[Perspective] Bone accrual during adolescence: do endocrine disrupting chemicals play a role?

By Jessie P Buckley
J Clin Endocrinol Metab
June 28, 2022
DOI: 10.1210/clinem/dgac391

In a new study, Carwile et al (1) investigate the link between adolescent bone health and 2 classes of endocrine-disrupting chemicals: perfluoroalkyl and polyfluoroalkyl substances (PFAS) and phthalates. These synthetic chemicals are used in a myriad of consumer products and have been found in the bodies of nearly every American (2). PFAS have been dubbed “forever chemicals” given their resistance to degradation in the environment and long biological half-lives in humans, while phthalates are known as “everywhere chemicals” because of their extensive uses in plastics, personal care products, building materials, and many other everyday items. Decades of research indicates that PFAS and phthalates affect a wide range of endocrine-sensitive end points, particularly when exposures occur during critical periods of development (3). Findings from Carwile et al support the emerging hypothesis that these chemicals may also act as bone toxicants with implications for reduced bone mass accrual during adolescence.

Carwile et al conducted a cross-sectional study using data from the 2011 to 2016 National Health and Nutrition Examination Survey (NHANES) to examine relationships between biomarkers of exposure to PFAS and phthalates and total body less head areal bone mineral density (aBMD) Z scores among adolescents aged 12 to 19 years (1). The authors found that higher concentrations of several PFAS and phthalate biomarkers were associated with lower total body less head aBMD Z scores in males, while there were modest positive associations with aBMD for some chemicals among females. Similar to prior epidemiologic studies examining prenatal (45) or childhood (67) PFAS exposures, Carwile and colleagues found the strongest magnitude of association for exposure to perfluorooctanoate.

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