Associations of perfluoroalkyl and polyfluoroalkyl substances with markers of glycaemic control, insulin secretion and sensitivity, and diabetes risk: a systematic review and meta-analyses

作者：Sandra India Aldana, Xin Ming Yu, Meizhen Yao, Nathan Cohen, Eftychia Markopoulou, Maanal Chowdhury, Vishal Midya, Stephanie Marie Eick, Jessica Trowbridge, Anne P. Starling, Dinesh Kumar Barupal, Douglas I. Walker, Leda Chatzi, Veronica Wendy Setiawan, Ryan W. Walker, Elena Colicino, Damaskini Valvi · 发表于：EClinicalMedicine · 年份：2026 · DOI：10.1016/j.eclinm.2025.103747 · 被引用次数：9 · 研究领域：Per- and polyfluoroalkyl substances research、Fluorine in Organic Chemistry、Toxic Organic Pollutants Impact

Background Growing literature examines the impact of per- and polyfluoroalkyl substances (PFAS) on diabetes risk. We aimed to conduct a comprehensive systematic review and meta-analysis of epidemiological studies to characterize the associations of exposures to PFAS with markers of glycemic control, insulin resistance, pancreatic β-cell function, and diabetes risk. Methods A systematic search of epidemiological articles published through July 21, 2025 was conducted by two researchers in PubMed/MEDLINE and Ovid/EMBASE following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Experimental studies were excluded from our review. Reported findings were extracted from published articles. Risk of bias was evaluated using the Navigation Guide. Random-effects meta-analyses stratified by study design estimated PFAS associations with gestational diabetes mellitus (GDM), type 2 diabetes (T2D), and continuous measures of Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), HOMA-β, fasting insulin, fasting glucose, and hemoglobin A1c (HbA1c). This study was registered in PROSPERO (CRD42022369711). Findings Out of 738 records retrieved, we identified 129 eligible studies. Most studies focused on GDM (n = 25) and/or T2D (n = 36), while three focused on type 1 diabetes (T1D). Participant numbers ranged from n=40 to n=1,331,541 in the systematic review and from n=399 to n=111,544 in the meta-analyses. We found consistent associations betwee...