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Serum perfluoroalkyl substances and growth and development in US adolescents: a nationally representative cross-sectional study

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Abstract

Per- and polyfluoroalkyl substances (PFAS), synthetic organic chemicals, have been discovered in the blood of both humans and animals throughout the world. This has raised widespread concerns about its toxicity, especially for growing children and adolescents. Most research on growth and development to date has concentrated on children at birth and during the first two years, while few studies have analyzed weight, height, and Body Mass Index (BMI) changes in children later in life. The present study aims to assess the association between serum PFAS levels and growth and development in adolescents. Through multiple linear regression, we explored the relationship between serum PFAS levels and weight, height, and BMI in adolescents (aged 12 to 19 years) participating in the 2015–2018 National Health and Nutrition Examination Survey (NHANES). After covariate adjustment, serum perfluorooctane sulfonic acid (PFOS) was associated with decreased weight-for-age z-score in females (tertile 2 of PFOS: β =  − 0.22, 95% CI: -0.68, 0.23; tertile 3 of PFOS: β =  − 0.78, 95% CI: -1.20, − 0.36; P for trend = 0.009), while serum perfluorononanoic acid (PFNA) was associated with decreased weight-for-age z-score in males (tertile 2 of PFNA: β = 0.09, 95% CI: -0.40, 0.58; tertile 3 of PFNA: β =  − 0.44, 95% CI: -0.86, − 0.03; P for trend = 0.018).In addition, serum PFOS was associated with decreased BMI z-score in all participants (tertile 2 of PFOS: β =  − 0.15, 95% CI: -0.46, 0.16; tertile 3 of PFOS: β =  − 0.63, 95% CI: -1.06, − 0.20; P for trend = 0.013).

Conclusion: Our findings indicate a negative association between serum PFAS levels and weight, and BMI among adolescents, and we observed that the negative association was sex-specific in weight.

What is Known:

• Wide exposure to PFAS has led to concerns about its adverse effects, especially for children during their growth and development.

• So far, much research has evaluated the effects of prenatal PFAS exposures on children, and the current results are mixed, with some research showing that there are sex differences.

What is New:

• This study investigated the relationship between serum PFAS levels and height and weight in adolescents and is a good addition to current research.

• Our study found that exposure to PFAS negatively affects adolescent growth and development and that this effect is sex-specific.

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Authors and Affiliations

  1. Clinical School of Paediatrics, Tianjin Medical University, Tianjin, China

    Yi-Fan Wang

  2. Department of Pulmonology, Tianjin Children’s Hospital (Children’s Hospital of Tianjin University), Machang Compus, 225 Machang Road, Hexi District, Tianjin, 300074, China

    Yi-Fan Wang, Xu-Ran Zhang & Ying-Xue Zou

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Contributions

Yi-Fan Wang: Conceptualization, Methodology, Software, Writing—original draft, Review, & Editing. Xu-Ran Zhang: Data Curation, Writing- Original draft preparation. Ying-Xue Zou: Writing- Reviewing and Editing.

Corresponding author

Correspondence to Ying-Xue Zou.

Ethics declarations

Ethics approval

The data used in this study were obtained from the public database National Health and Nutrition Examination Survey (NHANES), which was approved by the Ethics Review Board of the National Center for Health Statistics of the Centers for Disease Control and Prevention (CDC). 

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All participants provided informed consent before participation.

Consent to publish

For each specific NHANES cycle, the approval protocol numbers are as follows:

NHANES 2017–2018: Protocol #2018–01 (Effective beginning October 26, 2017); Continuation of Protocol #2011–17 (Effective through October 26, 2017) NHANES 2015–2016: Continuation of Protocol #2011–17.

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The authors declare no competing interests.

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Wang, YF., Zhang, XR. & Zou, YX. Serum perfluoroalkyl substances and growth and development in US adolescents: a nationally representative cross-sectional study. Eur J Pediatr 182, 4673–4681 (2023). https://doi.org/10.1007/s00431-023-05136-4

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