Introduction: Per- and polyfluoroalkyl substances (PFAS) have adverse cardiometabolic effects.

Methods: We conducted a cross-sectional analysis in 1601 mothers who had joined the Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) study in Hong Kong in 2001-2006. All mothers underwent a 75g-oral-glucose-tolerance test at 24-32 weeks of gestation. We measured serum concentrations of six PFAS biomarkers using high-performance LC-MS-MS. We fitted linear-regression, weighted-quantile-sum (WQS) regression, and quantile-g-computation (qgcomp) models to estimate the associations of individual PFAS and their mixture with levels of HbA1c and plasma-glucose (PG). Subgroup analyses were performed based on the enrollment period by the severe-acute-respiratory-syndrome (SARS) epidemic in Hong Kong between March 2003 and May 2004.

Results: Maternal exposure to PFAS mixture was associated with increased HbA1c in both WQS (β=0.05, 95% CI: 0.02-0.07) and qgcomp models (β=0.04, 95% CI: 0.01-0.06). We did not observe significant associations of PFAS mixture with fasting PG, 1-h and 2-h PG in both models, except for 2-h PG in qgcmop model (β=0.074, 95% CI: 0.01-0.15). Pandemic-specific analyses showed a significant association of PFAS mixture with increased HbA1c in peri-SARS but not in pre-SARS and post-SARS epidemic period. Perfluorooctanoic-acid (PFOA) and perfluorooctane-sulfonic-acid (PFOS) were the main contributors to the overall positive effects on HbA1c. The level of PFOS was highest during the peri-SARS epidemic (median [IQR]: 24.7 [42.6-89.5] ng/mL) compared with pre-SARS (12.6 [20.0-49.8] ng/mL) and post-SARS (20.6 [27.8-46.4] ng/mL) epidemic.

Conclusions: Maternal exposure to PFAS mixture is associated with glucose metabolisms during pregnancy. Pandemic-specific associations call for further studies on its adverse health effects during the COVID-19 pandemic.

Disclosure

A.Yang: None. C.H.Tam: None. R.Ozaki: None. W.L.Lowe: None. B.E.Metzger: None. W.H.Tam: None. C.K.Wong: None. R.C.Ma: Advisory Panel; AstraZeneca, Merck & Co., Inc., Other Relationship; Bayer Inc., Boehringer-Ingelheim, Research Support; Tricida, Inc., Roche Diagnostics, Novo Nordisk.

Funding

Health and Medical Research Fund (13140761); Eunice Kennedy Shriver National Institute of Child Health and Human Development/National Institute of Diabetes and Digestive and Kidney Diseases (R01HD34242, R01HD34243); Research Grants Council of Hong Kong (473408, 471713)

© 2023 by the American Diabetes Association
2023
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