Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; IUF - Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany.
Environ Int. 2014 Sep;70:95-105. doi: 10.1016/j.envint.2014.05.014. Epub 2014 Jun 7.
Air pollution is an important risk factor for global burden of disease. There has been recent interest in its possible role in the etiology of diabetes mellitus. Experimental evidence is suggestive, but epidemiological evidence is limited and mixed. We therefore explored the association between air pollution and prevalent diabetes, in a population-based Swiss cohort. We did cross-sectional analyses of 6392 participants of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults [SAPALDIA], aged between 29 and 73 years. We used estimates of average individual home outdoor PM10 [particulate matter <10μm in diameter] and NO2 [nitrogen dioxide] exposure over the 10 years preceding the survey. Their association with diabetes was modeled using mixed logistic regression models, including participants' study area as random effect, with incremental adjustment for confounders. There were 315 cases of diabetes (prevalence: 5.5% [95% confidence interval (CI): 2.8, 7.2%]). Both PM10 and NO2 were associated with prevalent diabetes with respective odds ratios of 1.40 [95% CI: 1.17, 1.67] and 1.19 [95% CI: 1.03, 1.38] per 10μg/m(3) increase in the average home outdoor level. Associations with PM10 were generally stronger than with NO2, even in the two-pollutant model. There was some indication that beta blockers mitigated the effect of PM10. The associations remained stable across different sensitivity analyses. Our study adds to the evidence that long term air pollution exposure is associated with diabetes mellitus. PM10 appears to be a useful marker of aspects of air pollution relevant for diabetes. This association can be observed at concentrations below air quality guidelines.
空气污染是全球疾病负担的一个重要危险因素。最近人们对其在糖尿病病因学中的可能作用产生了兴趣。实验证据是有提示性的，但流行病学证据有限且不一致。因此，我们在一项基于人群的瑞士成年人空气污染与肺部和心脏疾病队列研究中，探讨了空气污染与糖尿病流行之间的关系。我们对瑞士空气污染与成人肺部和心脏疾病研究（SAPALDIA）中年龄在 29 至 73 岁之间的 6392 名参与者进行了横断面分析。我们使用了参与者在调查前 10 年中个人家庭室外 PM10（直径<10μm 的颗粒物）和 NO2（二氧化氮）暴露的平均个体估计值。使用混合逻辑回归模型来模拟它们与糖尿病的关系，包括参与者的研究区域作为随机效应，并逐步调整混杂因素。有 315 例糖尿病病例（患病率：5.5%[95%置信区间：2.8，7.2%]）。PM10 和 NO2 均与糖尿病流行相关，其平均家庭室外水平每增加 10μg/m3，相应的比值比分别为 1.40[95%置信区间：1.17，1.67]和 1.19[95%置信区间：1.03，1.38]。PM10 与糖尿病的相关性通常强于 NO2，即使在双污染物模型中也是如此。有一些迹象表明，β受体阻滞剂减轻了 PM10 的影响。在不同的敏感性分析中，这些关联仍然稳定。我们的研究增加了长期暴露于空气污染与糖尿病有关的证据。PM10 似乎是与糖尿病相关的空气污染方面的有用标志物。这种关联可以在低于空气质量指南的浓度下观察到。
