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5080614 
Journal Article 
Perfluoroalkyl substances, metabolomic profiling, and alterations in glucose homeostasis among overweight and obese Hispanic children: A proof-of-concept analysis 
Alderete, TL; Jin, R; Walker, DI; Valvi, D; Chen, Z; Jones, DP; Peng, C; Gilliland, FD; Berhane, K; Conti, DV; Goran, MI; Chatzi, L 
2019 
Environment International
ISSN: 0160-4120
EISSN: 1873-6750 
126 
Elsevier 
445-453 
English 
OBJECTIVE: To examine the prospective associations between exposure to perfluoroalkyl substances (PFASs) and longitudinal measurements of glucose metabolism in high-risk overweight and obese Hispanic children.

METHODS: Forty overweight and obese Hispanic children (8-14 years) from urban Los Angeles underwent clinical measures and 2-hour oral glucose tolerance tests (OGTT) at baseline and a follow-up visit (range: 1-3 years after enrollment). Baseline plasma perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonic acid (PFHxS), and the plasma metabolome were measured by liquid-chromatography with high-resolution mass spectrometry. Multiple linear regression models were used to assess the association between baseline PFASs and changes in glucose homeostasis over follow-up. A metabolome-wide association study coupled with pathway enrichment analysis was performed to evaluate metabolic dysregulation associated with plasma PFASs concentrations. We performed a structural integrated analysis aiming to characterize the joint impact of all factors and to identify latent clusters of children with alterations in glucose homeostasis, based on their exposure and metabolomics profile.

RESULTS: Each ln (ng/ml) increase in PFOA and PFHxS concentrations was associated with a 30.6 mg/dL (95% CI: 8.8-52.4) and 10.2 mg/dL (95% CI: 2.7-17.7) increase in 2-hour glucose levels, respectively. A ln (ng/ml) increase in PFHxS concentrations was also associated with 17.8 mg/dL increase in the glucose area under the curve (95% CI: 1.5-34.1). Pathway enrichment analysis showed significant alterations of lipids (e.g., glycosphingolipids, linoleic acid, and de novo lipogenesis), and amino acids (e.g., aspartate and asparagine, tyrosine, arginine and proline) in association to PFASs exposure. The integrated analysis identified a cluster of children with increased 2-h glucose levels over follow up, characterized by increased PFAS levels and altered metabolite patterns.

CONCLUSIONS: This proof-of-concept analysis shows that higher PFAS exposure was associated with dysregulation of several lipid and amino acid pathways and longitudinal alterations in glucose homeostasis in Hispanic youth. Larger studies are needed to confirm these findings and fully elucidate the underlying biological mechanisms. 
Alkanesulfonic Acids; Amino Acids; Caprylates; Environmental Pollutants; Fluorocarbons; perfluorooctanoic acid; 947VD76D3L; perfluorooctane sulfonic acid; 9H2MAI21CL; perflexane; FX3WJ41CMX; Glucose; IY9XDZ35W2; Index Medicus; Type 2 diabetes; Glucose metabolism; Metabolomics; Children; Perfluoroalkyl substances; Adolescent; Hispanic Americans; Homeostasis; Lipids -- blood; Amino Acids -- blood; Los Angeles; Alkanesulfonic Acids -- blood; Overweight -- blood; Caprylates -- blood; Glucose -- metabolism; Environmental Pollutants -- blood; Fluorocarbons -- blood 
PFAS
• Additional PFAS (formerly XAgency)
     Literature Search November 2019
          Other Sources
               Reference list review of included studies
               TEDX
     Screened Studies
          Excluded
               Exclude (TIAB)
• Expanded PFAS SEM (formerly PFAS 430)
     Litsearch: September 2019
          PubMed
          Web of Science
          Other Sources
               PFAS TOX Database
     Screened Studies
          Excluded
               Exclude (TIAB)
     Not prioritized for screening
     Perfluorooctane
     Potassium perfluorooctanoate
     Sodium perfluorooctanoate
• PFAS 150
     Literature Search Update December 2020
          PubMed
          WOS
     Literature Search August 2019
          PubMed
          Web of Science
          Other sources
               Reference list review of included studies
               PFAS TOX Database
     Not prioritized for screening
     Ammonium perfluorooctanoate
     Perfluorohexanesulfonic acid
     Perfluorooctane
     Perfluorooctanesulfonic acid
     Perfluorooctanoic acid
• PFHxS
     Database searches
          Pubmed
          WOS
          Scopus
          Pelch PFAS SEM
     Inclusion
          TiAb
          Full Text
               Human Study
• PFNA
     Title and Abstract Screening
          Full Text Screening
               Studies Meeting PECO
                    Human health effects studies
• PFOA (335-67-1) and PFOS (1763-23-1)
     Literature Search Update (2013-2019)
          PubMed
          WOS
• PFOA and PFOS OW MCLG Approaches
     Cited in White Papers