Environmental chemicals may interfere in infants’ bone development

European Society of Endocrinology

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Infants exposed to certain environmental chemicals, including breast milk and everyday products such as personal care items, are more likely to have lower bone density in the first year of their lives, according to research presented at the 28th European Congress of Endocrinology in Prague. The findings highlight how exposure to environmental pollutants early in life may negatively affect bone development, and the use of which urgently needs to be better regulated on a national and international level.

Endocrine-disrupting chemicals (EDCs) used in the manufacture of plastics, cosmetics, pesticides and medicines can interfere with the normal function of our hormones, as we are constantly exposed to these in our daily lives. EDCs have previously been associated with puberty and child development, including skeletal development. However, except for perfluoroalkyl and polyfluoroalkyl substances (PFAS) which are well-known to have a negative effect on bone health, there is little research on bisphenols and phthalates.

 

In this study, researchers from the University of Parma, University Hospital of Parma, University of Florence, University of Messina and G. Martino University Hospital of Messina in Italy analysed 52 different chemicals in urine of 88 healthy one-month-old infants. By using Radiofrequency Echographic Multi Spectrometry (REMS) technology, they also measured the infants’ bone mineral density (BMD) — at 48 hours after birth, one month, three months, six months and one year.

The researchers found that at least 21 of the environmental chemicals analysed were detectable in one-month-old infants and only boys had a lower bone mineral density only at birth. Higher levels of Bisphenol A (BPA) were associated with lower bone density at birth, while higher levels of phthalates were linked to lower bone density at both six and 12 months of age. This association was stronger at 12 months when BPA and several phthalates were combined. In addition, several PFAS, including PFHxS, and parabens were also implicated in lower bone density at different months.

“Evidence has suggested that EDCs may adversely affect skeletal development that begins in fetal life and continues through infancy, but hardly any studies have measured bone mineral density during the first 12 months and assessed these chemicals at such a young age as we did in ours,” said lead investigator, Professor Maria Elisabeth Street from the University of Parma.

She added: “Measuring the bone mineral density in infants is very difficult due to technical, biological and practical barriers.”

“Our study shows that early exposure to some EDCs — such as PFAS and a combination of Bisphenol A, phthalates and parabens — is associated with a lower bone mineral density at 12 months after birth, suggesting that infancy is a vulnerable window for environmental exposure and skeletal development,” said Professor Street. “This calls for protection and action to reduce exposure during pregnancy and after delivery for better bone health in future generations.”

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Abstract
OC8.5

Bone mineral density (BMD) evaluated using REMS is associated during the first year of life with early life exposure to endocrine-disrupting chemicals (EDCs)

Background: Human data on early exposure to EDCs and bone outcomes remain limited. This study-clinical trial (NCT06750523) evaluated bone status from intrauterine life and investigated factors affecting BMD in infants. We present data on early-life exposure to EDCs and BMD from birth to 12 months of age.

Materials and methods: This prospective, longitudinal cohort study analyzed urinary concentrations of EDCs in 88 full-term, healthy AGA infants at 1 month of age. 52 compounds were analyzed, including bisphenols (BPA, BPS, BPF, BPFDGE), phthalates (DBP, BBP, DEHP, DEP, DMP, DnOP, MBP, MBzP, MEHP, MEHHP, MEOHP, MEP, MMP, MnOP), parabens (EtPB, MePB, PrPB, iBuPB, iPrPB) and per- and polyfluoroalkyl substances (PFAS: 11Cl- PF3OUdS, 4-2_FTS,8-2_FTS,6-2_FTS,9Cl-PF3ONS, ADONA, FBSA, FOSA, GenX_HFPO-DA, PFBA, PFBS, PFDA, PFDS, PFDoDA, PFHpS, PFHxS, PFNA, PFNS, PFOA, PFOS, PFPHpA, PFPHxA, PFPeA, PFPeS, PFTrDA,PFTreDA, PFUnDA) by UPLC-MS/MS. BMD was assessed using Radiofrequency Echographic Multi Spectrometry (REMS), and BMD z-scores were defined at 48hours after birth(V0), at 1 (V1), 3 (V3), 6 (V6) and 12 months of life (V12). Associations between urinary EDC concentrations and BMD z-scores across time points were evaluated by correlation and principal component (PCA) analyses.

Results: At V0, BMD z-score was 1.31+0.87; -0.09+0.61at V1; -0.06+0.99 at V3; -0.03+0.97at V6, and -0.04+1.01 at V12. At birth, BMD z-scores were different in males and females (p:0.028), but this disappeared thereafter. In the infant’s urine, BPA was detected in 62.5% of samples, BPS in 19.3%; EtPB in 1.1%,MePB in 21.6%,PrPB in 9.1%. Among PFAS,6-2_FTS was detected in 73.9% of samples, PFBA in 70.5%, PFDA in 3.4%,PGHxS in 29.5%, PFNA in 15.9%, PFOA in 69.3%, PFOS in 76.1%, PFPHpA in 78.4%, PFPHxA in 63.6%. DBP was detected in 2.3%, MBP in 100%, MBzP in 22.7%, MEHHP in 62.5%, MEHP in 1.1%, MEOHP in 42.0% and MEP in 98.9%. BPA and PFDA were associated with BMD z-score at V0 (r: -0.31,p:0.025 and r:0.99,p:0.038, respectively). MePB was associated with BMD z-scores at V6 and V12 (r:-0.52,p:0.044 and r:-0.738,p:0.009). PFHxS,PFNA and PFOS presented associations with BMD z-scores at V6 (r:-0.49, p:0.015; r:-0.615, p:0.037; r:-0.287,p:0.030). Phthalates showed the most consistent associations with BMD at both V6 and V12. DEP showed a linear association with BMD z-scores at 6 (r:-0.557,p:0.039) and 12 (r:-0.703, p:0.035) months. MBP,MBzP and MEOHP were associated with BMD z-scores at V12 (r:-0.346, p:0.015; r:-0.654,p:0.040; r:-0.501, p:0.021). Notably, PCA found a cluster (19%) of BPA and phthalates(MBzP, MBP, MEOHP) with BMD z-score at V12, suggesting that higher exposure is associated with lower BMD at 1 year of age. Additionally, PFHxS contributed to BMD z-scores at V1,V3 and V6 (13.4%).

Funding: PNNR-MAD-2022–12376819; Project funded under the National Recovery and Resilience Plan (NRRP, M6/C2_CALL 2022 Italian Ministry of Health funded by the European Union – NextGenerationEU).