Plasma Concentrations of Perfluoroalkyl Substances and Risk of Type 2 Diabetes: A Prospective Investigation among U.S. Women

Qi Sun, Geng Zong, Damaskini Valvi, Flemming Nielsen, Brent Coull, Philippe Grandjean

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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Resumé

BACKGROUND: Emerging evidence suggests that perfluoroalkyl substances (PFASs) are endocrine disruptors and may contribute to the etiology of type 2 diabetes (T2D), but this hypothesis needs to be clarified in prospective human studies. OBJECTIVES: Our objective was to examine the associations between PFAS exposures and subsequent incidence of T2D in the Nurses’ Health Study II (NHSII). In addition, we aimed to evaluate potential demographic and lifestyle determinants of plasma PFAS concentrations. METHODS: A prospective nested case–control study of T2D was conducted among participants who were free of diabetes, cardiovascular disease, and cancer in 1995–2000 [(mean ± SD): 45:3 ±4:4 y) of age]. We identified and ascertained 793 incident T2D cases through 2011 (mean ± SD) years of follow-up: 6:7 ±3:7 y). Each case was individually matched to a control (on age, month and fasting status at sample collection, and menopausal status and hormone replacement therapy). Plasma concentrations of five major PFASs, including perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexanesulfonate, perfluorononanoic acid, and perfluorodecanoic acid were measured. Odds ratios (ORs) of T2D by PFAS tertiles were estimated by conditional logistic regression. RESULTS: Shorter breastfeeding duration and higher intake of certain foods, such as seafood and popcorn, were significantly associated with higher plasma concentrations of PFASs among controls. After multivariate adjustment for T2D risk factors, including body mass index, family history, physical activity, and other covariates, higher plasma concentrations of PFOS and PFOA were associated with an elevated risk of T2D. Comparing extreme tertiles of PFOS or PFOA, ORs were 1.62 (95% CI: 1.09, 2.41; p trend =0:02) and 1.54 (95% CI: 1.04, 2.28; p trend =0:03), respectively. Other PFASs were not clearly associated with T2D risk. C ONCLUSIONS: Background exposures to PFASs in the late 1990s were associated with higher T2D risk during the following years in a prospective case– control study of women from the NHSII. These findings support a potential diabetogenic effect of PFAS exposures.

OriginalsprogEngelsk
Artikelnummer037001
TidsskriftEnvironmental Health Perspectives
Vol/bind126
Udgave nummer3
Antal sider10
ISSN0091-6765
DOI
StatusUdgivet - 1. mar. 2018

Fingeraftryk

Type 2 Diabetes Mellitus
perfluorooctanoic acid
Odds Ratio
Nurses
Endocrine Disruptors
Seafood
Women's Health
Case-Control Studies
Fasting
Body Mass Index
Logistic Models
Prospective Studies
Exercise
Incidence
Health
perfluorooctane sulfonic acid
Neoplasms

Citer dette

@article{e6c4af2fa9fc4f47a957784e91cf9286,
title = "Plasma Concentrations of Perfluoroalkyl Substances and Risk of Type 2 Diabetes: A Prospective Investigation among U.S. Women",
abstract = "BACKGROUND: Emerging evidence suggests that perfluoroalkyl substances (PFASs) are endocrine disruptors and may contribute to the etiology of type 2 diabetes (T2D), but this hypothesis needs to be clarified in prospective human studies. OBJECTIVES: Our objective was to examine the associations between PFAS exposures and subsequent incidence of T2D in the Nurses’ Health Study II (NHSII). In addition, we aimed to evaluate potential demographic and lifestyle determinants of plasma PFAS concentrations. METHODS: A prospective nested case–control study of T2D was conducted among participants who were free of diabetes, cardiovascular disease, and cancer in 1995–2000 [(mean ± SD): 45:3 ±4:4 y) of age]. We identified and ascertained 793 incident T2D cases through 2011 (mean ± SD) years of follow-up: 6:7 ±3:7 y). Each case was individually matched to a control (on age, month and fasting status at sample collection, and menopausal status and hormone replacement therapy). Plasma concentrations of five major PFASs, including perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexanesulfonate, perfluorononanoic acid, and perfluorodecanoic acid were measured. Odds ratios (ORs) of T2D by PFAS tertiles were estimated by conditional logistic regression. RESULTS: Shorter breastfeeding duration and higher intake of certain foods, such as seafood and popcorn, were significantly associated with higher plasma concentrations of PFASs among controls. After multivariate adjustment for T2D risk factors, including body mass index, family history, physical activity, and other covariates, higher plasma concentrations of PFOS and PFOA were associated with an elevated risk of T2D. Comparing extreme tertiles of PFOS or PFOA, ORs were 1.62 (95{\%} CI: 1.09, 2.41; p trend =0:02) and 1.54 (95{\%} CI: 1.04, 2.28; p trend =0:03), respectively. Other PFASs were not clearly associated with T2D risk. C ONCLUSIONS: Background exposures to PFASs in the late 1990s were associated with higher T2D risk during the following years in a prospective case– control study of women from the NHSII. These findings support a potential diabetogenic effect of PFAS exposures.",
keywords = "Journal Article",
author = "Qi Sun and Geng Zong and Damaskini Valvi and Flemming Nielsen and Brent Coull and Philippe Grandjean",
year = "2018",
month = "3",
day = "1",
doi = "10.1289/EHP2619",
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Plasma Concentrations of Perfluoroalkyl Substances and Risk of Type 2 Diabetes : A Prospective Investigation among U.S. Women. / Sun, Qi; Zong, Geng; Valvi, Damaskini; Nielsen, Flemming; Coull, Brent; Grandjean, Philippe.

I: Environmental Health Perspectives, Bind 126, Nr. 3, 037001, 01.03.2018.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Plasma Concentrations of Perfluoroalkyl Substances and Risk of Type 2 Diabetes

T2 - A Prospective Investigation among U.S. Women

AU - Sun, Qi

AU - Zong, Geng

AU - Valvi, Damaskini

AU - Nielsen, Flemming

AU - Coull, Brent

AU - Grandjean, Philippe

PY - 2018/3/1

Y1 - 2018/3/1

N2 - BACKGROUND: Emerging evidence suggests that perfluoroalkyl substances (PFASs) are endocrine disruptors and may contribute to the etiology of type 2 diabetes (T2D), but this hypothesis needs to be clarified in prospective human studies. OBJECTIVES: Our objective was to examine the associations between PFAS exposures and subsequent incidence of T2D in the Nurses’ Health Study II (NHSII). In addition, we aimed to evaluate potential demographic and lifestyle determinants of plasma PFAS concentrations. METHODS: A prospective nested case–control study of T2D was conducted among participants who were free of diabetes, cardiovascular disease, and cancer in 1995–2000 [(mean ± SD): 45:3 ±4:4 y) of age]. We identified and ascertained 793 incident T2D cases through 2011 (mean ± SD) years of follow-up: 6:7 ±3:7 y). Each case was individually matched to a control (on age, month and fasting status at sample collection, and menopausal status and hormone replacement therapy). Plasma concentrations of five major PFASs, including perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexanesulfonate, perfluorononanoic acid, and perfluorodecanoic acid were measured. Odds ratios (ORs) of T2D by PFAS tertiles were estimated by conditional logistic regression. RESULTS: Shorter breastfeeding duration and higher intake of certain foods, such as seafood and popcorn, were significantly associated with higher plasma concentrations of PFASs among controls. After multivariate adjustment for T2D risk factors, including body mass index, family history, physical activity, and other covariates, higher plasma concentrations of PFOS and PFOA were associated with an elevated risk of T2D. Comparing extreme tertiles of PFOS or PFOA, ORs were 1.62 (95% CI: 1.09, 2.41; p trend =0:02) and 1.54 (95% CI: 1.04, 2.28; p trend =0:03), respectively. Other PFASs were not clearly associated with T2D risk. C ONCLUSIONS: Background exposures to PFASs in the late 1990s were associated with higher T2D risk during the following years in a prospective case– control study of women from the NHSII. These findings support a potential diabetogenic effect of PFAS exposures.

AB - BACKGROUND: Emerging evidence suggests that perfluoroalkyl substances (PFASs) are endocrine disruptors and may contribute to the etiology of type 2 diabetes (T2D), but this hypothesis needs to be clarified in prospective human studies. OBJECTIVES: Our objective was to examine the associations between PFAS exposures and subsequent incidence of T2D in the Nurses’ Health Study II (NHSII). In addition, we aimed to evaluate potential demographic and lifestyle determinants of plasma PFAS concentrations. METHODS: A prospective nested case–control study of T2D was conducted among participants who were free of diabetes, cardiovascular disease, and cancer in 1995–2000 [(mean ± SD): 45:3 ±4:4 y) of age]. We identified and ascertained 793 incident T2D cases through 2011 (mean ± SD) years of follow-up: 6:7 ±3:7 y). Each case was individually matched to a control (on age, month and fasting status at sample collection, and menopausal status and hormone replacement therapy). Plasma concentrations of five major PFASs, including perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexanesulfonate, perfluorononanoic acid, and perfluorodecanoic acid were measured. Odds ratios (ORs) of T2D by PFAS tertiles were estimated by conditional logistic regression. RESULTS: Shorter breastfeeding duration and higher intake of certain foods, such as seafood and popcorn, were significantly associated with higher plasma concentrations of PFASs among controls. After multivariate adjustment for T2D risk factors, including body mass index, family history, physical activity, and other covariates, higher plasma concentrations of PFOS and PFOA were associated with an elevated risk of T2D. Comparing extreme tertiles of PFOS or PFOA, ORs were 1.62 (95% CI: 1.09, 2.41; p trend =0:02) and 1.54 (95% CI: 1.04, 2.28; p trend =0:03), respectively. Other PFASs were not clearly associated with T2D risk. C ONCLUSIONS: Background exposures to PFASs in the late 1990s were associated with higher T2D risk during the following years in a prospective case– control study of women from the NHSII. These findings support a potential diabetogenic effect of PFAS exposures.

KW - Journal Article

U2 - 10.1289/EHP2619

DO - 10.1289/EHP2619

M3 - Journal article

C2 - 29498927

VL - 126

JO - Environmental Health Perspectives

JF - Environmental Health Perspectives

SN - 0091-6765

IS - 3

M1 - 037001

ER -