Yi Yuanyuan, Guo Cui, Zheng Yiling, Chen Siyi, Lin Changqing, Lau Alexis K H, Wong Martin C S, Bishai David M
Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Urban Systems Institute, The University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.
Diabetes Care. 2025 Jan 1;48(1):93-100. doi: 10.2337/dc24-1041.
Both air pollution and diabetes are key urban challenges. The association between particulate matter with a diameter of <2.5 μm (PM2.5) exposure and prediabetes/diabetes in adults is well documented, but the health effects of life course exposure remain unclear. This study evaluated the impact of PM2.5 exposure throughout various life stages on the prevalence of prediabetes/diabetes in adulthood.
We included 4,551 individuals with 19,593 medical visits from two open cohorts in Taiwan and Hong Kong between 2000 and 2018. Ambient PM2.5 exposure was assessed using a satellite-based model, delivering a 2-year average exposure at a resolution of 1 km2. Logistic mixed-effects models were used to investigate longitudinal associations between PM2.5 exposure and the prevalence of prediabetes/diabetes. Life course models were used to examine the impact of PM2.5 exposure at different life stages on prediabetes/diabetes in adulthood.
Over an average follow-up period of 9.93 years, 1,660 individuals with prediabetes/diabetes were observed. For the longitudinal association, every 10 μg/m3 increase in PM2.5 was associated with an increased odds of having prediabetes/diabetes (odds ratio 1.32, 95% CI 1.13, 1.54). The odds of adulthood prediabetes/diabetes increased by 15%, 18%, and 29% for each 10 μg/m3 increase in PM2.5 exposure during school age, adolescence, and adulthood, respectively.
Our findings suggest a link between PM2.5 exposure during each life stage and the prevalence of prediabetes/diabetes in adulthood, with the health impacts of exposure during adulthood being slightly greater. This study underscores the need for life course air pollution control strategies to mitigate the substantial disease burden of diabetes.
空气污染和糖尿病都是城市面临的重大挑战。直径小于2.5微米的颗粒物（PM2.5）暴露与成年人糖尿病前期/糖尿病之间的关联已有充分记录，但生命历程暴露对健康的影响仍不清楚。本研究评估了不同生命阶段PM2.5暴露对成年期糖尿病前期/糖尿病患病率的影响。
我们纳入了2000年至2018年间来自台湾和香港两个开放队列的4551名个体，共19593次就诊记录。使用基于卫星的模型评估环境PM2.5暴露，以1平方公里的分辨率提供2年的平均暴露量。采用逻辑混合效应模型研究PM2.5暴露与糖尿病前期/糖尿病患病率之间的纵向关联。使用生命历程模型来检验不同生命阶段的PM2.5暴露对成年期糖尿病前期/糖尿病的影响。
在平均9.93年的随访期内，观察到1660例患有糖尿病前期/糖尿病的个体。对于纵向关联，PM2.5每增加10微克/立方米，患糖尿病前期/糖尿病的几率就会增加（优势比1.32，95%置信区间1.13，1.54）。在学龄期、青春期和成年期，PM2.5暴露每增加10微克/立方米，成年期糖尿病前期/糖尿病的几率分别增加15%、18%和29%。
我们的研究结果表明，每个生命阶段的PM2.5暴露与成年期糖尿病前期/糖尿病患病率之间存在联系，成年期暴露对健康的影响略大。本研究强调了实施生命历程空气污染控制策略以减轻糖尿病重大疾病负担的必要性。
