ArticleJournal of endocrinological investigation2026
Associations between urinary biomarkers of drinking-water disinfection byproducts and fasting plasma glucose: results from the TREE study.
Article in Journal of endocrinological investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeDrinking-water disinfection byproducts (DBPs) have been documented to disrupt glucose homeostasis in toxicological studies, but epidemiological evidence remains scarce. We aimed to investigate drinking-water DBP exposures in association with fasting plasma glucose (FPG).
methodsWe included 1,406 women participating in the Tongji Reproductive and Environmental (TREE) cohort. Urinary dichloroacetic acid (DCAA) and trichloroacetic acid (TCAA), as biomarkers of drinking-water DBPs, along with FPG, were measured. Hyperglycemia was identified as FPG ≥ 5.6 mmol/L. Multivariable linear and logistic regression models were fitted to quantify the associations of DBP exposures with FPG and hyperglycemia risk.
resultsElevated quartiles of urinary DCAA showed an association with increased hyperglycemia risk [odds ratio (OR) = 1.58, 95% confidence interval (CI): 0.97, 2.61 for the fourth vs. first quartile], particularly among younger women (OR = 3.15, 95% CI: 1.47, 7.05). In BMI-stratified analyses, urinary DCAA and TCAA in relation to higher FPG level (DCAA: 1.05%, 95% CI: 0.10%, 2.00%; TCAA: 0.99%, 95% CI: 0.11%, 1.88%) and hyperglycemia risk (DCAA: OR = 1.50, 95% CI: 1.03, 2.17; TCAA: OR = 1.62, 95% CI: 1.14, 2.27) were observed among women with BMI < 24 kg/m2, but not among women with BMI ≥ 24 kg/m2.
conclusionsOur results provide new evidence that DBP exposures may contribute to hyperglycemia.
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