Organophosphate esters exposure in relation to glucose homeostasis and type 2 diabetes in adults: A national cross-sectional study from the national health and nutrition survey

Exposure to organophosphate esters (OPEs) may be associated with impaired glucose homeostasis and increased risk of type 2 diabetes (T2D) in adolescent. However, the evidence in general population is scarce, especially for glucose homeostasis. We used data from the National Health and Nutrition Examination Survey (NHANES) 1999-2008 and 2011-2012 to investigate the relationship of urinary OPEs with glucose homeostasis and T2D in adults.A total of 5347 participants aged ≥20 years were included. The exposures were the concentrations of urinary OPEs metabolites [dimethyl phosphate (DMP), dimethyl thiophosphate (DMTP), dimethyl dithiophosphate (DMDTP), diethyl phosphate (DEP), diethyl thiophosphate (DETP), and diethyl dithiophosphate (DEDTP)]. The health outcomes were prevalence of T2D and glucose homeostasis [i.e., fasting glucose, 2-h plasma glucose during a 75-g oral glucose tolerance test (2 h-OGTT), serum insulin, HemoglobinA1c (HbA1c), HOMA-IR, and HOMA-β]. The multivariable linear regression model was used to evaluate the relationship between OPEs and glucose homeostasis. The multivariable binary logistic regression analysis was used to investigate the relationship between OPEs and prevalence of T2D.The OPEs compound DMTP was significantly associated with higher levels of serum insulin [β (95%confidence interval, CI) = 0.21 (0.06,0.36), for one unit increase in log2-transformed exposure] and HOMA IR [β (95%CI) = 0.08 (0.02,0.14)], and increased odds of T2D [odds ratio (95% CI) = 1.05 (1.01-1.08)]. Other OPEs were not statistically associated with the serum markers for glucose homeostasis or T2D prevalence.Our study found that the OPEs compound DMTP might be associated with impaired glucose homeostasis and may increase the prevalence of T2D in U.S. adults. Further longitudinal or experimental studies are warranted to verify our findings in different populations and different OPEs concentrations.