Exposure to Polyfluoroalkyl Chemicals and Cholesterol, Body Weight, and Insulin Resistance in the General U.S. Population
Open accessAbstract
BACKGROUND: Polyfluoroalkyl chemicals (PFCs) are used commonly in commercial applications and are detected in humans and the environment worldwide. Concern has been raised that they may disrupt lipid and weight regulation. OBJECTIVES: We investigated the relationship between PFC serum concentrations and lipid and weight outcomes in a large publicly available data set. METHODS: We analyzed data from the 20032004 National Health and Nutrition Examination Survey (NHANES) for participants 1280 years of age. Using linear regression to control for covariates, we studied the association between serum concentrations of perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorooctane sulfonic acid (PFOS), and perfluorohexane sulfonic acid (PFHxS) and measures of cholesterol, body size, and insulin resistance. RESULTS: We observed a positive association between concentrations of PFOS, PFOA, and PFNA and total and non-high-density cholesterol. We found the opposite for PFHxS. Those in the highest quartile of PFOS exposure had total cholesterol levels 13.4 mg/dL [95% confidence interval (CI), 3.823.0] higher than those in the lowest quartile. For PFOA, PFNA, and PFHxS, effect estimates were 9.8 (95% CI, 0.2 to 19.7), 13.9 (95% CI, 1.925.9), and 7.0 (95% CI, 13.2 to 0.8), respectively. A similar pattern emerged when exposures were modeled continuously. We saw little evidence of a consistent association with body size or insulin resistance. CONCLUSIONS: This exploratory cross-sectional study is consistent with other epidemiologic studies in finding a positive association between PFOS and PFOA and cholesterol, despite much lower exposures in NHANES. Results for PFNA and PFHxS are novel, emphasizing the need to study PFCs other than PFOS and PFOA.
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PFOA, PFOS, and PFNA are significantly related to total lipid and non-high-density cholesterol levels and negatively related to insulin resistance and weight.
“The authors observed that PFOA, PFOS, and PFNA are significantly related to the total lipid and non-high-density cholesterol (NHD-L) levels and negatively related to insulin resistance and weight.”
From Overview of emerging contaminants and associated human health effects (2015) · cites this paper as [32]
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- Authors
- Nelson, J. W., Hatch, E. E., & Webster, T. F.
- Affiliations
- Boston University (US)
- Department of Environmental Health and
- Corresponding author
- Nelson, Jessica W.
- Venue
- Environmental Health Perspectives
- Publisher
- American Chemical Society (ACS)
- Published
- 2009-11-02
- Volume
- 118
- Issue
- 2
- Pages
- 197-202
- ISSN
- 0091-6765 (ISSN-L)
- 1552-9924
- PMC
- PMC2831917
- OpenAlex
- W2025315910
- Cited by
- 538
- References
- 36
- Citations by year
- 2026: 16 · 2025: 38 · 2024: 41 · 2023: 34 · 2022: 42 · 2021: 55 · 2020: 65 · 2019: 34 · 2018: 38 · 2017: 27 · 2016: 18 · 2015: 30 · 2014: 21 · 2013: 29 · 2012: 19
- FWCI
- 12.66
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- public-domain
- creativecommons.org/licenses/by/4.0/ (vor, 2979 d)
- Locations
- Environmental Health Perspectives (publishedVersion, public-domain)
- PubMed Central (publishedVersion, public-domain)
- PubMed (publishedVersion)
- OpenBU (Boston University) (submittedVersion, other-oa)
- Funders
- National Institutes of Health
- Centers for Disease Control and Prevention
- National Institute of Environmental Health Sciences (R21ES013724, T32ES014562)
- Topics
- Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Toxic Organic Pollutants Impact
- Physical Sciences › Materials Science › Polymers and Plastics › Synthesis and properties of polymers
- Keywords
- perfluorooctanoic acid, PFOS, perfluorononanoic acid, perfluorohexane sulfonic acid, cholesterol, total cholesterol, HDL cholesterol, body weight, body size, insulin resistance, lipid regulation, endocrine disruptors, NHANES
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Body Weight, Caprylates, Child, Cholesterol, Cross-Sectional Studies, Environmental Exposure, Female, Fluorocarbons, Humans, Insulin Resistance, Male, Middle Aged, Linear Models, Alkanesulfonic Acids, Lipid Metabolism, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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