with BMI.

Keywords

perfluoroalkyl substances (PFAS); children; adolescents; lipid profile; cholesterol; generalized additive model

Subject

Environmental and Earth Sciences, Environmental Science

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