A new study has identified a link between specific per- and polyfluoroalkyl substances (PFAS) and an increased risk of metabolic dysfunction-associated steatotic liver disease (MASLD) in adolescents. The research indicates that higher levels of certain PFAS compounds are correlated with a greater probability of MASLD, a condition affecting a significant portion of children, particularly those with obesity. The findings were published in the journal Environmental Research.
Research Collaboration and Publication
The study was co-led by researchers at the University of Hawaiʻi at Mānoa and the Southern California Superfund Research and Training Program for PFAS Assessment, Remediation and Prevention (ShARP) Center. Additional study partners included the University of California Irvine, West Virginia University, Johns Hopkins University, and Children’s Hospital Los Angeles.
Key Findings
The study's findings include:
- Higher blood levels of two common PFAS, perfluorooctanoic acid (PFOA) and perfluoroheptanoic acid (PFHpA), were correlated with an increased incidence of MASLD.
- Adolescents with double the amount of PFOA in their blood showed a nearly three-fold higher probability of having MASLD.
- The risk of MASLD was further elevated for individuals possessing a specific genetic variant (PNPLA3 GG) known to influence liver fat accumulation.
- Among young adults, smoking appeared to intensify PFAS-related liver impacts.
- MASLD incidence increased with age among adolescents in the study, suggesting that puberty and early adulthood may represent periods of heightened susceptibility to environmental exposures.
Researchers, including Assistant Professor Shiwen “Sherlock” Li of UH Mānoa’s Department of Public Health Sciences, noted that adolescents may be particularly susceptible to PFAS effects due to their critical period of development and growth. Professor Lida Chatzi, director of the ShARP Center, indicated that the accumulation of liver fat during adolescence may contribute to long-term metabolic and liver health challenges.
About MASLD
MASLD, formerly known as fatty liver disease, affects approximately 10% of children and up to 40% of children classified as having obesity. It is a chronic condition that often presents without overt symptoms, though some individuals may experience fatigue, discomfort, and abdominal pain. The disease increases the long-term risk for type 2 diabetes, heart disease, advanced liver injury, cirrhosis, and liver cancer. Researchers also noted that MASLD can progress without symptoms for years before leading to severe health issues.
About PFAS
PFAS are manufactured chemicals used in various products, including nonstick cookware, stain- and water-repellent fabrics, food packaging, and certain cleaning agents. These substances, also known as “forever chemicals,” are persistent in the environment and can accumulate in the human body. Data indicates that over 99% of the U.S. population has detectable PFAS levels in their blood, and at least one PFAS is present in roughly half of U.S. drinking water sources. PFAS exposure has also been associated with other adverse health outcomes, including specific types of cancer.
Study Methodology
The research involved 284 adolescents and young adults from Southern California. These individuals were participants in two USC longitudinal studies and were pre-identified as being at higher metabolic risk due to their parents having type 2 diabetes or being overweight. PFAS levels were quantified via blood tests, and liver fat was assessed using MRI technology.
This study is noted as the first to investigate PFAS and MASLD in children using established diagnostic criteria and to explore potential interactions with genetic and lifestyle factors. The research complements previous USC findings that linked PFHpA to more severe liver disease, including inflammation and fibrosis, in adolescents undergoing bariatric surgery for obesity. The findings suggest that PFAS exposures, genetic predispositions, and lifestyle choices may collectively influence MASLD development across different life stages.
Recommendations and Future Implications
To mitigate exposure to PFAS, researchers suggested actions such as checking local Consumer Confidence Reports for PFAS testing results from water providers and utilizing a water filter if PFAS are detected. Avoiding products or packaging known to contain PFAS is also recommended. Given the global increase in MASLD rates among young people, the researchers advocate for continued investigation and the implementation of policies aimed at reducing PFAS use in consumer products.