Perfluorooctane sulfonic acid exposure and diabetes: a cross-sectional analysis of American adults and in vitro experiments

Abstract Background Perfluorooctane sulfonic acid (PFOS) exposure has a negative impact on the environment and biological health. However, the relationship between PFOS exposure and diabetes in adults is not clear. Objective In this study, we included two distinct components: (1) in the cross-sectional analysis, we used data from the National Health and Nutrition Inspection Survey (NHANES) from 2015 to 2018 and eventually included 2539 subjects. The association between PFOS exposure and the risk of diabetes in adults was assessed by a logistic regression model, and further subgroup analysis was carried out according to sex, hypertension status and high cholesterol status. We adjusted for all covariates and found that the positive association between higher PFOS exposure and diabetes remained stable. (2) In vitro experiments were conducted as follows, rat insulinoma β cells (INS-1) were used as experimental materials; cell proliferation activity was detected using the MTT assay; quantitative real-time PCR was used to detect the mRNA expression of insulin; and Western blotting was used to detect insulin protein expression levels. Results Compared with Q1, the OR of the highest exposure level group (Q4) of PFOS was 1.342(95% CI 0.940, 1.916). We conducted a logistic regression analysis based on sex, hypertension, and high cholesterol stratification. Stratified by sex, we found that the exposure level of PFOS was significantly positively associated with diabetes (P for trend < 0.05). Subgroup analysis showed that the positive association between PFOS exposure and diabetes was more significant in nonhypertensive individuals (P for trend < 0.01) and those with normal cholesterol levels (P for trend < 0.001). To further determine the causal relationship between PFOS exposure and diabetes, we used rat insulinoma β cells (INS-1) as experimental materials to study the effect of PFOS exposure on insulin secretion. We found that PFOS exposure significantly affected insulin secretion and insulin mRNA and protein expression. Conclusions In summary, PFOS exposure is positively associated with the risk of diabetes. However, further studies are needed to confirm our results