长期暴露于臭氧和二氧化硫会增加 30 至 50 岁成年人群中 2 型糖尿病的发病率。

Long-term exposure to ozone and sulfur dioxide increases the incidence of type 2 diabetes mellitus among aged 30 to 50 adult population.

机构信息

School of Public Health, College of Public Health, Taipei Medical University, No. 250 Wuxing St., Xinyi District, Taipei, 11031, Taiwan.

Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, No. 250 Wuxing St., Xinyi District, Taipei, 11031, Taiwan.

出版信息

Environ Res. 2021 Mar;194:110624. doi: 10.1016/j.envres.2020.110624. Epub 2021 Jan 5.

DOI:10.1016/j.envres.2020.110624

PMID:33412098

Abstract

AIMS/HYPOTHESIS: Worldwide, the information regarding the associations between long-term exposure to ozone (O) and sulfur dioxide (SO) and the development of type 2 diabetes remains scarce, especially in Asia. This study aimed to investigate the long-term effects of exposure to ambient O and SO on the incidence of type 2 diabetes with consideration of other air pollutants in Taiwanese adults aged 30 to 50 years.

METHODS

A total of 6,426,802 non-diabetic participants aged between 30 and 50 years old were obtained from the National Health Insurance Research Database between 2005 and 2016. Incident type 2 diabetes was the main diagnosis at medical visits. Air quality data were provided by the Taiwan Environmental Protection Administration. The air pollutant concentrations for each participant were estimated using the ordinary kriging method to interpolate daily concentrations of O, SO, carbon monoxide (CO), nitrogen dioxide (NO), suspended fine particles (with an aerodynamic diameter less than 2.5 μm; PM), and suspended particles (with an aerodynamic diameter less than 10 μm; PM) in residential districts across Taiwan. Six-year average concentrations of pollutants were calculated from January 1, 2005 to December 31, 2010, and data were categorized into quartiles. We performed Cox regression models to analyze the long-term effects of exposure to O and SO on the incidence of type 2 diabetes.

RESULTS

The hazard ratio (HR) for the incidence of diabetes per each interquartile range (IQR) increase in ozone exposure (3.30 ppb) was 1.058 (95% confidence interval (CI): 1.053, 1.064) and 1.011 (95% CI: 1.007, 1.015) for SO exposure (1.77 ppb) after adjusting for age, sex, socioeconomic status, urbanization level, temperature, humidity, and chronic comorbidities (Model 3). Furthermore, for every 3.30 ppb increase of O, the HR for incident type 2 diabetes was 1.093 (95% CI: 1.087, 1.100) after controlling factors shown in Model 3 plus SO and PM. On the other hand, for every 1.77 ppb increase of SO, the HR for incident type 2 diabetes was 1.073 (95% CI: 1.068, 1.079) after controlling factors shown in Model 3 plus NO and PM.

CONCLUSIONS

Long-term exposure to ambient O and SO was associated with a higher risk of developing type 2 diabetes for Taiwanese population. Exposure to O and SO may play a role in the adult early-onset type 2 diabetes.

摘要

目的/假设：在全球范围内，关于长期暴露于臭氧（O）和二氧化硫（SO）与 2 型糖尿病发展之间的关系的信息仍然很少，特别是在亚洲。本研究旨在探讨在考虑到台湾 30 至 50 岁成年人中其他空气污染物的情况下，长期暴露于环境臭氧和二氧化硫对 2 型糖尿病发病的影响。

方法

本研究共纳入了 2005 年至 2016 年期间国家健康保险研究数据库中年龄在 30 至 50 岁之间的 6,426,802 名非糖尿病参与者。主要诊断为门诊就诊时的 2 型糖尿病。空气质量数据由台湾环境保护署提供。使用普通克里金法估算每个参与者的空气污染物浓度，以插值台湾各居民区的臭氧、二氧化硫、一氧化碳（CO）、二氧化氮（NO）、悬浮细颗粒物（空气动力学直径小于 2.5μm；PM）和悬浮颗粒物（空气动力学直径小于 10μm；PM）的日浓度。从 2005 年 1 月 1 日至 2010 年 12 月 31 日计算了污染物的六年平均浓度，并将数据分为四分位。我们使用 Cox 回归模型分析了臭氧和二氧化硫暴露对 2 型糖尿病发病的长期影响。

结果

在调整年龄、性别、社会经济地位、城市化水平、温度、湿度和慢性合并症后（模型 3），臭氧每增加一个四分位距（IQR）（3.30 ppb），发生糖尿病的风险比（HR）为 1.058（95%置信区间（CI）：1.053，1.064），二氧化硫暴露（1.77 ppb）为 1.011（95%CI：1.007，1.015）。此外，在控制模型 3 中显示的因素以及 SO 和 PM 后，臭氧每增加 3.30 ppb，发生 2 型糖尿病的 HR 为 1.093（95%CI：1.087，1.100）。另一方面，在控制模型 3 中显示的因素以及 NO 和 PM 后，SO 每增加 1.77 ppb，发生 2 型糖尿病的 HR 为 1.073（95%CI：1.068，1.079）。