Per- and polyfluoroalkyl substance (PFAS) and serum lipid levels in Ecuadorian adolescents

Per- and polyfluoroalkyl substances (PFAS) are synthetic chemicals used for various purposes, including pesticide formulation. Recent evidence highlights PFAS's negative impact on human health, increasing the risk of altered serum lipids. The sex-specific relationship between PFAS and serum lipids remains unclear in adolescents. We aim to test the sex-stratified association between PFOS, PFOA, and PFNA exposure with serum lipids among adolescents. This cross-sectional study comprised 97 adolescents 11-17 years of age from Pedro Moncayo, Ecuador. A generalized linear model was used to estimate the associations of serum PFOS, PFNA, and PFOA concentrations with triglycerides, total cholesterol, HDL, and LDL levels. The final model was sex-stratified to assess sex-specific predictor impacts on triglycerides, with all data log-transformed. When stratified by sex, we found a significant inverse relationship between PFOS (β=-15.01 ng/dL [-24.72, -4.06]), PFNA (β=-25.49 ng/dL [-36.93, -12.00]), and PFOA (β=-16.55 ng/dL [-28.16, -3.07]),) with triglycerides in females but not in males (β=-6.12 ng/dL [-5.09, -18.65]; β=10.51 ng/dL [-1.09, 23.46]); β=0.61 ng/dL [-11.07, 13.82]), respectively). We found no sex-specific association of PFOA, PFNA, or PFOS with total cholesterol, HDL, or LDL. Our findings suggest an inverse association between triglycerides and PFOS, PFOA, and PFNA among adolescent females, but not males. Our findings contribute to the sparse research on PFAS in Latin America and rural populations. Further investigation into sex-related effect modification is necessary for a comprehensive understanding of this relationship