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Perfluoroalkyl substances and risk of type II diabetes: A prospective nested case-control study
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.ORCID iD: 0000-0003-1227-6859
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
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2019 (English)In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 123, p. 390-398Article in journal (Refereed) Published
Abstract [en]

Background: Perfluoroalkyl substances (PFAS) have drawn much attention due to bioaccumulation potential and their current omnipresence in human blood. We assessed whether plasma PFAS, suspected to induce endocrine-disrupting effects, were prospectively associated with clinical type 2 diabetes (T2D) risk.

Methods: We established a nested case-control study within the Swedish prospective population-based Västerbotten Intervention Programme cohort. Several PFAS were measured in plasma from a subset of 124 case-control pairs at baseline (during 1990–2003) and at 10-year follow-up. T2D cases were matched (1:1) according to gender, age and sample date with participants without T2D (controls).

Conditional logistic regressions were used to prospectively assess risk of T2D by baseline PFAS plasma concentrations. Associations between long-term PFAS plasma levels (mean of baseline and follow-up) and insulin resistance (HOMA2-IR) and beta-cell function (HOMA2-B%) at follow-up were prospectively explored among 178 and 181 controls, respectively, by multivariable linear regressions.

Results: After adjusting for gender, age, sample year, diet and body mass index, the odds ratio of T2D for the sum of PFAS (Σ z-score PFAS) was 0.52 (95% confidence interval, CI: 0.20, 1.36), comparing third with first tertile; and 0.92 (95% CI: 0.84, 1.00) per one standard deviation increment of sum of log-transformed PFAS. Among the controls, the adjusted β of HOMA2-IR and HOMA-B% for the sum of PFAS were −0.26 (95% CI: −0.52, −0.01) and −9.61 (95% CI: −22.60, 3.39) respectively comparing third with first tertile.

Conclusions: This prospective nested case-control study yielded overall inverse associations between individual PFAS and risk of T2D, although mostly non-significant. Among participants without T2D, long-term PFAS exposure was prospectively associated with lower insulin resistance.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 123, p. 390-398
Keywords [en]
Environmental contaminants, Plasma perfluoroalkyl substances, Environmental risk factors, Diabetes, Insulin resistance, Endocrine disruption, Environmental epidemiology, Nested case-control study, Prospective assessment
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-155947DOI: 10.1016/j.envint.2018.12.026ISI: 000455532500044PubMedID: 30622063OAI: oai:DiVA.org:umu-155947DiVA, id: diva2:1287005
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2012-0758Västerbotten County Council, 2017-00822Swedish Research CouncilAvailable from: 2019-02-08 Created: 2019-02-08 Last updated: 2019-02-08Bibliographically approved

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Bergdahl, IngvarTornevi, AndreasWennberg, MariaSommar, JohanRolandsson, Olov

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