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Urinary metal exposure and type 2 diabetes mellitus: the potential mediating role of biological aging in older adults

Year: 2026

Type: article

Abstract: The global burden of type 2 diabetes mellitus (T2DM) is increasing, and environmental exposures may contribute to diabetes susceptibility. Metals are widespread environmental contaminants associated with metabolic disorders; however, the role of aging-related processes in this association remains unclear. A total of 843 participants were enrolled. Urinary concentrations of six metals (Pb, Zn, Mn, Cr, As, and Co) were measured, and phenotypic age was calculated based on nine biomarkers. Multivariable regression models were used to assess individual-metal associations, while weighted quantile sum regression was used to evaluate mixed-metal exposure; mediation analyses were conducted as exploratory analyses. Pb, Zn, Mn, and Cr exposures were significantly associated with T2DM ( P < 0.05). Mixed-metal exposure was also associated with higher T2DM risk (OR = 1.515, 95% CI: 1.277–1.884). Additionally, Pb, Zn, Mn, and Cr were positively associated with phenotypic age, and each one-year increase in phenotypic age was associated with higher T2DM risk (OR = 1.391, 95% CI: 1.319–1.466). Exploratory mediation analyses suggested that phenotypic age may partially account for the associations between metal exposure and T2DM, with estimated mediation proportions of 10.9%–22.2%. Phenotypic aging may represent a potential pathway linking environmental metal exposure with diabetes susceptibility.

Source: Scientific Reports

DOI: 10.1038/s41598-026-78887-3