Association Between Perfiluoroalkyl and Polyfluoroalkyl (PFAS) Substances Mixture Exposure and Diabetes in U.S. Adults: Results from NHANES 2015-2018

Perfluoroalkyl and polyfluoroalkyl substances (PFAS), recognized as endocrine-disrupting chemicals, persist in the environment and pose significant health risks. Their association with a wide range of human diseases has been established. This study specifically seeks to investigate the correlation between PFAS exposure factors and diabetes. For our analysis, we utilized data from the National Health and Nutrition Survey (NHANES) spanning from 2015 to 2018. To assess the comprehensive effects of PFAS exposure factors on diabetes, we employed a logistic model, RCS regression analysis, and WQS regression.This study analyzed data from 221 individuals aged 18 years or older, among whom 37 had diabetes. After adjusting for potential confounders, significant associations were observed between diabetes and PFOSA (OR: 15.31, 95% CI: 1.78-130.93), PFUnDA (OR: 3.50, 95% CI: 1.25-11.82), PFOS (OR: 1.16, 95% CI: 1.08-1.28), and SmPFOS (OR: 1.44, 95% CI: 1.06-1.97). None of these associations exhibited a nonlinear correlation. Additionally, in the Weighted Quantile Sum Regression analysis (: 1.5081, P=0.002), PFAS exposure demonstrated a positive correlation with diabetes prevalence.Our findings suggest a positive correlation between PFAS exposure and diabetes in the studied population. However, further research is necessary to confirm this association and elucidate its underlying mechanisms.