Association Between Triclocarban And Triclosan Exposures And Type 2 Diabetes Mellitus And Impaired Glucose Tolerance In The National Health And Nutrition Examination Survey(NHANES 2013-2014)

Background:Diabetes mellitus(DM)is a chronic disease that is caused by the interaction of genetic factors and environmental factors.Exposure to environmental chemicals is also one of the causes of diabetes.At present,a variety of environmental chemicals such as cadmium,arsenic,polychlorinated biphenyls,etc.have been confirmed to be related to the occurrence of diabetes.Triclocarban(TCC)and Triclosan(TCS)are two synthetic antibacterial chemicals,which are widely found in personal care products,cosmetics,soil and water.Triclocarban and triclosan(TCs)are new endocrine disruptors,which may cause harm to people’s health through mechanisms such as endocrine disruption.However,the association between exposure to TCs and impaired glucose tolerance(IGT)and type 2 diabetes(T2DM)is currently unclear.Objective:This study explored the association between TCs and IGT and T2DM through data analysis,and at the same time explored the interaction between personal factors in abnormal impaired glucose tolerance and these two compounds.It will help formulate reasonable public health policies,guide and design health plans and services,and expand health knowledge for the global.Methods:A case-control study design was used to analyze the cross-sectional data of the National Health and Nutrition Examination(NHANES)of the United States from 2013to 2014.After screening the database,cleaning and collating the data,900 study subjects were included,541 healthy individuals,117 IGT,and 242 T2DM patients.1.Diagnose impaired glucose tolerance and type 2 diabetes according to WHO standards and Oral Glucose Tolerance Test(OGTT).2.Detect the concentration of triclocarban and triclosan in urine by HPLC-MS/MS method.3.Use t-test or Manny-Whitney test to evaluate differences in the parameters,and use?~2 test to analyze categorical variables.4.Through multivariate logistic regression analysis method,to study the association between urine triclocarban and triclosan concentration and impaired glucose tolerance and type 2 diabetes.5.Analyze the interaction between the urine triclocarban level and the abnormal glucose tolerance group by R software.Results:This study included 900 subjects(429 men and 471 women),of which 242(26.89%)had T2DM and 117(13.00%)had IGT.The T2DM group and the IGT group were collectively referred to as the abnormal glucose tolerance group,541 healthy people is called the healthy group,or the normal glucose tolerance group.1.The BMI index and the prevalence of hypertension of women in the study population were higher than those of men,and the difference was statistically significant(P<0.05).There were no statistical differences between men and women in age,race,education level,family income to poverty ratio,smoking,and exercise time(P>0.05).2.The age,BMI and the prevalence of hypertension in the IGT and T2DM groups were higher than those in the healthy group,and the difference was statistically significant(P<0.001).There were no statistical differences between the healthy group,the IGT group and the T2DM group in terms of gender,race,education level,ratio of family income to poverty,smoking and exercise time(P>0.05).3.Multivariate logistic regression was used to analyze the association between TCs exposure and abnormal glucose tolerance.In Model 1,female exposure to TCC increased the risk of disease in the abnormal glucose tolerance group(OR=1.78,95%CI:1.22-2.59,P=0.003).In Model 2,the demographic variables were adjusted.Female exposure to TCC also increased the risk of the abnormal glucose tolerance group(OR=1.66,95%CI:1.05-2.63,P=0.030).In Model 3,after adjusting for exercise and hypertension on the basis of Model 2,female exposure to TCC can still increase the risk of abnormal glucose tolerance(OR=1.64,95%CI:1.04-2.61,P=0.034).In all models,no association between TCS exposure and abnormal glucose tolerance group was observed in male and female subjects(P>0.05).4.Use multivariate logistic regression to analyze the association between healthy group,IGT group and T2DM group and TCs exposure.Taking the"healthy group"as the reference group,in Model 1,female exposure to TCC increased the risk of T2DM(OR=1.88,95%CI:1.23-2.89,P=0.004).After adjusting for demographic variables in Model 2,female exposure to TCC increased the risk of T2DM(OR=1.80,95%CI:1.06-3.07,P=0.030).In Model 3,after adjusting for exercise and hypertension on the basis of Model 2,female exposure to TCC can still increase the risk of T2DM(OR=1.79,95%CI:1.05-2.05,P=0.032).In all models,no significant associations between TCS exposure and IGT and T2DM were observed in male and female subjects(P>0.05).5.TCC exposure and hypertension or exercise duration have no additive or multiplicative interaction on the abnormal glucose tolerance group(P>0.05).Conclusions:Triclocarban exposure is strongly associated with type 2 diabetes in women,and further cohort studies and experiments are needed to confirm this result.No association was observed between triclosan exposure and impaired glucose tolerance and type 2diabetes.