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Eur J Nutr. 2016 Apr;55(3):1011-20. doi: 10.1007/s00394-015-0915-0. Epub 2015 May 5.

The modifying effect of vitamin C on the association between perfluorinated compounds and insulin resistance in the Korean elderly: a double-blind, randomized, placebo-controlled crossover trial.

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Department of Environmental Health, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, 110-799, Republic of Korea.
Department of Health, Environment and Safety, Eulji University, Sungnam, Republic of Korea.
Department of Marine Science, College of Natural Sciences, University of Incheon, Incheon, Republic of Korea.
Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, 110-799, Republic of Korea.
Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.



There is limited evidence whether environmental exposure to perfluorinated compounds (PFCs) affects insulin resistance (IR) and whether vitamin C intake protects against the adverse effect of PFCs. This study was carried out to investigate the effect of PFCs on IR through oxidative stress, and the effects of a 4-week consumption of vitamin C supplement compared placebo on development of IR by PFCs.


For a double-blind, community-based, randomized, placebo-controlled crossover intervention of vitamin C, we assigned 141 elderly subjects to both vitamin C and placebo treatments for 4 weeks. We measured serum levels of PFCs to estimate PFC exposures and urinary levels of malondialdehyde (MDA) and 8-hydroxy-2'-deoxyguanosine (8-OHdG) for oxidative stress. We also measured levels of fasting glucose and insulin and derived the homeostatic model assessment (HOMA) index to assess IR.


Perfluorooctane sulfonate (PFOS) and perfluorododecanoic acid (PFDoDA) levels were found to be positively associated with HOMA index at the baseline and after placebo treatment. Risks of IR for the top decile of PFOS and PFDoDA exposures were significantly elevated compared with those with lower PFOS and PFDoDA exposures (both, P < 0.0001). However, the effects of PFOS and PFDoDA on HOMA disappeared after vitamin C supplementation (both, P > 0.30). Furthermore, PFOS and PFDoDA levels were also significantly associated with MDA and 8-OHdG levels, and MDA levels were positively associated with HOMA index.


PFOS and PFDoDA exposures were positively associated with IR and oxidative stress, and vitamin C supplementation protected against the adverse effects of PFOS and PFDoDA on IR.


Insulin resistance; Oxidative stress; Perfluorinated compounds; Vitamin C supplementation

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