School of Public Health, Lanzhou University, Lanzhou 730000, China.
Jinchang Center for Disease Prevention and Control, Jinchang 737100, China.
Int J Environ Res Public Health. 2018 Mar 30;15(4):631. doi: 10.3390/ijerph15040631.
Air pollution exposure may play an adverse role in diabetes. However, little data are available directly evaluating the effects of air pollution exposure in blood lipids of which dysfunction has been linked to diabetes or its complications. We aimed to evaluate the association between air pollution and lipids level among type 2 diabetic patients in Northwest China. We performed a population-based study of 3912 type 2 diabetes patients in an ongoing cohort study in China. Both spline and multiple linear regressions analysis were used to examine the association between short-term exposure to PM, SO₂, NO₂ and total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). By spline analyses, we observed that the relationship between SO₂ and HDL-C and LDL-C was shown to be non-linear (_non-lin-association = 0.0162 and 0.000). An inverted U-shaped non-linear relationship between NO₂ and LDL-C was found (_non-lin-association < 0.0001). A J-shaped non-linear relationship between PM and TC, HDL-C (_non-lin-association = 0.0173, 0.0367) was also revealed. In linear regression analyses, a 10 μg/m³ increment in SO₂ was associated with 1.31% (95% CI: 0.40-2.12%), 3.52% (95% CI: 1.07-6.03%) and 7.53% (95% CI: 5.98-9.09%) increase in TC, TG and LDL-C, respectively. A 10 μg/m³ increment in PM was associated with 0.45% (95% CI: 0.08-0.82%), 0.29% (95% CI: 0.10-0.49%) and 0.83% (95% CI: 0.21-1.45%) increase in TC, HDL-C and LDL-C, respectively. For NO₂, an increment of 10 μg/m³ was statistically associated with -3.55% (95% CI: -6.40-0.61%) and 39.01% (95% CI: 31.43-47.03%) increase in HDL-C and LDL-C. The adverse effects of air pollutants on lipid levels were greater in female and elder people. Further, we found SO₂ and NO₂ played a more evident role in lipid levels in warm season, while PM appeared stronger in cold season. The findings suggest that exposure to air pollution has adverse effects on lipid levels among type 2 diabetes patients, and vulnerable people may pay more attention on severe air pollution days.
空气污染暴露可能在糖尿病中发挥不利作用。然而,直接评估空气污染暴露对血脂的影响的数据很少,而血脂功能障碍与糖尿病或其并发症有关。我们旨在评估中国西北地区 2 型糖尿病患者中空气污染与血脂水平之间的关系。我们在中国正在进行的一项队列研究中对 3912 名 2 型糖尿病患者进行了一项基于人群的研究。使用样条和多元线性回归分析来研究短期暴露于 PM、SO₂、NO₂ 和总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)之间的关系。通过样条分析,我们发现 SO₂ 与 HDL-C 和 LDL-C 之间的关系呈非线性(_non-lin-association = 0.0162 和 0.000)。发现 NO₂ 与 LDL-C 之间呈倒 U 型非线性关系(_non-lin-association < 0.0001)。PM 与 TC、HDL-C 之间也呈现出 J 型非线性关系(_non-lin-association = 0.0173,0.0367)。在线性回归分析中,SO₂ 增加 10μg/m³ 与 TC、TG 和 LDL-C 分别增加 1.31%(95%CI:0.40-2.12%)、3.52%(95%CI:1.07-6.03%)和 7.53%(95%CI:5.98-9.09%)相关。PM 增加 10μg/m³ 与 TC、HDL-C 和 LDL-C 分别增加 0.45%(95%CI:0.08-0.82%)、0.29%(95%CI:0.10-0.49%)和 0.83%(95%CI:0.21-1.45%)相关。对于 NO₂,增加 10μg/m³ 与 HDL-C 和 LDL-C 分别增加 3.55%(95%CI:-6.40-0.61%)和 39.01%(95%CI:31.43-47.03%)相关。空气污染对血脂水平的不良影响在女性和老年人中更大。此外,我们发现 SO₂ 和 NO₂ 在温暖季节对血脂水平的作用更为明显,而 PM 在寒冷季节更为明显。研究结果表明,暴露于空气污染对 2 型糖尿病患者的血脂水平有不利影响,易感人群在严重空气污染日可能需要更加关注。