Association between urinary polycyclic aromatic hydrocarbon metabolites and diabetes-related mortality: a longitudinal study in U.S. adults.

Abstract

Introduction: This study aimed to explore the association between urinary Polycyclic Aromatic Hydrocarbons (PAHs) and diabetes prevalence and all-cause mortality in U.S. adults using data from 8,124 participants in the 2003-2014 NHANES cycles METHODS: Weighted logistic regression and Cox proportional hazards models were employed to analyze the effects of individual and combined PAH metabolites. Confounders were adjusted, and nonlinear relationships were explored through restricted cubic splines.

Results: Weighted quantile sum regression revealed that co-exposure to six urinary PAHs was significantly associated with higher diabetes prevalence (OR = 1.131, 95% CI 1.008-1.269) and all-cause mortality (OR = 1.330, 95% CI 1.051-1.684), with 2-hydroxynaphthalene contributing most to diabetes risk and 1-hydroxynaphthalene to mortality risk within the mixture. In exploratory analyses of individual metabolites, nominal (unadjusted for multiple comparisons) positive associations were observed for ΣPAHs and 1-hydroxynaphthalene with diabetes prevalence. ΣPAHs also showed a modest association with all-cause mortality.

Conclusions: These findings suggest that PAH exposure is associated with a higher prevalence of diabetes and, among individuals with diabetes, higher all-cause mortality.