Brook Robert D, Jerrett Michael, Brook Jeffrey R, Bard Robert L, Finkelstein Murray M
Division of Cardiovascular Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106, USA.
J Occup Environ Med. 2008 Jan;50(1):32-8. doi: 10.1097/JOM.0b013e31815dba70.
Air pollution is associated with an increased risk for cardiovascular events. Many of the biological pathways involved could also promote diabetes mellitus (DM). We therefore investigated the association between DM prevalence and exposure to traffic-related air pollution (nitrogen dioxide [NO 2]).
Study participants were patients who attended two respiratory clinics in Hamilton (n = 5228) and Toronto (n = 2406). The diagnosis of DM was ascertained by linkage to administrative databases of the Ontario universal Health Insurance Plan for patients aged 40 years and above. Geographic Information systems methodology was used to assign individual estimates of NO2 based on a network of samplers in each city. Logistic regression was used to estimate the relations between NO2 exposures and the odds of DM diagnosis.
After adjusting for age, body mass index, and neighborhood income there were positive effects in women on the odds ratio for DM for each 1 ppb NO2 exposure in Toronto (OR 1.055, 95% CI: 0.99 to 1.11) and Hamilton (OR 1.029, 95% CI: 0.98 to 1.08). In a meta-analytic model including both cities, there was a significant effect in women (OR = 1.04; 95% CI: 1.00 to 1.08). Across the inter-quartile range (approximately 4 ppb NO2) there was nearly a 17% increase in the odds of DM for women. There were no positive associations among men.
Exposure to NO2, a marker of traffic-related air pollutants, was associated with DM prevalence among women. Exposure estimate errors in men may explain the apparent gender difference. These results suggest that common air pollutants are associated with DM and warrant more investigation to determine if this is a cause-and-effect relationship.
空气污染与心血管事件风险增加相关。许多涉及的生物学途径也可能促进糖尿病（DM）。因此，我们调查了DM患病率与交通相关空气污染（二氧化氮[NO₂]）暴露之间的关联。
研究参与者为在汉密尔顿（n = 5228）和多伦多（n = 2406）的两家呼吸诊所就诊的患者。40岁及以上患者的DM诊断通过与安大略省全民健康保险计划的行政数据库进行关联确定。使用地理信息系统方法根据每个城市的采样器网络分配个体NO₂估计值。采用逻辑回归估计NO₂暴露与DM诊断几率之间的关系。
在调整年龄、体重指数和邻里收入后，在多伦多，女性中每1 ppb NO₂暴露的DM优势比有正向影响（优势比1.055，95%置信区间：0.99至1.11），在汉密尔顿也是如此（优势比1.029，95%置信区间：0.98至1.08）。在包括两个城市的荟萃分析模型中，女性有显著影响（优势比 = 1.04；95%置信区间：1.00至1.08）。在四分位间距范围内（约4 ppb NO₂），女性患DM的几率增加了近17%。男性中无正向关联。
暴露于与交通相关的空气污染物标志物NO₂与女性DM患病率相关。男性的暴露估计误差可能解释了明显的性别差异。这些结果表明常见空气污染物与DM相关，需要更多研究来确定这是否为因果关系。
