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. 2023 Dec 6;131(12):127002. doi: 10.1289/EHP12597

Figure 2.

Figure 2A is a dot and whisker plot, plotting 2-(N-methyl-perfluorooctane sulfonamido) acetate, 2-(N-ethyl-perfluorooctane sulfonamido) acetate, perfluorononanoate, perfluorohexane sulfonate, perfluorooctanoate, perfluorooctane sulfonate (y-axis) across relative risk of obesity per doubling of per- and polyfluoroalkyl substances exposures, ranging from 1 to 1.5 in increments of 1.5 and 1.5 to 2 in increments of 0.5 (x-axis). Figure 2B is a horizontal bar graph, plotting 2-(N-methyl-perfluorooctane sulfonamido) acetate, 2-(N-ethyl-perfluorooctane sulfonamido) acetate, perfluorononanoate, perfluorohexane sulfonate, perfluorooctanoate, perfluorooctane sulfonate (y-axis) across negative weights, ranging from 0.75 to 0.25 in decrements of 0.25 and positive weights, ranging from 0.25 to 0.75 in increments of 0.25 (x-axis). Figure 2C is a set of six ribbon plus line graphs titled perfluorooctane sulfonate, perfluorooctanoate, perfluorohexane sulfonate, perfluorononanoate, 2-(N-ethyl-perfluorooctane sulfonamido) acetate, and 2-(N-methyl-perfluorooctane sulfonamido) acetate, plotting Difference in probit of the probability of obesity, ranging from negative 1 to 1 in unit increment (y-axis) across Log 2− per- and polyfluoroalkyl substances concentration, ranging from 3 to 7 in unit increments, 0 to 4 in increments of 2, negative 4 to 4 in increments of 2, negative 4 to 2 in increments of 2, and negative 4 to 4 in increments of 2, and negative 2 to 4 in increments of 2 (x-axis), respectively.

Multivariable-adjusted associations between individual prenatal PFAS and obesity in late adolescence estimated using (A) Poisson regression with robust variance estimates, (B) quantile g-computation, and (C) Bayesian kernel machine regression (n=545). (A) shows the relative risks and 95% confidence intervals of obesity per doubling of individual PFAS levels [estimates are provided in Table 3 (adjusted)]. (B) shows the weights for each PFAS that correspond to the proportion of the overall effect of all PFAS on obesity in the positive or negative direction (positive and negative weights, respectively, add up to 1, representing the proportion of the overall effect and the relative importance of each mixture component within each direction; the shading of bars represents the overall effect size within each direction, with darker shades indicating a larger effect compared with lighter shades; estimates are provided in Table S8). (C) shows the estimates and 95% credible intervals of PFAS with obesity risk when all other PFAS are fixed at their 50th percentile (percentile values for log2-transformed PFAS levels are provided in Table S2). Obesity was defined as BMI≥95th percentile for age and sex based on the Centers for Disease Control and Prevention Growth Charts (reference is BMI<95th percentile). Participants were from the Project Viva prebirth cohort. Pregnant women were enrolled between April 1999 and July 2002, and the late adolescence visit was conducted between July 2017 and September 2021. Models were adjusted for maternal age at enrollment, race and ethnicity, prepregnancy BMI, educational level, marital status, parity, and pregnancy smoking status. Note: BMI, body mass index; EtFOSAA, 2-(N-ethyl-perfluorooctane sulfonamido) acetate; MeFOSAA, 2-(N-methyl-perfluorooctane sulfonamido) acetate; PFAS, per- and polyfluoroalkyl substances; PFHxS, perfluorohexane sulfonate; PFNA, perfluorononanoate; PFOA, perfluorooctanoate; PFOS, perfluorooctane sulfonate.