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Cited by 59Per- and polyfluoroalkyl substances researchSynthesis and properties of polymersFluorine in Organic Chemistry

Associations between exposures to perfluoroalkyl substances and diabetes, hyperglycemia, or insulin resistance: a scoping review

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Margolis, Rachel, Sant, Karilyn E.·2021·Journal of Xenobiotics
DOI 10.3390/jox11030008PMC PMC8482218
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Abstract

Per- and polyfluoroalkyl substances (PFASs) are persistent environmental pollutants that are commonly found in the human body due to exposures via drinking water, surfactants used in consumer materials, and aqueous film-forming foams (AFFFs). PFAS exposure has been linked to adverse health effects such as low infant birth weights, cancer, and endocrine disruption, though increasingly studies have demonstrated that they may perturb metabolic processes and contribute to dysfunction. This scoping review summarizes the chemistry of PFAS exposure and the epidemiologic evidence for associations between exposure to per- and polyfluoroalkyl substances and the development of diabetes, hyperglycemia, and/or insulin resistance. We identified 11 studies on gestational diabetes mellitus, 3 studies on type 1 diabetes, 7 studies on type 2 diabetes, 6 studies on prediabetes or unspecified diabetes, and 15 studies on insulin resistance or glucose tolerance using the SCOPUS and PubMed databases. Approximately 24 reported positive associations, 9 negative associations, 2 non-linear associations, and 2 inverse associations, and 8 reported no associations found between PFAS and all diabetes search terms. Cumulatively, these data indicate the need for further studies to better assess these associations between PFAS exposure and diabetes.

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  • Several prospective cohort studies have reported that exposure to PFASs may increase the risk of T2D, as well as the potential positive association with IR.

    “Several prospective cohort studies have reported that exposure to PFASs may increase the risk of T2D, as well as the potential positive association with IR (Donat-Vargas et al., 2019; Margolis and Sant, 2021; Roth and Petriello, 2022; Sun et al., 2018).”

    From Exposure to per- and polyfluoroalkyl substances in early pregnancy, risk of gestational diabetes mellitus, potential pathways, and influencing factors in pregnant women: A nested case-control study (2023) · cites this paper as Margolis and Sant, 2021

    The Results (§3.3 and §3.5; page numbers unavailable) report positive associations between some PFAS exposures and T2D or insulin resistance. But the review does not establish that several prospective cohort studies found both outcomes: it describes mixed study designs, reports four T2D studies with no association, and calls for more longitudinal research in the Conclusions (§5). (LLM, conf=0.86)

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Cited by

Sorted by citations

Authors
Margolis, R., & Sant, K. E.
Affiliations
San Diego State University (US)
Corresponding author
Sant, Karilyn E.
ORCID
Venue
Journal of Xenobiotics
Publisher
MDPI AG
Published
2021-09-14
Volume
11
Issue
3
Pages
115-129
ISSN
  • 2039-4705 (ISSN-L)
  • 2039-4713
DOI
10.3390/jox11030008
PMC
PMC8482218
OpenAlex
W3200394047
Cited by
59
References
8
Citations by year
2026: 12 · 2025: 14 · 2024: 9 · 2023: 16 · 2022: 8
FWCI
0.61
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Xenobiotics (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • National Institute of Environmental Health Sciences (K01ES031640)
  • National Institute on Minority Health and Health Disparities (U54MD012397)
Topics
  • Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
  • Physical Sciences › Materials Science › Polymers and Plastics › Synthesis and properties of polymers
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmaceutical Science › Fluorine in Organic Chemistry
Keywords
per- and polyfluoroalkyl substances, PFAS exposure, diabetes mellitus, hyperglycemia, insulin resistance, gestational diabetes mellitus, type 1 diabetes, type 2 diabetes, prediabetes, glucose tolerance, endocrine disruption, persistent environmental pollutants, aqueous film-forming foam

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