Association of Urinary Polycyclic Aromatic Hydrocarbons and Diabetes in Korean Adults: Data from the Korean National Environmental Health Survey Cycle 2 (2012–2014)

Figures & data

Table 1 General Characteristics of the Study Subjects

	Total (n=6478)			Men (n=2774)			Women (n=3704)			P-value
Age (years)	46.3	±	0.4	45.4	±	0.4	47.1	±	0.5	<0.001
Age group (n,%)										<0.001
19–29 yr	537		17.7%	263		18.5%	274		16.9%
30–39 yr	1056		19.9%	435		20.7%	621		19.1%
40–49 yr	1226		21.4%	504		22.0%	722		20.8%
50–59 yr	1439		19.4%	578		19.7%	861		19.1%
60–69 yr	1335		11.1%	597		10.8%	738		11.3%
≥70 yr	885		10.6%	397		8.3%	488		12.8%
BMI group (n,%)										<0.001
Underweight	154		3.0%	48		1.6%	106		4.40%
Normal	2183		36.4%	809		29.9%	1374		42.80%
Overweight	1600		23.0%	738		25.1%	862		20.90%
Obese	2541		37.6%	1179		43.4%	1362		32.00%
Household income (USD/months)										<0.001
< 920 USD	1629		17.3%	639		14.6%	990		19.9%
920–2090 USD	1396		19.1%	615		19.0%	781		19.2%
2090–3400 USD	1488		26.4%	660		27.5%	828		25.4%
≥3400 USD	1965		37.2%	860		38.9%	1105		35.5%
Smoking (n,%)										<0.001
Never	4259		62.7%	762		30.6%	3497		93.9%
Former	1058		15.8%	990		29.6%	68		2.3%
Current	1161		21.5%	1022		39.8%	139		3.8%
Drinking (n,%)										<0.001
Never	2230		29.7%	447		15.30%	1783		43.6%
Former	424		5.6%	282		7.00%	142		4.2%
Current	3824		64.7%	2045		77.60%	1779		52.2%
Regular physical activity (n,%)										<0.001
No	4658		72.3%	1931		69.3%	2727		75.1%
Yes	1820		27.7%	843		30.7%	977		24.9%
Diabetes mellitus (n,%)										0.482
No	5928		93.5%	2504		93.3%	3424		93.8%
Yes	550		6.5%	270		6.7%	280		6.2%

Notes: Mean ± SE or number (%), BMI <18.5 for underweight, 18.5–22.9 for normal weight, 23–24.9 for overweight, ≥25 for obese.

Abbreviations: BMI,body mass index; USD, US dollars.

Table 2 Distributions of Urinary PAHs Metabolites Concentrations

		GM (95% CI)		Selected Percentiles
	N	Crude	%≥LOD	25th	50th	75th	95th
1-hydroxypyrene (μg/L)
Total	6418	0.15 (0.14–0.16)	97.1	0.09	0.14	0.25	0.60
Men^a	2745	0.18 (0.17–0.19)	98.1	0.1	0.18	0.32	0.76
Women	3673	0.13 (0.12–0.14)***	96.4	0.08	0.13	0.21	0.56
Smoking status
Never^a	4226	0.12 (0.12–0.13)	96.4	0.08	0.13	0.21	0.49
Former	1046	0.15 (0.14–0.16)***	97.7	0.09	0.14	0.23	0.57
Current	1146	0.27 (0.25–0.28)***	99.2	0.16	0.28	0.44	0.9
2-naphthol (μg/L)
Total	6410	2.23 (2.11–2.35)	98.8	0.83	1.91	5.32	19.9
Men^a	2750	3.02 (2.82–3.25)	99.3	1.09	2.93	8.5	23.1
Women	3660	1.64 (1.54–1.76)***	98.4	0.71	1.46	3.53	14.3
Smoking status
Never^a	4210	1.52 (1.43–1.61)	98.5	0.68	1.39	3.23	12.6
Former	1049	1.76 (1.60–1.92)**	98.7	0.8	1.66	3.85	17.1
Current	1151	7.93 (7.39–8.52)***	100.0	4.51	8.8	14.7	30.7
1-hydroxyphenanthrene (μg/L)
Total	6413	0.10 (0.09–0.10)	79.0	0.05	0.09	0.16	0.38
Men^a	2746	0.11 (0.10–0.11)	82.9	0.06	0.11	0.19	0.45
Women	3667	0.09 (0.08–0.09)***	76.1	0.05	0.08	0.14	0.39
Smoking status
Never^a	4220	0.08 (10.08–0.09)	75.8	0.05	0.08	0.14	0.33
Former	1047	0.09 (0.09–0.10)*	78.4	0.05	0.09	0.16	0.40
Current	1146	0.14 (0.13–0.15)***	91.5	0.09	0.14	0.24	0.48
2-hydroxyfluorene (μg/L)
Total	6397	0.27 (0.25–0.28)	92.9	0.12	0.24	0.51	1.86
Men^a	2735	0.40 (0.37–0.43)	95.7	0.17	0.38	1.00	2.38
Women	3662	0.18 (0.17–0.19)***	90.8	0.09	0.19	0.35	1.00
Smoking status
Never^a	4216	0.18 (0.17–0.19)	91.1	0.10	0.19	0.33	0.80
Former	1045	0.22 (0.20–0.24)***	93.6	0.12	0.23	0.42	1.11
Current	1136	1.01 (0.93–1.09)***	99.1	0.62	1.13	1.82	3.32

Notes: ^aReference for comparison of geometric mean in each variable. ***P<0.001, **P<0.01, *P<0.05.

Abbreviations: BMI, body mass index; CI, confidence interval; GM, geometric mean; LOD, limit of detection.

Table 3 Adjusted Geometric Mean of Polycyclic Aromatic Hydrocarbons (μg/L) Stratified by Participants Characteristics in Men

Factors	Adjusted Geometric Mean (95% CI)
	1-hydroxypyrene (μg/L)	2-naphthol (μg/L)	1-hydroxyphenanthrene (μg/L)	2-hydroxyfluorene (μg/L)
Total	0.19 (0.17–0.21)	3.66 (3.26–4.12)	0.11 (0.10–0.12)	0.43 (0.39–0.47)
Age group
19–29 yr^a	0.15 (0.13–0.17)	2.99 (2.45–3.65)	0.09 (0.08–0.10)	0.37 (0.32–0.43)
30–39 yr	0.15 (0.14–0.17)	3.21 (2.73–3.77)	0.10 (0.09–0.11)*	0.37 (0.33–0.43)
40–49 yr	0.20 (0.18–0.23)***	3.78 (3.26–4.39)**	0.11 (0.10–0.13)***	0.46 (0.40–0.53)**
50–59 yr	0.21 (0.19–0.24)***	3.84 (3.33–4.42)**	0.12 (0.11–0.14)***	0.50 (0.44–0.56)***
60–69 yr	0.22 (0.20–0.25)***	3.81 (3.24–4.48)*	0.12 (0.10–0.13)***	0.45 (0.39–0.51)**
≥70 yr	0.21 (0.19–0.24)***	4.55 (3.76–5.51)**	0.11 (0.10–0.13)***	0.42 (0.37–0.48)*
BMI group
Underweight	0.21 (0.16–0.27)	4.20 (3.17–5.55)	0.10 (0.08–0.12)	0.45 (0.35–0.57)
Normal^a	0.18 (0.16–0.19)	3.49 (3.07–3.97)	0.11 (0.10–0.12)	0.39 (0.35–0.43)
Overweight	0.19 (0.17–0.21)	3.48 (3.05–3.97)	0.11 (0.10–0.12)	0.43 (0.39–0.47)
Obese	0.19 (0.17–0.20)	3.52 (3.16–3.93)	0.11 (0.11–0.12)	0.44 (0.40–0.48)*
Household income (USD/month)
< 920 USD	0.19 (0.16–0.21)	3.85 (3.25–4.55)	0.10 (0.09–0.12)	0.43 (0.38–0.48)
920–2090 USD	0.20 (0.17–0.22)	3.67 (3.17–4.24)	0.11 (0.09–0.12)	0.42 (0.37–0.48)
2090–3400 USD	0.19 (0.17–0.21)	3.70 (3.22–4.25)	0.11 (0.10–0.12)	0.43 (0.38–0.48)
≥3400 USD^a	0.19 (0.17–0.22)	3.44 (3.01–3.93)	0.11 (0.10–0.12)	0.43 (0.38–0.48)
Alcohol consumption
Never^a	0.18 (0.16–0.21)	3.67 (3.17–4.25)	0.11 (0.10–0.12)	0.43 (0.38–0.48)
Former	0.19 (0.16–0.22)	3.68 (3.03–4.47)	0.11 (0.09–0.12)	0.43 (0.36–0.50)
Current	0.20 (0.18–0.22)	3.64 (3.23–4.09)	0.11 (0.10–0.12)	0.43 (0.39–0.47)
Regular physical activity
No^a	0.19 (0.17–0.21)	2.38 (2.20–2.59)	0.10 (0.09–0.11)	0.42 (0.38–0.46)
Yes	0.19 (0.17–0.22)	2.51 (2.30–2.74)	0.11 (0.10–0.12)*	0.43 (0.39–0.48)
Diabetes mellitus
No^a	0.18 (0.16–0.20)	3.26 (2.96–3.60)	0.10 (0.10–0.11)	0.40 (0.37–0.43)
Yes	0.20 (0.18–0.23)	4.11 (3.40–4.97)*	0.11 (0.10–0.13)	0.45 (0.39–0.52)*

Notes: BMI <18.5 for underweight, 18.5–22.9 for normal weight, 23–24.9 for overweight, ≥25 for obese. ^aReference for comparison of geometric mean in each variable. Adjusted for log-transformed urine creatinine, log-transformed urine cotinine, and all variables in the table. ***P< 0.001; **P < 0.01; *P < 0.05.

Abbreviations: BMI, body mass index; CI, confidence interval; USD, US dollars.

Table 4 Adjusted Geometric Mean of Polycyclic Aromatic Hydrocarbons (μg/L) Stratified by Participants Characteristics in Women

Factors	Adjusted Geometric Mean (95% CI)
	1-hydroxypyrene (μg/L)	2-naphthol (μg/L)	1-hydroxyphenanthrene (μg/L)	2-hydroxyfluorene (μg/L)
Total	0.13 (0.12–0.14)	1.64 (1.45–1.86)	0.09 (0.08–0.10)	0.19 (0.17–0.21)
Age group
19–29 yr^a	0.12 (0.10–0.14)	1.88 (1.48–2.39)	0.08 (0.07–0.09)	0.19 (0.16–0.23)
30–39 yr	0.11–(0.10–0.13)	1.51 (1.25–1.83)*	0.08 (0.07–0.10)	0.19 (0.17–0.23)
40–49 yr	0.13 (0.11–0.14)	1.57 (1.32–1.88)	0.09 (0.08–0.10)	0.20 (0.17–0.23)
50–59 yr	0.13 (0.12–0.15)	1.70 (1.44–2.02)	0.09 (0.08–0.10)	0.19 (0.17–0.22)
60–69 yr	0.15 (0.13–0.18)	1.54 (1.26–1.90)	0.09 (0.08–0.11)	0.19 (0.17–0.22)
≥70 yr	0.14 (0.12–0.16)	1.66 (1.33–2.07)	0.09 (0.08–0.10)	0.18 (0.15–0.21)
BMI group
Underweight	0.15 (0.12–0.18)*	1.55 (1.25–1.92)	0.10 (0.08–0.12)*	0.22 (0.18–0.26)*
Normal^a	0.12 (0.11–0.13)	1.64 (1.41–1.91)	0.08 (0.07–0.09)	0.18 (0.16–0.20)
Overweight	0.12 (0.11–0.13)	1.63 (1.37–1.93)	0.08 (0.07–0.09)	0.18 (0.16–0.20)
Obese	0.13 (0.12–0.15)*	1.76 (1.54–2.00)	0.09 (0.08–0.10)**	0.19 (0.17–0.21)
Household income (USD/month)
< 920 USD	0.13 (0.11–0.14)	1.73 (1.44–2.07)	0.09 (0.08–0.10)	0.19 (0.16–0.21)
920–2090 USD	0.14 (0.12–0.15)	1.77 (1.51–2.09)	0.09 (0.08–0.10)	0.20 (0.17–0.22)
2090–3400 USD	0.13 (0.11–0.14)	1.54 (1.30–1.82)	0.09 (0.08–0.10)	0.20 (0.18–0.22)
≥3400 USD^a	0.13 (0.12–0.15)	1.54 (1.34–1.77)	0.09 (0.08–0.10)	0.18 (0.16–0.21)
Alcohol consumption
Never^a	0.13 (0.11–0.14)	1.84 (1.64–2.07)	0.09 (0.08–0.10)	0.19 (0.17–0.21)
Former	0.13 (0.11–0.15)	1.44 (1.11–1.88)	0.09 (0.07–0.11)	0.20 (0.16–0.24)
Current	0.14 (0.12–0.15)	1.66 (1.48–1.87)	0.09 (0.08–0.09)	0.18 (0.17–0.20)
Regular physical activity
No^a	0.13 (0.12–0.14)	1.59 (1.40–1.80)	0.09 (0.08–0.10)	0.19 (0.17–0.22)
Yes	0.13 (0.12–0.15)	1.70 (1.46–1.97)	0.09 (0.08–0.10)	0.19 (0.17–0.21)
Menopause
No	0.13 (0.12–0.15)	1.61 (1.38–1.89)	0.08 (0.07–0.09)	0.18 (0.16–0.20)
Yes^a	0.13 (0.11–0.14)	1.67 (1.43–1.95)	0.09 (0.08–0.10)	0.20 (0.18–0.23)
Diabetes mellitus
No^a	0.14 (0.12–0.15)	0.56 (1.43–1.70)	0.09 (0.08–0.10)	0.19 (1.04–0.17)
Yes	0.13 (0.11–0.14)	1.81 (1.54–2.12)*	0.09 (0.08–0.10)	0.20 (1.07–0.18)

Notes: BMI <18.5 for underweight, 18.5–22.9 for normal weight, 23–24.9 for overweight, ≥25 for obese. ^aReference for comparison of geometric mean in each variable. Adjusted for log-transformed urine creatinine, log-transformed urine cotinine, and all variables in the table. **P < 0.01; *P < 0.05.

Abbreviations: BMI, body mass index; CI, confidence interval; USD, US dollars.

Table 5 Adjusted Odds Ratio (95% CI) for Diabetes Mellitus According to the Quartile of Urinary Polycyclic Aromatic Hydrocarbons (μg/L)

	Adjusted Odds Ratio (95% CI)				P-trend
	I	II	III	IV
1-hydroxypyrene
Total	1.00	0.98 (0.66–1.46)	0.85 (0.55–1.31)	1.02 (0.62–1.71)	0.963
Men	1.00	1.35 (0.73–2.50)	0.91 (0.49–1.68)	1.50 (0.70–3.20)	0.455
Women	1.00	0.79 (0.49–1.29)	0.84 (0.48–1.48)	0.74 (0.38–1.43)	0.427
2-naphthol
Total	1.00	1.08 (0.79–1.49)	1.57 (1.09–2.27)	1.83 (1.29–2.60)	<0.001
Men	1.00	0.91 (0.56–1.50)	1.27 (0.73–2.27)	2.07 (1.20–3.55)	0.013
Women	1.00	1.43 (0.89–2.29)	2.31 (1.41–3.81)	1.94 (1.18–3.18)	0.002
1-hydroxyphenanthrene
Total	1.00	0.89 (0.59–1.36)	1.02 (0.64–1.63)	0.77 (0.47–1.25)	0.936
Men	1.00	0.81 (0.41–1.59)	0.73 (0.34–1.57)	0.78 (0.36–1.67)	0.918
Women	1.00	1.04 (0.62–1.75)	1.40 (0.82–2.40)	0.71 (0.37–1.36)	0.425
2-hydroxyfluorene
Total	1.00	1.40 (0.95–2.05)	1.21 (0.78–1.90)	1.81 (1.10–2.98)	0.064
Men	1.00	1.59 (0.88–2.88)	1.29 (0.64–2.62)	2.19 (0.92–5.24)	0.212
Women	1.00	1.28 (0.79–2.02)	1.26 (0.69–2.29)	1.90 (0.98–3.71)	0.078

Notes: Odds ratios were adjusted for sex, age group, body mass index group, household income, alcohol consumption, physical activity, log-transformed urinary creatinine and cotinine, menopausal status (in women), and quartiles of all other PAHs.

Abbreviation: CI, confidence interval.