Parasin Nichapa, Amnuaylojaroen Teerachai, Saokaew Surasak, Sittichai Nuttawut, Tabkhan Natcha, Dilokthornsakul Piyameth
School of Allied Health Science, University of Phayao, Phayao, 56000, Thailand.
School of Energy and Environment, University of Phayao, Phayao, 56000, Thailand; Atmospheric Pollution and Climate Change Research Units, School of Energy and Environment, University of Phayao, Phayao, 56000, Thailand.
Environ Res. 2025 Mar 15;269:120885. doi: 10.1016/j.envres.2025.120885. Epub 2025 Jan 17.
The association between different air pollutants and Type 2 Diabetes Mellitus (T2DM) is a growing topic of interest in public health research. This umbrella review and meta-analysis aimed to consolidate current literature on the association between various outdoor air pollutants and T2DM. Subgroups and dose-response relationships were also analyzed to further quantify the association, especially by the factors such as the type of pollutants, duration of exposure, and geographical variation, etc. A thorough literature search of three databases revealed a total of 71 records for umbrella review and 1524 records for meta-analysis where 8 studies were included in the final review of umbrella review and 46 studies for meta-analysis. The evaluation of the study's quality in umbrella review and meta-analysis were conducted using the AMSTAR 2 criteria and the Newcastle-Ottawa Scale (NOS), respectively. Exposure to Particulate Matter (PM) 2.5, PM10, Nitrogen dioxides (NO2) and Ozone (O3) were significantly associated with the risk of T2DM [OR = 1.12 (95% Confidence Interval (CI): 1.09, 1.15), 1.12 (95% CI: 1.06, 1.18), 1.09 (95%CI: 1.07, 1.12), 1.05 (95%CI: 1.03, 1.08), respectively] and subgroup analysis further revealed that PM2.5, PM10, and NO2 associations were confounded by factors such as ages, study design, regions of exposure and air pollution concentration levels. Lastly, only exposure to PM10 had a significant dose-response relationship with the risk of T2DM (p-value = 0.000). These findings further emphasized the need for standardized methods in conducting air pollution research and additional research on other air pollutants to further explore the relationships between these air pollutants and T2DM.
不同空气污染物与2型糖尿病（T2DM）之间的关联是公共卫生研究中一个日益受关注的话题。本伞状综述和荟萃分析旨在整合有关各种室外空气污染物与T2DM之间关联的现有文献。还分析了亚组和剂量反应关系，以进一步量化这种关联，特别是通过污染物类型、暴露持续时间和地理差异等因素。对三个数据库进行全面的文献检索后，共获得71条用于伞状综述的记录和1524条用于荟萃分析的记录，其中8项研究纳入了伞状综述的最终评价，46项研究纳入了荟萃分析。分别使用AMSTAR 2标准和纽卡斯尔-渥太华量表（NOS）对伞状综述和荟萃分析中的研究质量进行评估。暴露于细颗粒物（PM）2.5、可吸入颗粒物（PM10）、二氧化氮（NO2）和臭氧（O3）与T2DM风险显著相关[比值比（OR）分别为1.12（95%置信区间（CI）：1.09，1.15）、1.12（95%CI：1.06，1.18）、1.09（95%CI：1.07，1.12）、1.05（95%CI：1.03，1.08）]，亚组分析进一步显示，PM2.5、PM10和NO2的关联受到年龄、研究设计、暴露区域和空气污染浓度水平等因素的混杂影响。最后，只有暴露于PM10与T2DM风险存在显著的剂量反应关系（p值=0.000）。这些发现进一步强调了在进行空气污染研究时采用标准化方法的必要性，以及对其他空气污染物进行更多研究以进一步探索这些空气污染物与T2DM之间关系的必要性。
