Division of Occupational Medicine, Department of Outpatient Service, Phramongkutklao Hospital, Bangkok, Thailand.
Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Prev Med Public Health. 2023 Sep;56(5):449-457. doi: 10.3961/jpmph.23.292. Epub 2023 Sep 26.
This study investigated the association between baseline exposures to particulate matter with a diameter < 2.5 microns (PM2.5) and subsequent temporal changes in PM2.5 exposure with the incidence of type 2 diabetes among Royal Thai Army personnel.
A retrospective cohort study was conducted using nationwide health check-up data from 21 325 Thai Army personnel between 2018 and 2021. Multilevel mixed-effects parametric survival statistics were utilized to analyze the relationship between baseline (i.e., PM2.5-baseline) and subsequent changes (i.e., PM2.5-change) in PM2.5 exposure and the occurrence of type 2 diabetes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were employed to assess this association while considering covariates.
There was a significant association between both PM2.5 baseline and PM2.5-change and the incidence of type 2 diabetes in a dose-response manner. Compared to quartile 1, the HRs for quartiles 2 to 4 of PM2.5-baseline were 1.11 (95% CI, 0.74 to 1.65), 1.51 (95% CI, 1.00 to 2.28), and 1.77 (95% CI, 1.07 to 2.93), respectively. Similarly, the HRs for quartiles 2 to 4 of PM2.5-change were 1.41 (95% CI, 1.14 to 1.75), 1.43 (95% CI, 1.13 to 1.81) and 2.40 (95% CI, 1.84 to 3.14), respectively.
Our findings contribute to existing evidence regarding the association between short-term and long-term exposure to PM2.5 and the incidence of diabetes among personnel in the Royal Thai Army.
本研究旨在探讨泰国皇家陆军人员在 PM2.5 暴露基线和随后 PM2.5 暴露变化与 2 型糖尿病发病之间的关联。
本研究采用回顾性队列研究，纳入了 2018 年至 2021 年期间 21325 名泰国皇家陆军人员的全国健康检查数据。采用多层次混合效应参数生存统计方法分析 PM2.5 暴露基线（即 PM2.5-基线）和随后变化（即 PM2.5-变化）与 2 型糖尿病发生之间的关系。在考虑协变量的情况下，使用风险比（HR）和 95%置信区间（CI）评估这种关联。
PM2.5 基线和 PM2.5-变化均与 2 型糖尿病的发生呈剂量-反应关系。与 quartile 1 相比，PM2.5-基线 quartile 2 至 quartile 4 的 HR 分别为 1.11（95%CI，0.74 至 1.65）、1.51（95%CI，1.00 至 2.28）和 1.77（95%CI，1.07 至 2.93）。同样，PM2.5-变化 quartile 2 至 quartile 4 的 HR 分别为 1.41（95%CI，1.14 至 1.75）、1.43（95%CI，1.13 至 1.81）和 2.40（95%CI，1.84 至 3.14）。
本研究结果为 PM2.5 短期和长期暴露与泰国皇家陆军人员糖尿病发病之间的关联提供了新的证据。
