The study on DM-2 incidence does not support the previously identified associations between environmental exposures and DM-2 prevalence, and a wide range of environmental exposures were not associated with DM-2 incidence.
Abstract
INTRODUCTION
Environmental exposures have been associated with type 2 diabetes (DM-2) prevalence, but associations for incidence remain inconclusive. This study examined the associations between environmental exposures (e.g. air pollution, greenness and traffic noise) and DM-2 incidence in a population where associations of these exposures with DM-2 prevalence have previously been established.
Methods
Data of 249,495 Dutch individuals who participated in the Public Health Monitor in 2012 were used, enriched with data on air pollution, greenness, road traffic noise, and obesogenic environment. The incidence of DM-2 was based on medication prescriptions from 2013 to 2022. Cox regression models were performed to investigate the association between the exposures and DM-2 incidence. Potential effect modification by age (<40 years, 40-64 years, 65-79 years and ≥80 years) and sex was examined.
Results
No significant associations were observed between the exposures and DM-2 incidence in the total population. No significant associations were also observed across age groups and men and women, except that greenness was statistically significantly associated with a lower DM-2 incidence (Hazard Ratio per interquartile range (HRIQR)=0.96, 95% confidence interval (CI)=[0.92;1.00]) in individuals aged 40-64 years.
Conclusion
In conclusion, a wide range of environmental exposures were not associated with DM-2 incidence. Therefore, our study on DM-2 incidence does not support the previously identified associations between environmental exposures and DM-2 prevalence.
Emerging evidence links air pollution exposure to metabolic dysfunction; however, few studies have examined diabetes-related mortality in relation to ambient air pollutants using high-resolution exposure data at the population level. In the United States, particularly in large and geographically diverse states such as California, exposure contrasts and population heterogeneity provide an important setting to evaluate these associations.
We conducted a matched case–control analysis using California Department of Public Health (CDPH) Vital Records (2010–2021). Diabetes-related mortality events (ICD-10 E11) were identified as primary or contributory causes. Decedents (cases) were geocoded to residential addresses, and one-year rolling averages of fine particulate matter (PM
2.5
) before death were assigned as individual exposures. Each death record was matched to its selected controls based on month and year of birth and race-ethnicity. Controls were identified from the same statewide CDPH mortality database and were eligible because they had not died by the corresponding case’s date of death. Because the number of eligible controls varied across matched strata, controls were randomly sampled within each matched stratum to achieve an overall control-to-case ratio of approximately 2:1 for the study population. The final dataset included 60,824 diabetes-related deaths and 119,053 controls. Exposures were standardized by their interquartile range (IQR) and conditional logistic regression models estimated associations between 1 year rolling average fine particulate matter (PM
2.5
) exposure and odds of diabetes-related mortality, adjusting for age, sex, race-ethnicity, marital status, and education. Nitrogen dioxide (NO
2
) was included as a co-pollutant for confounding control.
PM
2.5
exposure (per 2.65 μg/m
3
IQR increase) was associated with a 18% higher odds of diabetes-related mortality (OR = 1.18; 95% CI: 1.15–1.22) before traffic indicator NO
2
adjustment and showed a stronger association with 21% higher odds (OR = 1.21; 95% CI: 1.17–1.25) after NO
2
adjustment. Health economics analysis estimated that reducing PM
2.5
exposure by its IQR could avoid losses of $31.2 million per 100,000 people.
Higher ambient PM
2.5
exposure was associated with increased odds of diabetes-related mortality in California even after adjustment for NO
2
and other impact factors. These findings support the need for continued strengthening of ambient air quality regulations.
Richy Zheng, Jason G. Su, E. Shahriary et al.· Frontiers in Public Health· 0 citations
Positive associations between long-term exposure to NO2 and CKD incidence were greater in never smokers than in ever-smokers, and stronger associations among never-smokers suggest that environmental exposures may independently influence kidney health.
Gonzalo Hevia-Ramos, Jiawei Zhang, Stephane Tuffier et al.· Journal of Exposure Science...· 0 citations
B baseline U-Cd levels were not independently associated with new-onset diabetes in this large longitudinal Asian cohort, suggesting that chronic Cd exposure may not be a significant risk factor for diabetes in this population.
Shing-Hsien Chou, Cheng-Wei Lin, Fu-Chih Hsiao et al.· Ecotoxicology and Environmen...· 0 citations
A significant causal relationship between long-term PM exposure and elevated prevalence and mortality of T2DM is confirmed and populations susceptible to diabetes are recommended to take targeted measures to reduce air pollution exposure.
Jianming Jiao· Theoretical and Natural Scie...· 0 citations
Long-term exposure to air pollutants, particularly NO2 and PM10, is associated with an increased risk of microvascular complications among individuals with diabetes, and the observed risk appears to be persistent and may begin at relatively low exposure levels, underscoring the need for preventive strategies targeting environmental risk factors.
INTRODUCTION
Air pollution is a leading environmental risk factor for cardiovascular disease (CVD), yet its relationship with metabolic syndrome (MetS) and its components in sub-Saharan Africa are unclear. This study aimed to examine the association between long-term PM2.5 exposure and MetS (and its component conditions) in a Ghanaian adult cohort.
METHODS
We performed a cross-sectional analysis of 1,833 adults (40-60 years) from the Awi-Gen study. Long-term PM2.5 exposure (2007-2015) was estimated via a satellite-based model. MetS was defined using harmonized criteria. We used multivariable logistic regression with sequential adjustment for covariates.
RESULTS
A positive association was observed between PM2.5 and hypertension, while no association was found for MetS overall or its component conditions. Each 1 μg/m3 increase in PM2.5 was associated with 6% higher odds of hypertension (OR: 1.06, 95% CI: 1.02-1.11). PM2.5 quartiles also showed a dose-response relationship with hypertension (p-trend=0.003), with the highest exposure linked to a 50% greater likelihood of hypertension. The calculated population attributable fraction for PM2.5 and hypertension was 18.6%.
INTERPRETATION
In this rural Ghanaian population, long-term PM2.5 exposure was associated with hypertension but not with metabolic syndrome or its other components. These findings provide important evidence from an understudied sub-Saharan African population and support the integration of air quality management into cardiovascular disease prevention strategies.
Ali Moro, E. Nonterah, Godfred Agongo et al.· Environmental Research· 0 citations
