Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
Environ Res. 2022 May 1;207:112640. doi: 10.1016/j.envres.2021.112640. Epub 2022 Jan 3.
Obesity and ambient air pollution are independent risk factors of type 2 diabetes mellitus (T2DM), however, the evidence regarding their joint associations on T2DM was sparsely studied in low-middle income countries.
A total of 38,841 participants were selected from Henan Rural Cohort study which was carried out during 2015-2017. Obesity was identified by body mass index (BMI), WC (waist circumstance), WHR (waist-to-hip ratio), WHtR (waist-to-height ratio), BFP (body fat percent), and VFI (visceral fat index). Three-year averaged-concentrations of NO, PM, PM, and PM were assessed by using the method of spatiotemporal model incorporated into the satellites data. The independent associations of obesity indicators and exposure to air pollutants on fasting blood glucose (FBG) and T2DM were assessed by generalized linear and logistic regression model, respectively, and their interaction associations on T2DM were quantified by using relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (S).
Positive associations of six obesity measures and four air pollutants with FBG levels and prevalent T2DM were observed. Obese participants measured by BMI plus high exposure to NO, PM, PM and PM were related to a 2.96-fold (2.66-3.29), 2.87-fold (2.58-3.20), 2.98-fold (2.67-3.32) and 3.01-fold (2.70-3.35) increased risk for prevalent T2DM, respectively; similarity of joint associations of the other obesity measures and air pollutants on T2DM were observed. The additive associations of different obesity measures and air pollutants with prevalent T2DM were further found.
The synergistic associations of obesity and air pollutants on FBG levels and prevalent T2DM were observed, indicating that obese participants were at high risk for prevalent T2DM in highly polluted rural regions.
肥胖和环境空气污染是 2 型糖尿病（T2DM）的独立危险因素，然而，在中低收入国家，关于它们对 T2DM 的联合作用的证据很少。
本研究共纳入 38841 名参与者，他们来自于 2015-2017 年期间开展的河南农村队列研究。肥胖通过体重指数（BMI）、腰围（WC）、腰臀比（WHR）、腰高比（WHtR）、体脂肪百分比（BFP）和内脏脂肪指数（VFI）进行识别。利用时空模型与卫星数据相结合的方法评估 NO、PM、PM 和 PM 三年平均浓度。采用广义线性和逻辑回归模型分别评估肥胖指标和暴露于空气污染物与空腹血糖（FBG）和 T2DM 的独立相关性，并通过交互归因超额危险度（RERI）、交互归因比例（AP）和协同指数（S）来量化它们对 T2DM 的交互相关性。
六种肥胖指标和四种空气污染物与 FBG 水平和 T2DM 患病率均呈正相关。与高浓度 NO、PM、PM 和 PM 暴露相关的 BMI 肥胖参与者患 T2DM 的风险分别增加了 2.96 倍（2.66-3.29）、2.87 倍（2.58-3.20）、2.98 倍（2.67-3.32）和 3.01 倍（2.70-3.35）；其他肥胖指标和空气污染物对 T2DM 的联合作用相似。进一步发现不同肥胖指标和空气污染物对 T2DM 的相加作用。
肥胖和空气污染物对 FBG 水平和 T2DM 患病率的协同作用明显，表明在高度污染的农村地区，肥胖者患 T2DM 的风险较高。
