{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T16:03:14Z","timestamp":1789833794455,"version":"4.0.1"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are persistent, widespread environmental contaminants linked to cardiometabolic outcomes including obesity, hyperlipidemia, and diabetes. We examined whether baseline plasma PFAS concentrations are associated with incident cardiovascular disease (CVD) in adults with prediabetes, leveraging data from DPPOS (Diabetes Prevention Program Outcomes Study).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among 1382 participants, we quantified baseline plasma concentrations of 6 PFAS. We used Cox proportional hazards models to estimate the risks of developing CVD outcomes during a median of 21\u2009years of follow\u2010up for each PFAS and used quantile g\u2010computation to evaluate the joint effect of all 6 PFAS. Effect modification by age, sex, menopausal status, diet, and physical activity was explored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The incidence of major adverse cardiovascular events was 9.6%; 3.9% had CVD\u2010related death. Each increase in interquartile range (1.1\u2009ng\/mL) in 2\u2010(\n                      <jats:italic toggle=\"no\">N<\/jats:italic>\n                      \u2010methyl\u2010perfluorooctane sulfonamido) acetate was associated with a 16% higher risk of major adverse cardiovascular events (95% CI, 1\u201333%) and a 24% higher risk of CVD death (95% CI, 2\u201352%). Higher concentrations of perfluorohexane sulfonate, perfluorooctane sulfonate, 2\u2010(\n                      <jats:italic toggle=\"no\">N<\/jats:italic>\n                      \u2010ethyl\u2010perfluorooctane sulfonamido) acetate, and perfluorooctanoate were associated with greater risk of CVD outcomes, including nonfatal myocardial infarction, hospitalized congestive heart failure, and cardiovascular death. However, PFAS mixture was not associated with CVD. Age, sex, treatment arm, physical activity, and diet did not modify the associations of individual PFAS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p xml:lang=\"en\">In adults with prediabetes, higher plasma concentrations of select PFAS, but not their mixture, were prospectively associated with increased CVD risk. These findings underscore PFAS as a potential environmental risk factor for CVD in high\u2010risk populations.<\/jats:p>\n                    <jats:p xml:lang=\"en\">\n                      <jats:bold>REGISTRATION:<\/jats:bold>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/\">https:\/\/clinicaltrials.gov\/<\/jats:ext-link>\n                      ; Unique identifiers: NCT00004992 and NCT00038727.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.046298","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T04:15:22Z","timestamp":1766117722000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Associations of Perfluoroalkyl and Polyfluoroalkyl Substances With Cardiovascular Disease Incidence in Adults With Prediabetes: Findings From the Diabetes Prevention Program"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3564-4255","authenticated-orcid":false,"given":"Pi\u2010I Debby","family":"Lin","sequence":"first","affiliation":[{"name":"Harvard Medical School and Harvard Pilgrim Health Care Institute","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2284-3298","authenticated-orcid":false,"given":"Andres","family":"Cardenas","sequence":"additional","affiliation":[{"name":"Stanford University","place":["Stanford, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9976-745X","authenticated-orcid":false,"given":"Marinella","family":"Temprosa","sequence":"additional","affiliation":[{"name":"Milken Institute School of Public Health, the George Washington University","place":["Washington, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julianne Cook","family":"Botelho","sequence":"additional","affiliation":[{"name":"National Center for Environmental Health, Centers for Disease Control and Prevention","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9796-7482","authenticated-orcid":false,"given":"Antonia M.","family":"Calafat","sequence":"additional","affiliation":[{"name":"National Center for Environmental Health, Centers for Disease Control and Prevention","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane R.","family":"Gold","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health","place":["Boston, USA"]},{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2513-3339","authenticated-orcid":false,"given":"Emily","family":"Oken","sequence":"additional","affiliation":[{"name":"Harvard Medical School and Harvard Pilgrim Health Care Institute","place":["Boston, USA"]},{"name":"Harvard T.H. Chan School of Public Health","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abby F","family":"Fleisch","sequence":"additional","affiliation":[{"name":"Center for Interdisciplinary Population & Health Research","place":["Westbrook, USA"]},{"name":"MaineHealth Institute for Research","place":["Westbrook, USA"]},{"name":"Pediatric Endocrinology and Diabetes, Maine Medical Center","place":["Portland, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2023.108033"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.706352"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2021.106789"},{"key":"e_1_3_2_5_2","volume-title":"Toxicological Profile for Perfluoroalkyls","author":"Agency for Toxic Substances and Disease Registry (ATSDR)","year":"2021","unstructured":"Agency for Toxic Substances and Disease Registry (ATSDR) . 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