title: Prenatal exposures to perfluoroalkyl acids and serum lipids at ages 7 and 15 in females.
abstract: BACKGROUND
  In some cross-sectional epidemiologic studies the shape of the association between serum concentrations of perfluoroalkyl acids (PFAAs) and lipids suggests departures from linearity.
  
  
  OBJECTIVE
  We used statistical approaches allowing for non-linearity to determine associations of prenatal exposures of perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) with lipid concentrations.
  
  
  METHODS
  PFAAs were measured in serum from pregnant women collected in 1991-1992 at enrollment in the Avon Longitudinal Study of Parents and Children and lipids in serum from their daughters at ages 7 (n=111) and 15 (n=88). The associations of PFAAs with lipids were first explored by cubic splines, followed by piecewise linear regressions by tertiles to obtain regression coefficients (β) and their 95% confidence limits (95% CL) (in mg/dL per 1ng/mL).
  
  
  RESULTS
  At age 7, total cholesterol was positively associated with prenatal PFOA concentrations in the lower tertile (β=15.01; 95% CL=2.34, 27.69) but not with PFOA concentrations in the middle (β=-3.63; 95% CL=-17.43, 10.16) and upper (β=-1.58; 95% CL=-4.58, 1.42) tertiles. At age 15, a similar pattern was noted as well. Positive associations between LDL-C and prenatal PFOA concentration in the lower tertile were observed in daughters at ages 7 (β=14.91; 95% CL=3.53, 28.12) and 15 (β=13.93; 95% CL=0.60, 27.26). LDL-C was not associated with PFOA concentrations in the middle or upper tertile at any age. Neither HDL-C nor triglycerides was associated with prenatal PFOA exposure. Non-linear patterns of association of total cholesterol and LDL-C with prenatal PFOS were less consistently noted.
  
  
  CONCLUSIONS
  Exposure to low levels of PFOA during prenatal development may alter lipid metabolism later in life. Given the small sample size further replication of the association in large independent cohorts is important.
authors.affiliation: Department of Epidemiology and Biostatistics, College of Public Health, East Tennessee State University, Johnson City, TN, United States; Center for Environmental and Respiratory Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland. Electronic address: maisonetnogu@etsu.edu.
authors.forename: Mildred
authors.initials: M
authors.lastname: Maisonet
authors.affiliation: Center for Environmental and Respiratory Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.
authors.forename: Simo
authors.initials: S
authors.lastname: Näyhä
authors.affiliation: MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Debbie A
authors.initials: DA
authors.lastname: Lawlor
authors.affiliation: Epidemiology Department, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
authors.forename: Michele
authors.initials: M
authors.lastname: Marcus
mesh_terms: D000293:Adolescent; D000328:Adult; D017738:Alkanesulfonic Acids; D002210:Caprylates; D002648:Child; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005466:Fluorocarbons / Q000097:blood*; D006801:Humans; D016014:Linear Models; D008055:Lipids / Q000097:blood*; D008137:Longitudinal Studies; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000097:blood*; D014280:Triglycerides
chemical_list: D017738:Alkanesulfonic Acids; D002210:Caprylates; D005466:Fluorocarbons; D008055:Lipids; D014280:Triglycerides; C023036:perfluorooctanoic acid; D002784:Cholesterol; C076994:perfluorooctane sulfonic acid
keywords: ALSPAC; Endocrine disruption; Fetal origins of adult disease; Lipid metabolism; PFOA; PFOS; Perfluoroalkyl acids