Oral Presentation International Celiac Disease Symposium 2026

PFAS in early life and risk of celiac disease: Results from two Scandinavian cohorts (145324)

Ketil Stordal 1 2 , Panu Rantakokko 3 , Lars C. C. Stene 4 , Elin HÅRD AF SEGERSTAD 2 , German Tapia 4 , Heikki Hyoty 5 6 , Jutta Laiho 5 , Mikael Knip 2 , Jorma Toppari 7 , Riitta Veijola 8 , Tytti Pokka 8 , Aino K Rantala 9 , Kalle Kurppa 10 , Jani Koponen 3
  1. Department of pediatric research, University of Oslo, Oslo, Norway
  2. Department of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
  3. Lifestyles and Living Environments Unit, Chemical Risks Team, Finnish Institute for Health and Welfare , , Kuopio, Finland
  4. Department of chronic diseases, Norwegian Institute of Public Health, Oslo, Norway
  5. Faculty of Medicine and Health Technology , Tampere University, Tampere, Finland
  6. Department of Pediatrics, Tampere University Hospital, Tampere, Finland
  7. Department of Pediatrics and Institute of Biomedicine, Turku University Hospital and University of Turku , Turku, Finland
  8. Department of Pediatrics, Research Unit of Clinical Medicine, Medical Research Center, University of Oulu, Oulu, Finland
  9. Center for Environmental and Respiratory Health Research, Research Unit of Population Health, University of Oulu, Oulu, Finland
  10. Celiac Disease Research Centre, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland

Background/aim:

The external environment, including toxicants, remains largely unexplored in celiac disease (CeD). Some of the per- and polyfluoroalkyl substances (PFAS), often labelled “forever chemicals”, 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 (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 collected at birth (cord blood, MoBa) or at the age of 6 months (DIPP) and 15 PFAS compounds were analyzed at the Finnish Institute for Health and Welfare using liquid chromatography mass spectrometry. The sum of  four common PFASs (PFOS + PFOA + PFHxS + PFNA = PFAS4) was the primary exposure in logistic regression models, adjusted for parity, maternal education, and other covariates.

Results

The cord blood PFAS4 concentration in MoBa was similar between cases (mean 8.47; 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 (13.36; SD 10.44) and controls (13.71; SD 10.28), and the adjusted odds ratio per unit increase was 1.00 (0.97-1.02). 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.

Conclusions 

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 routes/pathway.