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Title: Examining confounding by diet in the association between perfluoroalkyl acids and serum cholesterol in pregnancy

Journal Article · · Environmental Research
;  [1];  [2]; ;  [3];  [2];  [4];  [5]
  1. Faculty of Food Science and Nutrition, University of Iceland, Reykjavik (Iceland)
  2. Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus (Denmark)
  3. Division of Environmental Medicine, Norwegian Institute of Public Health, Oslo (Norway)
  4. Pediatric Department, Aarhus University Hospital, Aarhus (Denmark)
  5. Center for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen (Denmark)

Background: Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) have consistently been associated with higher cholesterol levels in cross sectional studies. Concerns have, however, been raised about potential confounding by diet and clinical relevance. Objective: To examine the association between concentrations of PFOS and PFOA and total cholesterol in serum during pregnancy taking into considerations confounding by diet. Methods: 854 Danish women who gave birth in 1988–89 and provided a blood sample and reported their diet in week 30 of gestation. Results: Mean serum PFOS, PFOA and total cholesterol concentrations were 22.3 ng/mL, 4.1 ng/mL and 7.3 mmol/L, respectively. Maternal diet was a significant predictor of serum PFOS and PFOA concentrations. In particular intake of meat and meat products was positively associated while intake of vegetables was inversely associated (P for trend <0.01) with relative difference between the highest and lowest quartile in PFOS and PFOA concentrations ranging between 6% and 25% of mean values. After adjustment for dietary factors both PFOA and PFOS were positively and similarly associated with serum cholesterol (P for trend ≤0.01). For example, the mean increase in serum cholesterol was 0.39 mmol/L (95%CI: 0.09, 0.68) when comparing women in the highest to lowest quintile of PFOA concentrations. In comparison the mean increase in serum cholesterol was 0.61 mmol/L (95%CI: 0.17, 1.05) when comparing women in the highest to lowest quintile of saturated fat intake. Conclusion: In this study associations between PFOS and PFOA with serum cholesterol appeared unrelated to dietary intake and were similar in magnitude as the associations between saturated fat intake and serum cholesterol. - Highlights: • PFOS and PFOA have consistently been linked with raised serum cholesterol • Clinical relevance remains uncertain and confounding by diet has been suggested • The aim of this study was to address these issues in a cohort of 854 pregnant women • With detailed dietary information we found no indication of such confounding • As predictors cholesterol PFOSA and PFOA were similar to other known risk factors.

OSTI ID:
22687707
Journal Information:
Environmental Research, Vol. 143, Issue Part A; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0013-9351
Country of Publication:
United States
Language:
English