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

Jordan R. Kuiper, Department of Environmental and Occupational Health, The George Washington University Milken Institute School of Public Health, Washington, D.C., USA.
Shelley H. Liu, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
Bruce P. Lanphear, Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada.
Antonia M. Calafat, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Kim M. Cecil, Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH.
Yingying Xu, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Kimberly Yolton, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Heidi J. Kalkwarf, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Aimin Chen, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Joseph M. Braun, Department of Epidemiology, Brown University, Providence, RI, USA.
Jessie P. Buckley, Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA.

Document Type

Journal Article

Publication Date

2-23-2024

Journal

American journal of epidemiology

DOI

10.1093/aje/kwae014

Keywords

Area under the curve; PFAS; adolescence; body composition; latent profile analysis

Abstract

Few methods have been used to characterize repeatedly measured biomarkers of chemical mixtures. We applied latent profile analysis (LPA) to serum concentrations of four perfluoroalkyl and polyfluoroalkyl substances (PFAS) at four timepoints from gestation to age 12 years. We evaluated the relations 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 curve (AUC) for all PFAS. We identified two profiles: a higher (35% of sample) and lower PFAS profile (relative to each other), based on their average PFAS concentrations at all timepoints. The higher PFAS profile had generally lower z-scores for all outcomes, with somewhat larger effects for males, though all CIs crossed the null. For example, the higher PFAS profile was associated with a -0.50 (95% CI: -1.07, 0.08) lower BMI z-score among males but not females (0.04; 95% CI: -0.45, 0.54). We observed similar patterns with AUCs. We found that higher childhood PFAS profile and higher cumulative PFAS mixtures may be associated with altered growth in early adolescence.

Department

Environmental and Occupational Health

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