Urinary Bisphenol Mixtures at Population-Exposure Levels Are Associated with Diabetes Prevalence: Evidence from Advanced Mixture Modeling

Background/Objectives: There is a ubiquitous presence of plastics worldwide, and recent data highlight the continuous growth in their production and usage—a trend paralleled by the rise in chronic diseases like diabetes. The multifactorial nature of these diseases suggests that environmental exposure, notably to bisphenol A (BPA), could be a contributing factor. This study investigates the potential correlation between emerging BPA substitutes, bisphenol S and F (BPS and BPF), and diabetes in a cohort of the general adult population. Methods: A retrospective cohort study was conducted using data from the U.S. National Health and Nutrition Examination Survey (NHANES) 2013–2014 and 2015–2016 cycles. Basic comparative analyses and Pearson correlation tests were performed, followed by logistic regression models. Advanced statistical approaches, including Weighted Quantile Sum (WQS) regression and quantile g-computation, were subsequently applied to evaluate the combined effects of bisphenol exposures. Results: Findings reveal a positive association between combined bisphenols (BPs) and glycated hemoglobin (HbA1c), with binomial logistic regression demonstrating an odds ratio (OR) of 1.103 (1.002–1.214) between BP levels corrected for creatinine (crucial due to glomerular filtration variations) and diabetes. weighted quantile sum (WQS) and quantile G-computation analyses showed a combined positive effect on diabetes, glucose levels, and HbA1c. Individual effect analysis identifies BPS as a significant monomer warranting attention in future diabetes-related research. Conclusions: Replacing BPA with new molecules like BPS or BPF may pose a greater risk in the context of diabetes.