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PFAS in Early Life and Risk of Celiac Disease: Results from Two Scandinavian Cohorts

Størdal, Ketil ; Rantakokko, Panu ; Stene, Lars C. ; Hård af Segerstad, Elin M LU orcid ; Hyöty, Heikki ; Laiho, Jutta E. ; Toppari, Jorma ; Knip, Mikael ; Veijola, Riitta and Pokka, Tytti , et al. (2026) p.1-17
Abstract
Background: The external environment, including toxicants, remains largely unexplored in celiac disease (CeD). Some of the per- and polyfluoroalkyl substances (PFAS) have immune-toxic properties and may play a role in the development of autoimmune diseases.

Methods: In case-control studies nested in the Norwegian MoBa and the Finnish DIPP cohorts, children with CeD were identified by case-finding (n=349, MoBa) or screening with clinical ascertainment (n=129, DIPP). Cohort controls were randomly selected (n=324, MoBa) or matched by age, sex and place of birth (n=273, DIPP). Blood samples were collected at birth (cord blood, MoBa) or at the age of 6 months (DIPP) and 15 PFAS compounds were measured using liquid chromatography mass... (More)
Background: The external environment, including toxicants, remains largely unexplored in celiac disease (CeD). Some of the per- and polyfluoroalkyl substances (PFAS) have immune-toxic properties and may play a role in the development of autoimmune diseases.

Methods: In case-control studies nested in the Norwegian MoBa and the Finnish DIPP cohorts, children with CeD were identified by case-finding (n=349, MoBa) or screening with clinical ascertainment (n=129, DIPP). Cohort controls were randomly selected (n=324, MoBa) or matched by age, sex and place of birth (n=273, DIPP). Blood samples were collected at birth (cord blood, MoBa) or at the age of 6 months (DIPP) and 15 PFAS compounds were measured using liquid chromatography mass spectrometry. The sum of four common PFASs (PFOS + PFOA + PFHxS + PFNA = PFAS4) were the primary exposure in logistic regression models, adjusted for parity, maternal education, breastfeeding (DIPP) and other covariates.

Findings: The cord blood PFAS4 concentration in MoBa was similar between cases (mean 8·47 ng/mL; SD 3·60) and controls (8·63; 4·21), and the adjusted odds ratio for CeD per unit increase was 0·99 (95% CI 0·95–1·04). In DIPP, the serum PFAS4 concentration at the age of 6 months was also similar between cases (13·30 ng/mL; SD 10·47) and controls (13·61; SD 10·29), and the adjusted odds ratio per unit increase was 1·00 (0·97–1·03). None of the specific PFASs (PFOS, PFOA, PFHxS, PFNA) were associated with CeD in MoBa or DIPP. The PFAS4 concentrations were significantly lower by increasing birth year and parity.

Interpretation: The findings suggest that pre- and postnatal exposure to the environmental toxicant PFAS does not contribute to the risk of CeD in childhood. The findings were robust across cohorts and exposure pathways. Funding Funded by a grant from EU Horizon 2020. (Less)
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publishing date
type
Working paper/Preprint
publication status
published
pages
1 - 17
publisher
SSRN
DOI
10.2139/ssrn.7344903
language
English
LU publication?
no
id
21ebf4e6-f5a9-450a-9c34-c1f0897a4b76
date added to LUP
2026-09-01 23:35:08
date last changed
2026-09-02 08:03:52
@misc{21ebf4e6-f5a9-450a-9c34-c1f0897a4b76,
  abstract     = {{Background: The external environment, including toxicants, remains largely unexplored in celiac disease (CeD). Some of the per- and polyfluoroalkyl substances (PFAS) have immune-toxic properties and may play a role in the development of autoimmune diseases.<br/><br/>Methods: In case-control studies nested in the Norwegian MoBa and the Finnish DIPP cohorts, children with CeD were identified by case-finding (n=349, MoBa) or screening with clinical ascertainment (n=129, DIPP). Cohort controls were randomly selected (n=324, MoBa) or matched by age, sex and place of birth (n=273, DIPP). Blood samples were collected at birth (cord blood, MoBa) or at the age of 6 months (DIPP) and 15 PFAS compounds were measured using liquid chromatography mass spectrometry. The sum of four common PFASs (PFOS + PFOA + PFHxS + PFNA = PFAS4) were the primary exposure in logistic regression models, adjusted for parity, maternal education, breastfeeding (DIPP) and other covariates.<br/><br/>Findings: The cord blood PFAS4 concentration in MoBa was similar between cases (mean 8·47 ng/mL; SD 3·60) and controls (8·63; 4·21), and the adjusted odds ratio for CeD per unit increase was 0·99 (95% CI 0·95–1·04). In DIPP, the serum PFAS4 concentration at the age of 6 months was also similar between cases (13·30 ng/mL; SD 10·47) and controls (13·61; SD 10·29), and the adjusted odds ratio per unit increase was 1·00 (0·97–1·03). None of the specific PFASs (PFOS, PFOA, PFHxS, PFNA) were associated with CeD in MoBa or DIPP. The PFAS4 concentrations were significantly lower by increasing birth year and parity.<br/><br/>Interpretation: The findings suggest that pre- and postnatal exposure to the environmental toxicant PFAS does not contribute to the risk of CeD in childhood. The findings were robust across cohorts and exposure pathways.  Funding Funded by a grant from EU Horizon 2020.}},
  author       = {{Størdal, Ketil and Rantakokko, Panu and Stene, Lars C. and Hård af Segerstad, Elin M and Hyöty, Heikki and Laiho, Jutta E. and Toppari, Jorma and Knip, Mikael and Veijola, Riitta and Pokka, Tytti and Paciencia, Ines and Kurppa, Kalle and Koponen, Jani and Tapia, German}},
  language     = {{eng}},
  note         = {{Preprint}},
  pages        = {{1--17}},
  publisher    = {{SSRN}},
  title        = {{PFAS in Early Life and Risk of Celiac Disease: Results from Two Scandinavian Cohorts}},
  url          = {{http://dx.doi.org/10.2139/ssrn.7344903}},
  doi          = {{10.2139/ssrn.7344903}},
  year         = {{2026}},
}