Coogan Patricia F, White Laura F, Yu Jeffrey, Burnett Richard T, Marshall Julian D, Seto Edmund, Brook Robert D, Palmer Julie R, Rosenberg Lynn, Jerrett Michael
Slone Epidemiology Center at Boston University, 1010 Commonwealth Ave., Boston, MA 02215, USA.
Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Avenue, 3rd Floor, Boston, MA 02118, USA.
Environ Res. 2016 Jul;148:360-366. doi: 10.1016/j.envres.2016.04.021. Epub 2016 Apr 25.
While laboratory studies show that air pollutants can potentiate insulin resistance, the epidemiologic evidence regarding the association of air pollution with diabetes incidence is conflicting. The purpose of the present study was to assess the association of the traffic-related nitrogen dioxide (NO2) with the incidence of diabetes in a longitudinal cohort study of African American women. We used Cox proportional hazards models to calculate hazard ratios and 95% confidence intervals (CI) for diabetes associated with exposure to NO2 among 43,003 participants in the Black Women's Health Study (BWHS). Pollutant levels at participant residential locations were estimated with 1) a land use regression model for participants living in 56 metropolitan areas, and 2) a dispersion model for participants living in 27 of the cities. From 1995 to 2011, 4387 cases of diabetes occurred. The hazard ratios per interquartile range of NO2 (9.7 ppb), adjusted for age, metropolitan area, education, vigorous exercise, body mass index, smoking, and diet, were 0.96 (95% CI 0.88-1.06) using the land use regression model estimates and 0.94 (95% CI 0.80, 1.10) using the dispersion model estimates. The present results do not support the hypothesis that exposure to NO2 contributes to diabetes incidence in African American women.
虽然实验室研究表明空气污染物会增强胰岛素抵抗,但关于空气污染与糖尿病发病率之间关联的流行病学证据并不一致。本研究的目的是在一项针对非裔美国女性的纵向队列研究中,评估与交通相关的二氧化氮(NO₂)与糖尿病发病率之间的关联。我们使用Cox比例风险模型,计算了黑人女性健康研究(BWHS)中43,003名参与者因接触NO₂而患糖尿病的风险比和95%置信区间(CI)。通过以下两种方式估算参与者居住地点的污染物水平:1)针对居住在56个大都市区的参与者,使用土地利用回归模型;2)针对居住在其中27个城市的参与者,使用扩散模型。1995年至2011年期间,共发生了4387例糖尿病病例。使用土地利用回归模型估算,经年龄、大都市区、教育程度、剧烈运动、体重指数、吸烟和饮食因素调整后,NO₂每增加一个四分位间距(9.7 ppb)的风险比为0.96(95% CI 0.88 - 1.06);使用扩散模型估算,风险比为0.94(95% CI 0.80, 1.10)。目前的结果不支持接触NO₂会导致非裔美国女性患糖尿病的假设。