Exposure to per- and polyfluoroalkyl substances and bone health: a systematic review and meta-analysis

ABSTRACT

Perfluoroalkyl substances (PFAS) as a large group of synthetic compounds widely contaminated the environment and lead to health problems. However, the correlation between PFAS exposure, bone health parameters and osteoporosis remains controversial. Therefore, we conducted a systematic review and meta-analysis of published literature to evaluate the effects of PFAS on human bone health. All observational studies were collected up to 2 December 2023. A total of 2096 articles were retrieved. Of these, 21 articles investigated the association between PFAS exposure and human bone health. However, only 10 studies were included in the final meta-analysis. Doubling of serum perfluorooctanoic acid (PFOA) (β = -0.11, 95% confidence interval (CI): −0.18, −0.05) and perfluorooctane sulfonic acid (PFOS) (β = -0.06, 95% CI: −0.11, −0.01) levels showed significant negative correlations with total body less head bone mineral density (TBLH-BMD). Subgrouping showed that only perfluorohexane sulfonate (PFHxS) (odds ratio [OR] = 1.37, 95% CI: 1.12, 1.68) was correlated with osteoporosis.

KEYWORDS:

• Per- and polyfluoroalkyl substances
• bone mineral density
• bone mineral content
• fracture
• osteoporosis

Acknowledgments

This research was performed with financial support from Sabzevar University of Medical Sciences. Present study has ethnical approval code (IR.MEDSAB.REC.1401.051) from Sabzevar University of Medical Sciences.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplemental material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/09603123.2024.2338269

Additional information

Funding

This work was supported by [Sabzevar University of Medical Sciences] (Grant numbers [401038]).