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中国环境空气污染暴露与糖尿病患病率及糖化血红蛋白(HbA1c)水平的关联。来自世界卫生组织老龄化与成人健康研究第一轮的横断面分析。

Ambient air pollution exposure association with diabetes prevalence and glycosylated hemoglobin (HbA1c) levels in China. Cross-sectional analysis from the WHO study of AGEing and adult health wave 1.

作者信息

Elbarbary Mona, Honda Trenton, Morgan Geoffrey, Kelly Patrick, Guo Yuming, Negin Joel

机构信息

Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Sydney, Australia.

Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah, USA.

出版信息

J Environ Sci Health A Tox Hazard Subst Environ Eng. 2020;55(10):1149-1162. doi: 10.1080/10934529.2020.1787011. Epub 2020 Jul 2.

DOI:10.1080/10934529.2020.1787011
PMID:32615056
Abstract

Over the past decades, air pollution has become one of the critical environmental health issues in China. The present study aimed to evaluate links between ambient air pollution and the prevalence of type 2 diabetes mellitus (T2DM) and the levels of glycosylated hemoglobin (HbA1c). A multilevel linear and logistic regression was used to assess these associations among 7,770 participants aged ≥50 years from the WHO Study on global AGEing and adult health (SAGE) in China in 2007-2010. The average exposure to each of pollutants (particulate matter with an aerodynamic diameter of ≤10 μm/≤2.5 μm/≤1 μm [PM/PM/PM] and nitrogen dioxide [NO]) was estimated using a satellite-based spatial statistical model. In logistic models, a 10 µg/m increase in PM and PM was associated with increased T2DM prevalence (Prevalence Odds Ratio, POR: 1.27; 95% CI: 1.11, 1.45 and POR: 1.23; 95% CI: 1.03, 1.46). Similar increments in PM, PM, PM and NO were associated with increase in HbA1c levels of 1.8% (95% CI: 1.3, 2.3), 1.3% (95% CI: 1.1, 1.5), 0.7% (95% CI: 0.1, 1.3), and 0.8% (95% CI: 0.4, 1.2), respectively. In a large cohort of older Chinese adults, air pollution was liked to both higher T2DM prevalence and elevated HbA1c levels.

摘要

在过去几十年中,空气污染已成为中国关键的环境卫生问题之一。本研究旨在评估环境空气污染与2型糖尿病(T2DM)患病率及糖化血红蛋白(HbA1c)水平之间的关联。采用多水平线性和逻辑回归分析,对2007年至2010年来自中国的世界卫生组织全球老龄化与成人健康研究(SAGE)中7770名年龄≥50岁的参与者进行了这些关联的评估。使用基于卫星的空间统计模型估算了每种污染物(空气动力学直径≤10μm/≤2.5μm/≤1μm的颗粒物[PM/PM/PM]和二氧化氮[NO])的平均暴露量。在逻辑模型中,PM和PM每增加10μg/m,与T2DM患病率增加相关(患病率比值比,POR:1.27;95%置信区间:1.11,1.45和POR:1.23;95%置信区间:1.03,1.46)。PM、PM、PM和NO的类似增加分别与HbA1c水平升高1.8%(95%置信区间:1.3,2.3)、1.3%(95%置信区间:1.1,1.5)、0.7%(95%置信区间:0.1,1.3)和0.8%(95%置信区间:0.4,1.2)相关。在一大群中国老年成年人中,空气污染与较高的T2DM患病率和升高的HbA1c水平均相关。

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