The Association Between Air Pollution Exposure and Glucose and Lipids Levels.

CONTEXT

Evidence from recent decades supports a causal association between air pollution (particulate matter <10 μm in diameter [PM10] and PM <2.5 μm in diameter [PM2.5]) and oxidative stress, possibly involving impaired metabolism of glucose and lipids.

OBJECTIVE

Using a satellite based model to assess PM exposure at 1-km spatial resolution, we examined the associations between PM and glucose, hemoglobin A1c (HbA1c), and lipids.

DESIGN

Population-based retrospective cohort study of a 10-year period.

SETTING

Members of the largest health care provider in Southern Israel.

PARTICIPANTS

We included all serum glucose, HbA1c, and lipids tests of subjects with known cardiovascular diseases and risk factors. Subjects' glycemic status was defined as normal or diabetes.

MAIN OUTCOME

Log-transformed glucose, HbA1c, and lipid values were explored by mixed models, with adjustment for personal and seasonal confounders.

RESULTS

We assessed 73 117 subjects with over 600 000 samples. Three-month average concentration of PM10, but not 1- to 7-d exposure, was associated with increases of serum glucose, HbA1c, low-density lipoprotein and triglycerides, and decrease of high-density lipoprotein. The strongest associations were observed among subjects with diabetes (percent increase [95% confidence interval], for interquartile range increase of PM10 and PM2.5): 3.58% (1.03%; 6.20%) and 2.93% (0.35%; 5.59%) increase in HbA1c and 2.37% (2.11%; 2.63%) and 1.54% (1.26%; 1.83%) increase in low-density lipoprotein. Antidiabetic medications (other than insulin) attenuated the air pollution effect on serum glucose.

CONCLUSIONS

Intermediate-term, but not short term, exposure to PM is associated with alterations in glucose, HbA1c, and lipids, especially among people with diabetes.