Perfluoroalkyl substances and beta cell deficient diabetes

Abstract

Aims Perfluoroalkyl Substances (PFAS) are synthetic hydrocarbons shown to preserve pancreatic islet cell viability and reduce islet cell hypoxia and apoptosis. We investigated the relationship of serum PFAS with diabetes, and whether this varied by diabetes type. Methods 6,460 individuals with and 60,439 without diabetes from the C8 Health Project, were categorized into three groups: Type 1 (n=820), Type 2 (n=4,291), or Uncategorized diabetes (n=1,349, missing data on diabetes type or diabetes based on blood sugar at study entry). Four PFAS were investigated: perfluorohexane sulfonate (PFHxS), perfluoroctanoic acid (PFOA), perfluoroctane sulfonate (PFOS), and perfluorononaoic acid (PFNA). Results PFAS levels were significantly lower in those with diabetes, and lowest in those with Type 1 diabetes. In age and sex adjusted analyses, ORs (CI) for Type 1, Type 2, and Uncategorized diabetes compared to no diabetes were 0.59 (0.54–0.64), 0.74 (0.71–0.77), 0.84 (0.78–0.90) respectively for PFHxS; 0.69 (0.65–0.74), 0.87 (0.89–0.91), 0.92 (0.88–0.97) respectively for PFOA; 0.65 (0.61–0.70), 0.86 (0.82–0.90), 0.93 (0.86–1.03) respectively for PFOS; and 0.65 (0.57–0.74), 0.94 (0.88–1.00), 0.95 (0.85–1.06), respectively for PFNA. Further adjustment for eGFR and other covariates did not eliminate these inverse associations. Conclusions PFAS levels were negatively associated with diabetes. This inverse relationship was strongest for Type 1 diabetes, suggesting the relationship with serum PFAS may vary with the severity of islet cell deficiency.

Plasma Concentrations of Per- and Polyfluoroalkyl Substances at Baseline and Associations with Glycemic Indicators and Diabetes Incidence among High-Risk Adults in the Diabetes Prevention Program Trial

“…Within this same population, implementing a retrospective longitudinal study with estimated exposure measures of PFOA, no association was observed for incident diabetes or fasting glucose levels ( Karnes et al 2014 ). Additionally, in a cross-sectional survey of the C8 Health Project, protective associations for serum concentration of PFOS, PFOA, PFHxS, and PFNA and diabetes prevalence were observed ( Conway et al 2016 ). However, studies from the C8 Health Project may not be generalizable to other populations, including ours, as PFOA exposures were much higher as a result of drinking water contamination in this region ( Frisbee et al 2009 ).…”

“…Health concerns related to PFAS exposure include endocrine disruption, altered lipid metabolism, and immunotoxicity ( Khalil et al 2015 ). In addition, several epidemiological studies have investigated associations of PFAS exposure with diabetes and markers of insulin secretion and insulin resistance ( Conway et al 2016 ; Lind et al 2014 ; MacNeil et al 2009 ; Steenland et al 2010 ; Su et al 2016 ). However, these studies have yielded inconsistent results, with some studies reporting positive associations, no associations, or even protective associations of some PFAS.…”

Endocrine Disrupting Chemicals and Type 1 Diabetes

“…Finally, a large cross-sectional study from the U.S. analyzed serum PFASs levels in a highly exposed population in the mid-Ohio River valley including 820 subjects with T1D [76]. PFOA levels, but not PFOS ones, were higher than in the general U.S. population [77] and both PFOA and PFOS concentrations were higher than in the Italian [74] and Finnish/Estonian studies [67].…”

Exposure to environmental chemicals and type 1 diabetes: an update

“…In contrast, a large cross-sectional study from the USA found that higher levels of four PFASs (PFOA, PFOS, PFHxS and PFNA) were associated with a lower risk of T1DM 19. The US study analysed serum PFAS levels in children and adults from a highly exposed population in the mid-Ohio River valley, where drinking water is contaminated.…”