Per- and Polyfluoroalkyl Substance Exposure Associated with Later Puberty in Norwegian Girls: Data from the Bergen Growth Study 2

Per- and polyfluoroalkyl substances (PFAS) are a group of endocrine-disrupting chemicals, however their effect on pubertal development remains largely unknown. In this cross-sectional study, we examined associations between PFAS exposure and pubertal timing in a cohort of 618 girls aged 6 to 16 years from the Bergen Growth Study 2 in Norway, 2016. Serum concentrations of 19 PFAS were measured, and pubertal development was assessed using several pubertal markers, including ultrasound-assessed breast development, Tanner staging, pubertal hormone levels, and age at menarche. We applied quantile g-computation, elastic net, and Bayesian regression to evaluate both combined and individual effects of PFAS exposure, in addition to single-pollutant analyses. Higher PFAS concentrations were significantly associated with later thelarche, pubarche, lower serum levels of luteinizing hormone, follicle-stimulating hormone, estrone, and estradiol, and later menarche. Among the PFAS analyzed, perfluorooctanesulfonic acid (PFOS) and perfluorodecanoic acid (PFDA) emerged as the key predictors of later pubertal markers. Our results indicate that PFAS exposure is associated with later puberty in girls.