Estimating effects of longitudinal and cumulative exposure to PFAS mixtures on early adolescent body composition

Am J Epidemiol. 2024 Jun 3;193(6):917-925. doi: 10.1093/aje/kwae014.

Abstract

Few methods have been used to characterize repeatedly measured biomarkers of chemical mixtures. We applied latent profile analysis (LPA) to serum concentrations of 4 perfluoroalkyl and polyfluoroalkyl substances (PFAS) measured at 4 time points from gestation to age 12 years. We evaluated the relationships between profiles and z scores of height, body mass index, fat mass index, and lean body mass index at age 12 years (n = 218). We compared LPA findings with an alternative approach for cumulative PFAS mixtures using g-computation to estimate the effect of simultaneously increasing the area under the receiver operating characteristic curve (AUC) for all PFAS. We identified 2 profiles: a higher PFAS profile (35% of sample) and a lower PFAS profile (relative to each other), based on their average PFAS concentrations at all time points. The higher PFAS profile had generally lower z scores for all outcomes, with somewhat larger effects for males, though all 95% CIs crossed the null. For example, the higher PFAS profile was associated with a 0.50-unit lower (β = -0.50; 95% CI, -1.07 to 0.08) BMI z score among males but not among females (β = 0.04; 95% CI, -0.45 to 0.54). We observed similar patterns with AUCs. We found that a higher childhood PFAS profile and higher cumulative PFAS mixtures may be associated with altered growth in early adolescence. This article is part of a Special Collection on Environmental Epidemiology.

Keywords: PFAS; adolescence; area under the receiver operating characteristic curve; body composition; latent profile analysis; perfluoroalkyl and polyfluoroalkyl substances.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Alkanesulfonic Acids / blood
  • Body Composition* / drug effects
  • Body Mass Index*
  • Caprylates / blood
  • Child
  • Child, Preschool
  • Environmental Exposure* / adverse effects
  • Environmental Exposure* / analysis
  • Environmental Pollutants / blood
  • Female
  • Fluorocarbons* / blood
  • Humans
  • Longitudinal Studies
  • Male
  • Pregnancy
  • Prenatal Exposure Delayed Effects

Substances

  • Fluorocarbons
  • Environmental Pollutants
  • Alkanesulfonic Acids
  • Caprylates