Liu Xiaotian, Dong Xiaokang, Song Xiaoqin, Li Ruiying, He Yaling, Hou Jian, Mao Zhenxing, Huo Wenqian, Guo Yuming, Li Shanshan, Chen Gongbo, Wang Chongjian
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
Physical Examination Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
Environ Sci Pollut Res Int. 2022 Dec;29(60):90290-90300. doi: 10.1007/s11356-022-22076-y. Epub 2022 Jul 22.
The association of ozone with type 2 diabetes mellitus (T2DM) is uncertain. Moreover, the moderating effect of physical activity on this association is largely unknown. This study aims to evaluate the independent and combined effects of ozone and physical activity on T2DM and fasting blood glucose (FBG) in a Chinese rural adult population. A total of 39,192 participants were enrolled in the Henan Rural Cohort Study. Individual ozone exposure was assessed by using a satellite-based random forest model. The logistic regression and generalized linear models were used to evaluate the associations of ozone and physical activity with T2DM and FBG, respectively. Interaction plots were used to visualize the interaction effects of ozone and physical activity on T2DM or FBG. An interquartile range (IQR) increase in ozone exposure concentration was related to a 53.3% (odds ratio (OR),1.533; 95% confidence interval (CI), 1.426, 1.648) increase in odds of T2DM and a 0.292 mmol/L (95%CI, 0.263, 0.321) higher FBG level, respectively. The effects of ozone on T2DM and FBG generally decreased as physical activity levels increased. Negative additive interactions between ozone and physical activity on T2DM risk were observed (relative excess risk due to interaction (RERI), -0.261; 95%CI, -0.473, -0.048; attributable proportion due to interaction (AP), -0.203; 95%CI, -0.380, -0.027; synergy index (S), 0.520; 95%CI, 0.299, 0.904). The larger effects of ozone were observed among elderly and men on T2DM and FBG than young and women. Long-term exposure to ozone was associated with higher odds of T2DM and higher FBG levels, and these associations might be attenuated by increasing physical activity levels. In addition, there was a negative additive interaction (antagonistic effect) between ozone exposure and physical activity level on T2DM risk, suggesting that physical activity might be an effective method to reduce the burden of T2DM attributed to ozone exposure. Trail registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (registration number: ChiCTR-OOC-15006699). Date of registration: 06 July 2015, http://www.chictr.org.cn/showproj.aspx?proj=11375.
臭氧与2型糖尿病（T2DM）之间的关联尚不确定。此外，身体活动对这种关联的调节作用在很大程度上也不清楚。本研究旨在评估臭氧和身体活动对中国农村成年人群T2DM和空腹血糖（FBG）的独立及联合影响。共有39192名参与者纳入了河南农村队列研究。采用基于卫星的随机森林模型评估个体臭氧暴露情况。分别使用逻辑回归和广义线性模型评估臭氧和身体活动与T2DM及FBG之间的关联。使用交互作用图来直观显示臭氧和身体活动对T2DM或FBG的交互作用。臭氧暴露浓度增加一个四分位数间距（IQR）分别与T2DM患病几率增加53.3%（比值比（OR）为1.533；95%置信区间（CI）为1.426, 1.648）以及FBG水平升高0.292 mmol/L（95%CI为0.263, 0.321）相关。随着身体活动水平的增加，臭氧对T2DM和FBG的影响总体上有所降低。观察到臭氧和身体活动在T2DM风险上存在负相加交互作用（交互作用所致相对超额危险度（RERI）为 -0.261；95%CI为 -0.473, -0.048；交互作用所致归因比例（AP）为 -0.203；95%CI为 -0.380, -0.027；协同指数（S）为0.520；95%CI为0.299, 0.904）。在老年人和男性中观察到臭氧对T2DM和FBG的影响比年轻人和女性更大。长期暴露于臭氧与T2DM患病几率升高及FBG水平升高相关，而增加身体活动水平可能会减弱这些关联。此外，臭氧暴露与身体活动水平在T2DM风险上存在负相加交互作用（拮抗作用），这表明身体活动可能是减轻因臭氧暴露所致T2DM负担的有效方法。试验注册：河南农村队列研究已在中国临床试验注册中心注册（注册号：ChiCTR - OOC - 15006699）。注册日期：2015年7月6日，http://www.chictr.org.cn/showproj.aspx?proj = 11375 。
