Serum perfluoroalkyl substances and growth and development in US adolescents: a nationally representative cross-sectional study

Per- and polyfluoroalkyl substances (PFAS), synthetic organic chemicals, have been discovered in the blood of both humans and animals throughout the world. This has raised widespread concerns about its toxicity, especially for growing children and adolescents. Most research on growth and development to date has concentrated on children at birth and during the first two years, while few studies have analyzed weight, height, and Body Mass Index (BMI) changes in children later in life. The present study aims to assess the association between serum PFAS levels and growth and development in adolescents. Through multiple linear regression, we explored the relationship between serum PFAS levels and weight, height, and BMI in adolescents (aged 12 to 19 years) participating in the 2015-2018 National Health and Nutrition Examination Survey (NHANES). After covariate adjustment, serum perfluorooctane sulfonic acid (PFOS) was associated with decreased weight-for-age z-score in females (tertile 2 of PFOS: beta = - 0.22, 95% CI: -0.68, 0.23; tertile 3 of PFOS: beta = - 0.78, 95% CI: -1.20, - 0.36; P for trend = 0.009), while serum perfluorononanoic acid (PFNA) was associated with decreased weight-for-age z-score in males (tertile 2 of PFNA: beta = 0.09, 95% CI: -0.40, 0.58; tertile 3 of PFNA: beta = - 0.44, 95% CI: -0.86, - 0.03; P for trend = 0.018). In addition, serum PFOS was associated with decreased BMI z-score in all participants (tertile 2 of PFOS: beta = - 0.15, 95% CI: -0.46, 0.16; tertile 3 of PFOS: beta = - 0.63, 95% CI: -1.06, - 0.20; P for trend = 0.013). Conclusion: Our findings indicate a negative association between serum PFAS levels and weight, and BMI among adolescents, and we observed that the negative association was sex-specific in weight.