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

Table 3.

Associations (estimates and 95% confidence intervals) of individual prenatal PFAS levels with adiposity and body composition measures in late adolescence in Project Viva.

Adiposity and body composition measures (units)	Models	PFOS	PFOA	PFHxS	PFNA	EtFOSAA	MeFOSAA
Obesity
Obesity^a	Unadjusted	1.59 (1.23, 2.05)	1.26 (1.00, 1.58)	1.07 (0.88, 1.30)	1.19 (0.90, 1.58)	1.27 (1.06, 1.51)	1.15 (0.94, 1.41)
Obesity^a	Adjusted^b	1.59 (1.19, 2.12)	1.24 (0.98, 1.57)	1.14 (0.93, 1.40)	1.49 (1.11, 1.99)	1.16 (0.97, 1.39)	1.13 (0.90, 1.42)
Overall adiposity
BMI ( ${kg / m}^{2}$ )	Unadjusted	1.05 (0.42, 1.68)	0.44 ( $negative 0.17$ , 1.05)	0.13 ( $negative 0.27$ , 0.54)	0.12 ( $negative 0.44$ , 0.69)	0.66 (0.24, 1.07)	0.38 ( $negative 0.10$ , 0.86)
BMI ( ${kg / m}^{2}$ )	Adjusted^b	0.74 (0.15, 1.33)	0.31 ( $negative 0.28$ , 0.90)	0.25 ( $negative 0.12$ , 0.62)	0.43 ( $negative 0.10$ , 0.96)	0.38 ( $negative 0.00$ , 0.77)	0.20 ( $negative 0.24$ , 0.64)
BMI $z$ -score	Unadjusted	0.19 (0.06, 0.31)	0.07 ( $negative 0.05$ , 0.19)	0.04 ( $negative 0.04$ , 0.12)	0.01 ( $negative 0.10$ , 0.12)	0.13 (0.04, 0.21)	0.09 ( $negative 0.00$ , 0.19)
BMI $z$ -score	Adjusted^b	0.13 (0.01, 0.25)	0.03 ( $negative 0.09$ , 0.15)	0.05 ( $negative 0.03$ , 0.13)	0.06 ( $negative 0.05$ , 0.17)	0.08 ( $negative 0.00$ , 0.16)	0.06 ( $negative 0.03$ , 0.16)
Sum of subscapular and triceps skinfold thicknesses (mm)	Unadjusted	1.84 ( $negative 0.07$ , 3.74)	0.73 ( $negative 1.08$ , 2.55)	$negative 0.22$ ( $negative 1.42$ , 0.98)	0.43 ( $negative 1.28$ , 2.14)	1.67 (0.41, 2.92)	0.59 ( $negative 0.85$ , 2.04)
Sum of subscapular and triceps skinfold thicknesses (mm)	Adjusted^b	1.31 ( $negative 0.59$ , 3.22)	0.51 ( $negative 1.36$ , 2.38)	0.12 ( $negative 1.06$ , 1.29)	0.86 ( $negative 0.84$ , 2.55)	1.17 ( $negative 0.07$ , 2.41)	0.41 ( $negative 1.00$ , 1.82)
BIA percentage fat	Unadjusted	1.18 ( $negative 0.11$ , 2.47)	0.67 ( $negative 0.56$ , 1.90)	$negative 0.18$ ( $negative 0.99$ , 0.63)	$negative 0.23$ ( $negative 1.38$ , 0.91)	1.08 (0.23, 1.94)	0.34 ( $negative 0.64$ , 1.32)
BIA percentage fat	Adjusted^b	0.72 ( $negative 0.57$ , 2.01)	0.48 ( $negative 0.79$ , 1.76)	0.00 ( $negative 0.80$ , 0.80)	0.16 ( $negative 0.98$ , 1.31)	0.68 ( $negative 0.16$ , 1.53)	0.08 ( $negative 0.88$ , 1.03)
DXA percentage fat	Unadjusted	0.85 ( $negative 0.31$ , 2.01)	0.38 ( $negative 0.74$ , 1.49)	$negative 0.46$ ( $negative 1.16$ , 0.24)	$negative 0.05$ ( $negative 1.07$ , 0.98)	0.88 (0.11, 1.65)	0.08 ( $negative 0.81$ , 0.97)
DXA percentage fat	Adjusted^b	0.48 ( $negative 0.71$ , 1.66)	0.12 ( $negative 1.05$ , 1.28)	$negative 0.37$ ( $negative 1.06$ , 0.32)	0.26 ( $negative 0.78$ , 1.29)	0.59 ( $negative 0.19$ , 1.37)	$negative 0.07$ ( $negative 0.95$ , 0.81)
BIA fat mass index ( ${kg / m}^{2}$ )	Unadjusted	0.63 (0.14, 1.12)	0.32 ( $negative 0.14$ , 0.79)	$negative 0.02$ ( $negative 0.32$ , 0.29)	$negative 0.02$ ( $negative 0.45$ , 0.42)	0.47 (0.14, 0.79)	0.16 ( $negative 0.21$ , 0.53)
BIA fat mass index ( ${kg / m}^{2}$ )	Adjusted^b	0.41 ( $negative 0.06$ , 0.88)	0.25 ( $negative 0.22$ , 0.71)	0.08 ( $negative 0.21$ , 0.37)	0.18 ( $negative 0.24$ , 0.59)	0.28 ( $negative 0.03$ , 0.59)	0.03 ( $negative 0.32$ , 0.38)
DXA fat mass index ( ${kg / m}^{2}$ )	Unadjusted	0.61 (0.10, 1.11)	0.23 ( $negative 0.26$ , 0.72)	$negative 0.11$ ( $negative 0.42$ , 0.19)	0.00 ( $negative 0.44$ , 0.45)	0.48 (0.14, 0.81)	0.15 ( $negative 0.24$ , 0.53)
DXA fat mass index ( ${kg / m}^{2}$ )	Adjusted^b	0.34 ( $negative 0.15$ , 0.83)	0.08 ( $negative 0.40$ , 0.56)	$negative 0.04$ ( $negative 0.33$ , 0.24)	0.19 ( $negative 0.24$ , 0.62)	0.29 ( $negative 0.04$ , 0.61)	0.04 ( $negative 0.33$ , 0.40)
Central adiposity
Waist circumference (cm)	Unadjusted	1.80 (0.26, 3.34)	0.58 ( $negative 0.89$ , 2.06)	0.16 ( $negative 0.82$ , 1.13)	$negative 0.49$ ( $negative 1.87$ , 0.88)	1.37 (0.35, 2.39)	0.42 ( $negative 0.76$ , 1.60)
Waist circumference (cm)	Adjusted^b	1.09 ( $negative 0.40$ , 2.59)	$negative 0.00$ ( $negative 1.48$ , 1.48)	0.25 ( $negative 0.68$ , 1.18)	0.04 ( $negative 1.29$ , 1.38)	0.82 ( $negative 0.16$ , 1.80)	0.08 ( $negative 1.04$ , 1.20)
Waist-to-hip circumference ratio ( $times 100$ )	Unadjusted	0.62 ( $negative 0.14$ , 1.38)	0.41 ( $negative 0.32$ , 1.14)	$negative 0.04$ ( $negative 0.53$ , 0.44)	$negative 0.37$ ( $negative 1.04$ , 0.31)	0.54 (0.03, 1.04)	0.34 ( $negative 0.25$ , 0.92)
Waist-to-hip circumference ratio ( $times 100$ )	Adjusted^b	0.31 ( $negative 0.46$ , 1.08)	0.03 ( $negative 0.73$ , 0.79)	$negative 0.15$ ( $negative 0.63$ , 0.33)	$negative 0.21$ ( $negative 0.89$ , 0.48)	0.34 ( $negative 0.17$ , 0.84)	0.23 ( $negative 0.34$ , 0.80)
Subscapular-to-triceps skinfold thickness ratio ( $times 100$ )	Unadjusted	4.08 (0.61, 7.54)	3.53 (0.24, 6.81)	0.73 ( $negative 1.44$ , 2.91)	1.88 ( $negative 1.24$ , 4.99)	2.58 (0.30, 4.87)	$negative 0.22$ ( $negative 2.85$ , 2.41)
	Adjusted^b	2.71 ( $negative 0.83$ , 6.25)	3.23 ( $negative 0.24$ , 6.70)	0.73 ( $negative 1.46$ , 2.92)	1.72 ( $negative 1.44$ , 4.88)	1.69 ( $negative 0.62$ , 4.00)	$negative 0.67$ ( $negative 3.29$ , 1.95)
DXA trunk fat mass index ( ${kg / m}^{2}$ )	Unadjusted	0.33 (0.07, 0.59)	0.17 ( $negative 0.08$ , 0.43)	$negative 0.04$ ( $negative 0.20$ , 0.12)	0.03 ( $negative 0.20$ , 0.26)	0.24 (0.07, 0.42)	0.07 ( $negative 0.13$ , 0.27)
DXA trunk fat mass index ( ${kg / m}^{2}$ )	Adjusted^b	0.19 ( $negative 0.07$ , 0.44)	0.07 ( $negative 0.18$ , 0.32)	$negative 0.02$ ( $negative 0.17$ , 0.13)	0.12 ( $negative 0.10$ , 0.34)	0.15 ( $negative 0.02$ , 0.31)	0.01 ( $negative 0.18$ , 0.20)
Lean mass
BIA lean mass index ( ${kg / m}^{2}$ )	Unadjusted	0.46 (0.15, 0.77)	0.13 ( $negative 0.16$ , 0.43)	0.15 ( $negative 0.04$ , 0.35)	0.16 ( $negative 0.12$ , 0.43)	0.21 (0.01, 0.42)	0.23 ( $negative 0.00$ , 0.46)
BIA lean mass index ( ${kg / m}^{2}$ )	Adjusted^b	0.36 (0.05, 0.66)	0.08 ( $negative 0.23$ , 0.38)	0.17 ( $negative 0.02$ , 0.36)	0.26 ( $negative 0.01$ , 0.53)	0.12 ( $negative 0.08$ , 0.32)	0.18 ( $negative 0.05$ , 0.40)
DXA lean mass index ( ${kg / m}^{2}$ )	Unadjusted	0.45 (0.09, 0.80)	0.10 ( $negative 0.25$ , 0.44)	0.16 ( $negative 0.06$ , 0.37)	0.01 ( $negative 0.31$ , 0.32)	0.23 ( $negative 0.01$ , 0.47)	0.27 (0.00, 0.55)
DXA lean mass index ( ${kg / m}^{2}$ )	Adjusted^b	0.25 ( $negative 0.10$ , 0.61)	$negative 0.02$ ( $negative 0.37$ , 0.33)	0.19 ( $negative 0.01$ , 0.40)	0.10 ( $negative 0.21$ , 0.40)	0.11 ( $negative 0.12$ , 0.34)	0.20 ( $negative 0.06$ , 0.46)

Note: Pregnant women were enrolled between April 1999 and July 2002, and the late adolescence visit was conducted between July 2017 and September 2021. Estimates show differences in continuous values of adiposity and body composition measures or relative risks of obesity (yes vs. no) per doubling of PFAS levels ( $lowercase italic n equals 439$ to 545). $lowercase italic n equals 545$ for obesity, 545 for BMI, 545 for BMI $z$ -score, 534 for sum of subscapular and triceps skinfold thicknesses, 544 for BIA percentage fat, 439 for DXA percentage fat, 543 for BIA fat mass index, 439 for DXA fat mass index, 544 for waist circumference, 544 for waist-to-hip circumference ratio, 534 for subscapular-to-triceps skinfold thickness ratio, 439 for DXA trunk fat mass index, 543 for BIA lean mass index, and 439 DXA lean mass index. BIA, bioelectrical impedance analysis; BMI, body mass index; DXA, dual-energy X-ray absorptiometry; 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.

^{^a}

Obesity was defined as $body mass index greater than or equal to ninety-fifth$ percentile for age and sex based on the Centers for Disease Control and Prevention Growth Charts (reference is $body mass index less than ninety-fifth$ percentile).

^{^b}

Models were adjusted for maternal age at enrollment, race and ethnicity, prepregnancy BMI, educational level, marital status, parity, and pregnancy smoking status.