Prenatal PFAS exposure associates with DXA assessed markers of adiposity in 7-year-old children from the Odense Child Cohort

The global increase in childhood overweight and obesity presents significant public health concerns due to its long-term health implications. Emerging evidence suggests that exposure to endocrine disrupting chemicals, such as per- and polyfluoroalkylated substances (PFAS), may be obesogenic and contribute to adiposity. This study aimed to investigate the association between prenatal PFAS exposure and markers of adiposity in 7-year-old children, focusing on potential sex-specific differences. Data was analyzed from 881 mother-child pairs in the Odense Child Cohort, Denmark. Maternal serum concentrations of perfluorohexane sulfonic acid (PFHxS), perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA) were measured in early pregnancy. At age 7, body composition, including body mass index (BMI), lean mass and fat distribution (total, gynoid, and android), was assessed using dual-energy X-ray absorptiometry (DXA). The median (25th;75th percentile) concentrations of PFHxS, PFOS, PFOA, PFNA, and PFDA were 0.4 (0.2;0.5), 7.6 (5.6;10.4), 1.7 (1.1;2.3), 0.6 (0.5;0.8), and 0.3 (0.2;0.4) ng/mL, respectively. Multiple linear regressions were used to assess sex specific associations between maternal PFAS concentrations and markers of adiposity. In girls, 1 ng/mL increase in maternal PFOA was associated with 2.0 % (95 % confidence interval: 0.3; 3.7) increase in total fat, 1.3 % (-0.3; 2.9) increase in gynoid fat, and 3.8 % (0.6; 7.0) increase in android fat. Associations for PFNA and PFDA followed similar trends, whereas higher maternal PFOS concentrations were associated with lower BMI among both girls and boys. These findings suggest that prenatal exposure to certain PFAS may influence the accumulation of excess fat in girls. Our findings highlight the importance of studying sex specific differences and using accurate measures of body composition as BMI may not adequately reflect body fat in children during growth.