Diabetologia

, Volume 57, Issue 3, pp 473–479

Circulating levels of perfluoroalkyl substances and prevalent diabetes in the elderly

  • Lars Lind
  • Björn Zethelius
  • Samira Salihovic
  • Bert van Bavel
  • P. Monica Lind
Article

DOI: 10.1007/s00125-013-3126-3

Cite this article as:
Lind, L., Zethelius, B., Salihovic, S. et al. Diabetologia (2014) 57: 473. doi:10.1007/s00125-013-3126-3

Abstract

Aims/hypothesis

Several environmental contaminants, such as polychlorinated biphenyls, dioxins, bisphenol A and phthalates, have been linked to diabetes. We therefore investigated whether other kinds of contaminants, perfluoroalkyl substances (PFAS), also called perfluorinated compounds (PFCs), are also associated with diabetes.

Methods

The Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study investigated 1,016 men and women aged 70 years. Seven PFAS were detected in almost all participant sera by ultra-high performance liquid chromatograph/tandem mass spectrometry. Diabetes was defined as use of hypoglycaemic agents or fasting glucose >7.0 mmol/l.

Results

114 people had diabetes. In the linear analysis, no significant relationships were seen between the seven PFAS and prevalent diabetes. However, inclusion of the quadratic terms of the PFAS revealed a significant non-linear relationship between perfluorononanoic acid (PFNA) and diabetes, even after adjusting for multiple confounders (OR 1.96, 95% CI 1.19, 3.22, p = 0.008 for the linear term and OR 1.25, 95% CI 1.08, 1.44, p = 0.002 for the quadratic term). Perfluorooctanoic acid (PFOA) also showed such a relationship (p = 0.01). PFOA was related to the proinsulin/insulin ratio (a marker of insulin secretion), but none of the PFAS was related to the HOMA-IR (a marker of insulin resistance) following adjustment for multiple confounders.

Conclusions/interpretation

PFNA was related to prevalent diabetes in a non-monotonic fashion in this cross-sectional study, supporting the view that this perfluoroalkyl substance might influence glucose metabolism in humans at the level of exposure seen in the general elderly population.

Keywords

Diabetes Elderly Environmental contaminants Epidemiology Insulin Perfluoroalkyl substances 

Abbreviations

L-PFOS

Linear isomer of perfluorooctane sulfonic acid

PCB

Polychlorinated biphenyl

PFAS

Perfluoroalkyl substances

PFBuS

Perfluorobutane sulfonic acid

PFC

Perfluorinated compound

PFDA

Perfluorodecanoic acid

PFDS

Perfluorodecane sulfonic acid

PFDoDA

Perfluorododecanoic acid

PFHpA

Perfluoroheptanoic acid

PFHxA

Perfluorohexanoic acid

PFHxS

Perfluorohexane sulfonic acid

PFNA

Perfluorononanoic acid

PFOA

Perfluorooctanoic acid

PFOS

Perfluorooctane sulfonic acid

PFOSA

Perfluorooctane sulfonamide

PFPeA

Perfluoropentanoic acid

PFTrDA

Perfluorotridecanoic acid

PFUnDA

Perfluoroundecanoic acid

PIVUS

Prospective Investigation of the Vasculature in Uppsala Seniors

PPAR

Peroxisome proliferator-activated receptor

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Lars Lind
    • 1
  • Björn Zethelius
    • 2
    • 3
  • Samira Salihovic
    • 1
    • 4
  • Bert van Bavel
    • 4
  • P. Monica Lind
    • 5
  1. 1.Department of Medical Sciences, Cardiovascular EpidemiologyUppsala UniversityUppsalaSweden
  2. 2.Department of Public Health/GeriatricsUppsala UniversityUppsalaSweden
  3. 3.Medical Product AgencyUppsalaSweden
  4. 4.MTM Research CentreÖrebro UniversityÖrebroSweden
  5. 5.Department of Medical Sciences, Occupational and Environmental MedicineUppsala UniversityUppsalaSweden