Associations of Perfluoroalkyl and Polyfluoroalkyl Substances With Incident Diabetes and Microvascular Disease

被引：68

作者：

Cardenas, Andres ^{[1
,2
]}

Hivert, Marie-France ^{[2
,3
]}

Gold, Diane R. ^{[4
,5
]}

Hauser, Russ ^{[4
]}

Kleinman, Ken P. ^{[6
]}

Lin, Pi-I D. ^{[2
]}

Fleisch, Abby F. ^{[7
,8
]}

Calafat, Antonia M. ^{[9
]}

Ye, Xiaoyun ^{[9
]}

Webster, Thomas F. ^{[10
]}

Horton, Edward S. ^{[11
]}

Oken, Emily ^{[2
]}

机构：

[1] Univ Calif Berkeley, Sch Publ Hlth, Div Environm Hlth Sci, Berkeley, CA 94720 USA

[2] Harvard Med Sch, Div Chron Dis Res Lifecourse, Dept Populat Med, Boston, MA 02115 USA

[3] Massachusetts Gen Hosp, Diabet Unit, Boston, MA 02114 USA

[4] Harvard TH Chan Sch Publ Hlth, Dept Environm Hlth, Boston, MA USA

[5] Brigham & Womens Hosp, Channing Div Network Med, 75 Francis St, Boston, MA 02115 USA

[6] Univ Massachusetts, Sch Publ Hlth & Hlth Sci, Dept Biostat & Epidemiol, Amherst, MA 01003 USA

[7] Maine Med Ctr, Div Pediat Endocrinol & Diabet, Portland, ME 04102 USA

[8] Maine Med Ctr, Res Inst, Ctr Outcomes Res & Evaluat, Portland, ME 04102 USA

[9] Ctr Dis Control & Prevent, Div Lab Sci, Natl Ctr Environm Hlth, Atlanta, GA USA

[10] Boston Univ, Sch Publ Hlth, Dept Environm Hlth, Boston, MA 02215 USA

[11] Harvard Med Sch, Joslin Diabet Ctr, Boston, MA 02115 USA

来源：

DIABETES CARE | 2019年 / 42卷 / 09期

基金：

美国国家卫生研究院;

关键词：

LIFE-STYLE INTERVENTION; PERFLUOROOCTANOIC ACID; GLUCOSE-METABOLISM; PREVENTION PROGRAM; WEIGHT-LOSS; EXPOSURE; PFOS; SERUM; CHEMICALS; RISK;

D O I：

10.2337/dc18-2254

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVE Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are suspected endocrine disruptors widely detected across populations. We examine the extent to which PFASs are associated with diabetes incidence and microvascular disease. Secondarily, we tested whether a lifestyle intervention modifies associations and decreases concentrations. RESEARCH DESIGN AND METHODS We analyzed data from a prospective cohort of 957 participants from the Diabetes Prevention Program (DPP) trial and Diabetes Prevention Program Outcomes Study (DPPOS). At baseline, participants were randomized to an intensive lifestyle intervention of diet, physical activity, and behavior modification or a placebo medication. We quantified plasma concentrations of six PFASs at baseline and 2 years after randomization. Participants were monitored for similar to 15 years, repeatedly tested for diabetes, and evaluated for microvascular disease at the end of the follow-up. RESULTS A doubling in baseline branched perfluorooctanoic acid concentration was associated with a 14% increase in diabetes risk for the placebo (hazard ratio [HR] 1.14, 95% CI 1.04, 1.25) but not in the lifestyle intervention group (HR 1.01, 95% CI 0.92, 1.11, P-interaction = 0.11). Mean change in plasma baseline branched perfluorooctanoic acid concentration was greater for the placebo (0.96 ng/mL; 95% CI 0.71, 1.22) compared with the lifestyle intervention group (0.31 ng/mL; 95% CI 0.14, 0.48) 2 years after randomization. Each doubling in N-ethyl-perfluorooctane sulfonamido acetic acid was associated with 17% greater odds of prevalent microvascular disease (OR 1.17, 95% CI 1.05, 1.31), and a similar association was observed for perfluorodimethylhexane sulfonic acid (OR 1.18, 95% CI 1.04, 1.35), regardless of treatment. CONCLUSIONS Some plasma PFASs were associated with diabetes and microvascular disease. Our results suggest that exercise and diet may attenuate the diabetogenic association of PFASs.

引用

页码：1824 / 1832

页数：9

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