Link between type 1 diabetes and early life exposure to per- and polyfluoroalkyl chemicals

Abstract Background Type 1 diabetes mellitus (T1D) is a long-term autoimmune disorder where the body's immune system attacks and destroys the insulin-producing beta cells in the pancreas. This results in a lack of insulin and elevated blood sugar levels. It is estimated that in 2024 nearly 3 million people in Europe and over 9 million in the world are living with T1D. Per- and polyfluoroalkyl substances (PFAS) are a class of environmental pollutants consisting over 15 000 chemicals. They are used all over the world in a wide range of products, including non-stick cookware, water-repellent clothing and firefighting foams. Although genetic factors are crucial in the development of T1D, recent studies indicate that environmental pollutants might also contribute to the onset and progression of the disease. PFAS have established immunomodulatory properties, but only few prospective studies exist on the link between PFAS and T1D. Methods In the prospective Finnish DIPP study, a T1D case-control setup was applied. Two separate 1996-2004 and 2010-2019 birth year timelines were selected, since PFAS exposure was expected to have decreased during the last two decades. PFAS exposure was determined by measuring the PFAS levels in serum at the age of 6 months. For statistics Mann-Whitney U and Wilcoxon tests were applied. Results PFAS levels in children serum was significantly lower in 2010-2019 birth year timeline as compared to 1996-2004 timeline with median PFAS concentrations of 15 ng/mL and 5 ng/mL, respectively. Case-control setup showed that in both timelines the control group had higher median PFAS exposure than the case group, but this difference was not statistically significant. Conclusions The potential link between environmental pollutants and T1D has garnered increasing attention, as researchers seek to understand the multifactorial etiology of this complex disease. This study suggests that there is no direct link between early life PFAS exposure and the development of T1D. Key messages • No direct link between development of T1D and early life PFAS exposure was found. • PFAS exposure has decreased during the past decades.