Department of Global Health, School of Public Health, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
Wuhan Centers for Disease Control and Prevention, 288#Machang Road, Wuhan, China.
Environ Res. 2022 Sep;212(Pt A):113158. doi: 10.1016/j.envres.2022.113158. Epub 2022 Mar 26.
Epidemiological evidence linking type 2 diabetes mellitus (T2DM) with air pollution is discrepant and most are restricted to the influences of air-pollutant mass concentration. This study aims to explore the effects of long-term exposure to air pollution and its metal constituents on T2DM prevalence in China.
We used data on 10,253 adult residents from the baseline survey of Wuhan Chronic Disease Cohort in 2019. Ambient PM, PM and NO exposure were estimated at residences based on Chinese Air Quality Reanalysis Dataset. Concentrations of 10 metal constituents were measured by 976 PM filter samples collected from four monitoring stations. Logistic regression models were employed to examine associations of T2DM prevalence with 3-year mean concentrations of each air pollutant and PM metal constituents prior to the baseline investigation.
A total of 673 T2DM cases (6.6%) were identified. The 3-year mean exposures to PM, PM and NO were 50.89 μg/m, 82.86 μg/m, and 39.79 μg/m, respectively. And interquartile range (IQR) of 10 metals in PM varied from 0.03 ng/m to 78.30 ng/m. For 1 μg/m increment in PM, PM and NO, the odds of T2DM increased by 7.2% (95%CI: 1.026, 1.136), 3.1% (95%CI: 1.013, 1.050), and 2.1% (95%CI: 1.005, 1.038) after adjusting for potential confounders. Cd and Sb in PM were significant risk factors to T2DM with odds ratios of 1.350 (95%CI: 1.089, 1.673) and 1.389 (95%CI: 1.164, 1.658) for per IQR increase, respectively. Stratification analyses indicated that males and those aged ≥45 years were more susceptive to long-term air pollution.
Long-term exposure to PM, PM and NO increased T2DM prevalence in a Wuhan population, especially for men and middle-aged and elderly people. Moreover, T2DM was significantly associated with Cd and Sb in PM. Further research to validate these results and to clarify the underlying mechanisms is warranted.
将 2 型糖尿病（T2DM）与空气污染联系起来的流行病学证据存在差异，大多数证据仅限于空气污染质量浓度的影响。本研究旨在探讨长期暴露于空气污染及其金属成分对中国 T2DM 患病率的影响。
我们使用了 2019 年武汉慢性病队列研究基线调查中 10253 名成年居民的数据。根据中国空气质量再分析数据集，在居民住所估算环境 PM、PM 和 NO 暴露量。通过收集自四个监测站的 976 个 PM 滤膜样本，测量了 10 种金属成分的浓度。在基线调查之前，采用 logistic 回归模型来检验 T2DM 患病率与 3 年平均浓度每种空气污染物和 PM 金属成分的关系。
共发现 673 例 T2DM 病例（6.6%）。3 年平均 PM、PM 和 NO 暴露量分别为 50.89μg/m、82.86μg/m 和 39.79μg/m，PM 中 10 种金属成分的四分位间距（IQR）范围为 0.03ng/m 至 78.30ng/m。PM、PM 和 NO 每增加 1μg/m，T2DM 的患病风险分别增加 7.2%（95%CI：1.026，1.136）、3.1%（95%CI：1.013，1.050）和 2.1%（95%CI：1.005，1.038），调整潜在混杂因素后。PM 中的 Cd 和 Sb 是 T2DM 的显著危险因素，其比值比（OR）分别为 1.350（95%CI：1.089，1.673）和 1.389（95%CI：1.164，1.658）。分层分析表明，男性和年龄≥45 岁的人群更容易受到长期空气污染的影响。
武汉人群长期暴露于 PM、PM 和 NO 会增加 T2DM 的患病率，尤其是男性和中老年人。此外，T2DM 与 PM 中的 Cd 和 Sb 显著相关。需要进一步研究来验证这些结果并阐明潜在机制。
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