Shin Moon-Kyung, Kim Kyoung-Nam
Department of Preventive, Hanyang University College of Medicine, Seoul, Republic of Korea; Institute for Health and Society, Hanyang University, Seoul, Republic of Korea.
Department of Preventive, Hanyang University College of Medicine, Seoul, Republic of Korea.
Environ Int. 2023 Apr;174:107908. doi: 10.1016/j.envint.2023.107908. Epub 2023 Mar 29.
Studies on the modifying effects of dietary factors on the association between air pollution and diabetes-related outcomes are limited. We examined whether dietary nutrients could modify the association between long-term air pollution exposure and the development of diabetes.
We used data from the Cardiovascular Disease Association Study, which enrolled adults aged 40-69 years in Korea between 2005 and 2011 and followed them up until 2016 (n = 14,667). Annual concentrations of fine particulate matter (PM) and nitrogen dioxide (NO) at each participant's residence(s) were estimated using community multiscale air quality models. Intake of 22 dietary nutrients was assessed using a validated food frequency questionnaire during the baseline survey. We examined the product terms between air pollution levels (continuous) and each dietary nutrient (quartile) using Cox regression models, adjusted for potential confounders.
PM [hazard ratio (HR) = 1.49, 95 % confidence interval (CI): 1.11, 2.00] and NO (HR = 1.29, 95 % CI: 1.12, 1.49) concentrations were found to be associated with incident diabetes. NO levels interacted with dietary intake of retinol, vitamin A, and cholesterol (p-values for interaction < 0.05). Stronger associations were observed between NO levels and the occurrence of diabetes among individuals with a lower intake of these nutrients compared to those with a higher intake. No interaction was found between PM and the 22 investigated dietary nutrients.
Adequate intake of dietary nutrients, such as retinol, vitamin A, and cholesterol, from various food items in a balanced diet may prevent the occurrence of diabetes in a setting wherein reduction of air pollution levels cannot be achieved in a short time frame.
关于饮食因素对空气污染与糖尿病相关结局之间关联的调节作用的研究有限。我们研究了膳食营养素是否能调节长期暴露于空气污染与糖尿病发生之间的关联。
我们使用了心血管疾病关联研究的数据，该研究于2005年至2011年在韩国招募了40 - 69岁的成年人，并对他们进行随访直至2016年（n = 14,667）。使用社区多尺度空气质量模型估计每个参与者居住地的细颗粒物（PM）和二氧化氮（NO）的年浓度。在基线调查期间，使用经过验证的食物频率问卷评估22种膳食营养素的摄入量。我们使用Cox回归模型检验空气污染水平（连续变量）与每种膳食营养素（四分位数）之间的乘积项，并对潜在混杂因素进行了调整。
发现PM[风险比（HR）= 1.49，95%置信区间（CI）：1.11，2.00]和NO（HR = 1.29，95%CI：1.12，1.49）浓度与糖尿病发病有关。NO水平与视黄醇、维生素A和胆固醇的膳食摄入量存在相互作用（相互作用的p值<0.05）。与摄入量较高的个体相比，在这些营养素摄入量较低的个体中，观察到NO水平与糖尿病发生之间的关联更强。未发现PM与所研究的22种膳食营养素之间存在相互作用。
在短期内无法实现空气污染水平降低的情况下，从均衡饮食中的各种食物中充分摄入视黄醇、维生素A和胆固醇等膳食营养素可能预防糖尿病的发生。
