Abstract

Background:

Per- and polyfluoroalkyl substances (PFAS) may impair bone accrual and strength via endocrine disruption and nuclear receptor agonism, but human studies are primarily of adults or cross-sectional.

Objectives:

We assessed associations of individual PFAS and their mixture during pregnancy with child bone mineral content (BMC) and areal bone mineral density (aBMD) at age 12 y.

Methods:

Among 206 mother–child pairs enrolled in a prospective cohort (2003–2006), we quantified perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorohexane sulfonic acid (PFHxS), and perfluorooctane sulfonic acid (PFOS) in maternal serum collected during gestation or delivery. When children were age 12 y, we performed dual energy X-ray absorptiometry and calculated BMC, aBMD, and bone mineral apparent density (BMAD) $z$-scores for six skeletal sites. We estimated covariate-adjusted $z$-score differences per doubling of individual PFAS using linear regression and assessed the PFAS mixture using quantile g-computation and Bayesian kernel machine regression. We explored whether associations were modified by child’s sex or mediated by whole-body lean mass.

Results:

In covariate-adjusted models, we found that higher maternal serum concentrations of PFOA, PFNA, and the PFAS mixture were associated with lower total hip and forearm (one-third distal radius) BMC $z$-scores in children. Differences in forearm BMC $z$-scores were $-0.17$ [95% confidence interval (CI): $-0.35$, 0.01] and $-0.24$ (95% CI: $-0.44$, $-0.05$) per doubling of PFOA and PFNA, respectively, and $-0.18$ (95% CI: $-0.34$, $-0.02$) per quartile increase in the PFAS mixture. Child’s sex modified PFOA associations for some skeletal sites; for example, differences in spine BMAD $z$-score per doubling were $-0.31$ (95% CI: $-0.58$, $-0.03$) among males and 0.07 (95% CI: $-0.16$, 0.30) among females (modification $p=0.04$). Except for PFNA among females, these associations were not mediated by whole-body lean mass.

Discussion:

Maternal PFAS concentrations during pregnancy may be associated with lower bone mineral accrual and strength in early adolescence. https://doi.org/10.1289/EHP9424

中文翻译：

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母亲血清全氟烷基物质浓度与青春期早期骨矿物质含量和密度的关联：健康结果和环境措施 (HOME) 研究

摘要

背景：

全氟烷基物质和多氟烷基物质 (PFAS) 可能会通过内分泌干扰和核受体激动作用损害骨质增生和强度，但人体研究主要针对成人或横断面研究。

目标：

我们评估了怀孕期间个体 PFAS 及其混合物与 12 岁儿童骨矿物质含量 (BMC) 和面积骨矿物质密度 (aBMD) 之间的关联。

方法：

在前瞻性队列（2003-2006 年）中登记的 206 对母子中，我们量化了期间收集的母体血清中的全氟辛酸 (PFOA)、全氟壬酸 (PFNA)、全氟己烷磺酸 (PFHxS) 和全氟辛烷磺酸 (PFOS)妊娠或分娩。当儿童 12 岁时，我们进行双能 X 射线骨密度测定并计算 BMC、aBMD 和骨矿物质表观密度 (BMAD)$z$- 六个骨骼部位的分数。我们估计协变量调整$z$-使用线性回归对单个 PFAS 每次加倍的差异进行评分，并使用分位数 g 计算和贝叶斯核机器回归评估 PFAS 混合物。我们探讨了关联是否会因孩子的性别而改变或受全身瘦体重的影响。

结果：

在协变量调整模型中，我们发现较高的母体血清 PFOA、PFNA 和 PFAS 混合物浓度与较低的全髋和前臂（桡骨远端三分之一）BMC 相关$z$- 儿童分数。前臂 BMC 的差异$z$-分数是$-0.17$[95% 置信区间 (CI)：$-0.35$, 0.01] 和$-0.24$（95% 置信区间：$-0.44$,$-0.05$) 分别将 PFOA 和 PFNA 每增加一倍，以及$-0.18$（95% 置信区间：$-0.34$,$-0.02$) PFAS 混合物的每四分位数增加。儿童某些骨骼部位的性别修饰 PFOA 关联；例如，脊柱 BMAD 的差异$z$-每加倍的分数是$-0.31$（95% 置信区间：$-0.58$,$-0.03$) 在男性中为 0.07 (95% CI:$-0.16$, 0.30) 在女性中 (修改$p=0.04$). 除了女性中的 PFNA 外，这些关联不受全身瘦体重的影响。

讨论：

怀孕期间母亲的 PFAS 浓度可能与青春期早期较低的骨矿物质积累和强度有关。https://doi.org/10.1289/EHP9424