Association of urinary personal care products levels with diabetes in adults aged 18 years and above in China

Objective: To investigate the association between urinary personal care products (PCPs) level and the risk of diabetes among adults aged 18-79 years. Methods: Data was derived from the China National Human Biomonitoring survey conducted in 2017-2018, with a final sample size of 911 adults. Information on general demographic characteristics, behavioral habits, and dietary frequency was collected through questionnaire surveys and physical examinations. Fasting venous blood and midstream random urine samples were collected to measure fasting blood glucose and urinary personal care product levels. Multivariable logistic regression models were used to examine the associations between urinary PCP levels and diabetes prevalence. Subgroup analyses were further conducted according to age, sex, residence, and history of hair dyeing or perming. Results: A total of 911 participants were included in this study, including 458 females (50.3%), 319 residents aged 19-39 years (35.0%), and 456 rural residents (50.1%). The concentrations of the three parabens were 23.30 (20.73, 26.19), 2.00 (1.74, 2.30), and 2.74 (2.34, 3.22) μg/g creatinine, respectively. Multivariable logistic regression analysis showed that, after adjusting for potential confounding factors, urinary ethyl paraben (EtP) levels were positively associated with diabetes prevalence (OR=1.17, 95%CI: 1.02-1.34, P=0.025). Subgroup analyses further showed that the positive association between urinary EtP levels and diabetes prevalence was stronger among females (OR=1.25, 95%CI: 1.02-1.54, P=0.029) and individuals with a history of hair dyeing or perming (OR=1.29, 95%CI: 1.05-1.59, P=0.016). Conclusion: Urinary ethyl paraben exposure was positively associated with an increased risk of diabetes among Chinese adults, with women and individuals with a history of hair dyeing or perming potentially representing susceptible subpopulations warranting further attention.