Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, China.
Environ Pollut. 2018 Dec;243(Pt B):815-823. doi: 10.1016/j.envpol.2018.09.056. Epub 2018 Sep 14.
The linkage between ambient air pollution exposure and occurrence of diabetes mellitus is not well defined. This study examined the association between exposure to fine particles (PM) and the prevalence of diabetes among Chinese elderly people. We surveyed 11,504 adults aged ≥50 years in China, estimated the annual concentrations of ambient PM using a satellite-based model of aerosol optical depth information. We employed a generalized mixed effects model to examine the association between PM and the prevalence of diabetes and explored potential effect modifiers. We estimated diabetes burden attributable to ambient PM if the observed association is indeed causal. The diabetes prevalence among the participants was 6.5% (n = 745). Our analysis found a statistically significant association between PM and diabetes. The adjusted odds ratio was 1.27 (95% confidence interval (CI), 1.12, 1.43) for each 10 μg/m increment in ambient PM. Stratified analyses found a lower association among the participants with higher consumption of fruit. We estimated that 22.02% (95% CI: 8.59%, 43.29%) of the diabetes cases could be ascribable to ambient PM. Our finding suggests that PM exposures could increase the risk of diabetes, and if causal, could be responsible for substantial burden of diabetes among the Chinese elderly; and higher intakes of fruit might reduce the harmful effects of PM, however, due to the limitation of the cross-sectional study design, more studies are warranted to confirm this observation.
大气污染暴露与糖尿病发生之间的关联尚不清楚。本研究调查了细颗粒物(PM)暴露与中国老年人糖尿病患病率之间的关系。我们调查了中国 11504 名年龄≥50 岁的成年人,使用基于卫星的气溶胶光学深度信息模型来估计环境 PM 的年浓度。我们采用广义混合效应模型来研究 PM 与糖尿病患病率之间的关联,并探讨潜在的效应修饰剂。如果观察到的关联确实是因果关系,我们估计了归因于环境 PM 的糖尿病负担。参与者中的糖尿病患病率为 6.5%(n=745)。我们的分析发现 PM 与糖尿病之间存在统计学显著关联。与环境 PM 每增加 10μg/m,调整后的比值比为 1.27(95%置信区间(CI),1.12,1.43)。分层分析发现,水果摄入量较高的参与者之间的关联较低。我们估计,22.02%(95%CI:8.59%,43.29%)的糖尿病病例可归因于环境 PM。我们的研究结果表明,PM 暴露可能会增加患糖尿病的风险,如果是因果关系,可能会导致中国老年人中大量的糖尿病负担;而较高的水果摄入量可能会降低 PM 的有害影响,但由于横断面研究设计的局限性,需要更多的研究来证实这一观察结果。