Fiffer Melissa R, Chen Jie, Silva Emily L, Nethery Rachel C, Sun Qi, James Peter, Grady Stephanie T, Yanosky Jeff D, Kaufman Joel D, Laden Francine, Hart Jaime E
Children's Environmental Health Initiative, University of Illinois Chicago, Chicago, Illinois, USA.
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Environ Health Perspect. 2025 Jun;133(6):67009. doi: 10.1289/EHP15673. Epub 2025 Jun 12.
Research has detected associations between air pollution exposure and type 2 diabetes (T2DM), but findings from large cohort studies are needed to ascertain the most influential pollutants, susceptible subpopulations, and low-level exposure associations. Our aim was to prospectively evaluate the association between long-term exposure to fine particulate matter in aerodynamic diameter () and nitrogen dioxide () and T2DM incidence in the Nurses' Health Study (NHS) and Nurses' Health Study II (NHSII) cohorts of US women.
Monthly and exposures were predicted from spatiotemporal models and linked to participants' residential addresses. We used Cox proportional hazards models to assess the association between 24-month moving average and exposure and self-reported, clinician-diagnosed T2DM from 1992-2019. We adjusted for time-varying lifestyle factors, reproductive hormonal factors, and individual and neighborhood socioeconomic status (SES). Results were meta-analyzed. We evaluated whether relationships persisted at levels below the current US EPA National Ambient Air Quality Standards (NAAQS). Lastly, we examined multiplicative and additive interactions by body mass index (BMI), smoking status, physical activity, neighborhood SES, and region.
Over follow-up, there were 19,083 incident T2DM cases among the 208,733 women in NHS and NHSII. In fully adjusted single-pollutant models, the hazard ratio (HR) for an interquartile range (IQR) () higher 24-month average exposure was 1.05 [95% confidence interval (CI): 1.02, 1.08] for incident T2DM. The HR for an IQR () higher exposure was 1.05 (95% CI: 1.01, 1.09). Both associations were robust to co-adjustment. Associations remained stable when restricting to levels below the NAAQS as compared to the full dataset. Stronger associations were observed in individuals who had a BMI , were physically active, and resided in the Northeast.
Our results showed a positive association between T2DM and long-term exposure to and , persisting even at levels below the current EPA NAAQS. https://doi.org/10.1289/EHP15673.
研究已发现空气污染暴露与2型糖尿病（T2DM）之间存在关联，但需要大型队列研究的结果来确定最具影响力的污染物、易感亚人群以及低水平暴露关联。我们的目的是前瞻性评估美国护士健康研究（NHS）和护士健康研究II（NHSII）队列中女性长期暴露于空气动力学直径（）的细颗粒物和二氧化氮（）与T2DM发病率之间的关联。
通过时空模型预测每月的和暴露情况，并将其与参与者的居住地址相关联。我们使用Cox比例风险模型评估24个月移动平均和暴露与1992 - 2019年自我报告的、临床诊断的T2DM之间的关联。我们对随时间变化的生活方式因素、生殖激素因素以及个体和邻里社会经济地位（SES）进行了调整。对结果进行了荟萃分析。我们评估了在低于当前美国环境保护局国家环境空气质量标准（NAAQS）的水平下这种关系是否仍然存在。最后，我们通过体重指数（BMI）、吸烟状况、身体活动、邻里SES和地区检查了相乘和相加相互作用。
在随访期间，NHS和NHSII的208,733名女性中有19,083例T2DM发病病例。在完全调整的单污染物模型中，24个月平均暴露每增加一个四分位数间距（IQR）（），T2DM发病的风险比（HR）为1.05 [95%置信区间（CI）：1.02, 1.08]。暴露每增加一个IQR（），HR为1.05（95% CI：1.01, 1.09）。两种关联在共同调整后都很稳健。与完整数据集相比，当将限制在低于NAAQS的水平时，关联仍然稳定。在BMI、身体活跃且居住在东北部的个体中观察到更强的关联。
我们的结果表明T2DM与长期暴露于和之间存在正相关，即使在低于当前EPA NAAQS的水平下这种关联仍然存在。https://doi.org/10.1289/EHP15673。
