Association between urinary trans,trans-muconic acid and diabetes: a cross-sectional analysis of data from Korean National Environmental Health Survey (KoNEHS) cycle 3 (2015–2017)

Abstract

Background Benzene is a ubiquitous air pollutant that is well known to cause hematopoietic effects in humans including leukemia. Recently, several studies have discussed its non-carcinogenic effects such as diabetes. This study aimed to investigate the association between diabetes and urinary trans,trans-muconic acid (t,t-MA), one of benzene metabolite, using adult data from Korean National Environmental Health Survey (KoNEHS) cycle 3 (2015–2017). Methods This study analyzed 3,777 adults (1,645 men and 2,132 women) from the KoNEHS cycle 3 (2015–2017). The distribution and fraction of each independent variable were presented separately according to the urinary benzene metabolite levels (t,t-MA quartiles) and diabetes to determine the general characteristics of the subjects. Odds ratios (ORs) were calculated using logistic regression after stratification by gender and smoking status to identify the association between urinary t,t-MA and diabetes. Results Compared with the first quartile (reference), the risk of diabetes significantly increased above the 4th (1.834 [1.107–3.039]) quartile in men and above the 3rd (1.826 [1.095–3.044]) and 4th (2.243 [1.332–3.776]) quartiles in women after adjustment. Stratified analysis based on smoking revealed that the ORs for the 3rd (1.847 [1.146–2.976]) and 4th (1.862 [1.136–3.052]) quartiles in non-smokers and those for the 2nd (1.721 [1.046–2.832]), 3rd (1.797 [1.059–3.050]), and 4th (2.546 [1.509–4.293]) quartiles in smokers were significantly higher. Conclusions We confirmed that urinary t,t-MA is significantly associated with diabetes regardless of gender and smoking status. And further studies are necessary to access the clinical impacts of this findings.

Association of metabolites of benzene and toluene with lipid profiles in Korean adults: Korean National Environmental Health Survey (2015–2017)

“…The relationship between TG/HDL-C ratio, an indicator of insulin resistance, and urinary ttMA levels revealed in this study is in line with previous researches [ 12 – 15 ]. An association between urinary ttMA levels and insulin resistance has been reported in children, adolescents, and elderly adults [ 12 , 13 ].…”

“…An association between urinary ttMA levels and insulin resistance has been reported in children, adolescents, and elderly adults [ 12 , 13 ]. Additionally, several studies have revealed that benzene metabolites are associated with an increased risk of DM [ 14 , 15 ]. During benzene metabolism, Cytochrome P450 (CYP) 2E1 produces reactive oxygen species and free radicals, leading to oxidative stress [ 40 – 42 ].…”

“…Several epidemiological studies have demonstrated a relationship between environmental exposure to benzene and metabolic diseases [ 10 – 15 ]. In a retrospective cohort study, participants with a high Framingham risk score had significantly higher levels of urinary trans,trans-muconic acid (ttMA), which is a benzene metabolite [ 10 ].…”

“…Cross-sectional studies have reported that urinary ttMA is associated with metabolic syndrome, oxidative stress, and insulin resistance in children and elderly adults [ 11 – 13 ]. Moreover, a relationship between urinary ttMA and an increased risk of diabetes mellitus (DM) has been found among the adult population of Korea [ 14 , 15 ]. In the same study, no significant relationship was found between DM and urinary benzylmercapturic acid (BMA), a metabolite of toluene [ 14 ].…”

Distribution of volatile organic compounds around Ulsan Industrial Complexes and its possible health impact on the residents; a cross-sectional study

“…Moreover, VOCs can exert an effect on insulin resistance which is the main factor in the development of diabetes [27,[29][30][31][32]. Yang et al also reported that high urinary t,t-MA increased the risk of diabetes regardless of smoking status and sex [33]. Sim et al demonstrated that urine muconic acid and mono-(2-ethyl-5hydroxyhexyl) phthalate (MEHHP) levels, which are metabolites of benzene and phthalate, increased the risk of metabolic syndrome even after adjusting for confounders by 1.34 and 1.39, respectively [34].…”