Per- and polyfluoroalkyl substances and adolescent bone mineral density: assessing periods of susceptibility

Authors

• Jessie P. Buckley, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
• Katherine M. Marquess, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
• Joseph M. Braun, Department of Epidemiology, Brown University, Providence, RI 02912, USA.
• Antonia M. Calafat, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
• Kim M. Cecil, Department of Radiology and Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA.
• Aimin Chen, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphiax, PA 19104, USA.
• Bruce P. Lanphear, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC 8888, Canada.
• Halley Wasserman, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA.
• Yingying Xu, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA.
• Kimberly Yolton, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA.
• Jordan R. Kuiper, Department of Environmental and Occupational Health, The George Washington University Milken Institute School of Public Health, Washington, DC 20037, USA.

Document Type

Journal Article

Publication Date

4-1-2026

Journal

Journal of the Endocrine Society

Volume

10

Issue

4

DOI

10.1210/jendso/bvag039

Keywords

adolescent health; bone mineral density; critical periods; mixtures; perfluoroalkyl substances; susceptibility

Abstract

CONTEXT: Per- and polyfluoroalkyl substances (PFAS) may affect adolescent bone mineral density (BMD), but few studies have examined periods of susceptibility. OBJECTIVE: To assess associations of repeated serum PFAS concentrations with early adolescent BMD. METHODS: Among 218 children in a prospective pregnancy and birth cohort, we quantified serum concentrations of perfluorohexane sulfonic acid (PFHxS), perfluoroctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and perfluorononanoic acid (PFNA) at delivery (cord) and ages 3, 8, and 12 years. We measured BMD at 6 skeletal sites using dual-energy X-ray absorptiometry at age 12 years. We estimated covariate-adjusted differences and 95% confidence intervals (CIs) in BMD Z-scores per interquartile range (IQR) increase in each PFAS at each time point using multiple informant linear regression models. RESULTS: Higher PFOA concentrations were associated with lower 1/3 distal radius BMD at every time point: delivery (β: -0.39; 95% CI: -0.69, -0.10), 3 years (β: -0.36; 95% CI: -0.86, 0.14), 8 years (β: -0.54; 95% CI: -0.91, -0.16), and 12 years (β: -0.40; 95% CI: -0.75, -0.04). Higher 3-year PFHxS and PFOS concentrations were significantly associated with higher whole body, total hip, and femoral neck BMD Z-scores, while higher 12-year PFNA concentrations were associated with lower BMD Z-scores. Associations of 12-year PFAS with lower 1/3 distal radius BMD were stronger among females than males. CONCLUSION: Serum PFOA concentrations from delivery to age 12 years were associated with lower 1/3 distal radius BMD in early adolescence, while associations of other PFAS with BMD varied by exposure assessment time point, skeletal site, and sex.

APA Citation

Buckley, Jessie P.; Marquess, Katherine M.; Braun, Joseph M.; Calafat, Antonia M.; Cecil, Kim M.; Chen, Aimin; Lanphear, Bruce P.; Wasserman, Halley; Xu, Yingying; Yolton, Kimberly; and Kuiper, Jordan R., "Per- and polyfluoroalkyl substances and adolescent bone mineral density: assessing periods of susceptibility" (2026). GW Authored Works. Paper 8799.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/8799

Department

Environmental and Occupational Health