title: Perfluorooctanoic acid, perfluorooctanesulfonate, and serum lipids in children and adolescents: results from the C8 Health Project.
abstract: BACKGROUND
  Perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS) are man-made compounds with widespread presence in human sera. In previous occupational and adult studies, PFOA and PFOS were positively associated with serum lipid levels.
  
  
  OBJECTIVE
  To interrogate associations between PFOA and PFOS and serum lipids in children and adolescents.
  
  
  METHODS
  Cross-sectional community-based study.
  
  
  METHODS
  Mid-Ohio River Valley.
  
  
  METHODS
  A total of 12 476 children and adolescents included in the C8 Health Project, which resulted from the pretrial settlement of a class action lawsuit pursuant to PFOA contamination of the drinking water supply.
  
  
  METHODS
  Serum lipids (total, high-density lipoprotein [HDL-C], and low-density lipoprotein [LDL-C] cholesterol and fasting triglycerides).
  
  
  RESULTS
  Mean (SD) serum PFOA and PFOS concentrations were 69.2 (111.9) ng/mL and 22.7 (12.6) ng/mL, respectively. In linear regression after adjustment for covariables, PFOA was significantly associated with increased total cholesterol and LDL-C, and PFOS was significantly associated with increased total cholesterol, HDL-C, and LDL-C. Using general linear model analysis of covariance, between the first and fifth quintiles of PFOA there was a 4.6-mg/dL and a 3.8-mg/dL increase in the adjusted mean levels of total cholesterol and LDL-C levels, respectively, and an 8.5-mg/dL and a 5.8-mg/dL increase in the adjusted mean levels of total cholesterol and LDL-C, respectively, between the first and fifth quintiles of PFOS. Increases were 10 mg/dL for some age- and sex-group strata. Observed effects were nonlinear, with larger increases in total cholesterol and LDL-C levels occurring at the lowest range, particularly of PFOA.
  
  
  CONCLUSIONS
  Although the epidemiologic and cross-sectional natures of this study limit causal inferences, the consistently observed associations between increasing PFOA and PFOS and elevated total cholesterol and LDL-C levels warrant further study.
authors.affiliation: Department of Community Medicine, West Virginia University School of Medicine, Robert C. Byrd Health Sciences Center, 1 Medical Center Drive, Morgantown, WV 26506-9105, USA. sfrisbee@hsc.wvu.edu
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Frisbee
authors.forename: Anoop
authors.initials: A
authors.lastname: Shankar
authors.forename: Sarah S
authors.initials: SS
authors.lastname: Knox
authors.forename: Kyle
authors.initials: K
authors.lastname: Steenland
authors.forename: David A
authors.initials: DA
authors.lastname: Savitz
authors.forename: Tony
authors.initials: T
authors.lastname: Fletcher
authors.forename: Alan M
authors.initials: AM
authors.lastname: Ducatman
mesh_terms: D000293:Adolescent; D017738:Alkanesulfonic Acids / Q000097:blood*; D002210:Caprylates / Q000097:blood*; D002617:Chemical Industry; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D004781:Environmental Exposure; D005260:Female; D005466:Fluorocarbons / Q000097:blood*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008055:Lipids / Q000097:blood*; D016015:Logistic Models; D008297:Male; D014881:Water Supply
chemical_list: D017738:Alkanesulfonic Acids; D002210:Caprylates; D008078:Cholesterol, LDL; D005466:Fluorocarbons; D008055:Lipids; C023036:perfluorooctanoic acid; D002784:Cholesterol; C076994:perfluorooctane sulfonic acid
references.citation: Drug Chem Toxicol. 2006;29(2):137-45
references.pmid: 16707323
references.citation: Environ Health Perspect. 2007 Feb;115(2):226-30
references.pmid: 17384769
references.citation: Environ Health Perspect. 2009 Dec;117(12):1873-82
references.pmid: 20049206
references.citation: AIHA J (Fairfax, Va). 2003 Sep-Oct;64(5):651-9
references.pmid: 14521435
references.citation: J Occup Environ Med. 2009 Mar;51(3):364-72
references.pmid: 19225424
references.citation: Crit Rev Toxicol. 2004 Jul-Aug;34(4):351-84
references.pmid: 15328768
references.citation: J Chromatogr B Analyt Technol Biomed Life Sci. 2005 May 25;819(2):329-38
references.pmid: 15833298
references.citation: Environ Health Perspect. 2007 Nov;115(11):1596-602
references.pmid: 18007991
references.citation: Environ Sci Technol. 2007 Apr 1;41(7):2237-42
references.pmid: 17438769
references.citation: Crit Rev Toxicol. 2003;33(6):655-780
references.pmid: 14727734
references.citation: J Occup Environ Med. 2007 Aug;49(8):872-9
references.pmid: 17693785
references.citation: J Toxicol Sci. 2003 May;28(2):49-57
references.pmid: 12820537
references.citation: Environ Health Perspect. 2004 Aug;112(11):1204-7
references.pmid: 15289168
references.citation: Toxicol Sci. 2007 Oct;99(2):366-94
references.pmid: 17519394
references.citation: J Occup Environ Med. 2006 Aug;48(8):759-70
references.pmid: 16902368
references.citation: Biochim Biophys Acta. 1999 Mar 25;1437(3):393-401
references.pmid: 10101272
references.citation: Int Arch Occup Environ Health. 2007 Nov;81(2):231-46
references.pmid: 17605032
references.citation: J Occup Environ Med. 2006 Aug;48(8):771-9
references.pmid: 16902369
references.citation: J Occup Environ Med. 2007 Oct;49(10):1086-96
references.pmid: 18000414
references.citation: Am J Epidemiol. 2009 Nov 15;170(10):1268-78
references.pmid: 19846564