1
|
Li YJ, Takeda K, Yamamoto M, Kawada T. Potential of NRF2 Pathway in Preventing Developmental and Reproductive Toxicity of Fine Particles. FRONTIERS IN TOXICOLOGY 2022; 3:710225. [PMID: 35295150 PMCID: PMC8915851 DOI: 10.3389/ftox.2021.710225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 08/27/2021] [Indexed: 12/13/2022] Open
Abstract
Air pollution is associated with significant adverse health effects. Recent studies support the idea that inhalation of fine particles can instigate extrapulmonary effects on the cardiovascular system through several pathways. The systemic transfer of ultrafine particles (UFPs) or soluble particle components (organic compounds and metals) is of particular concern. An integral role of reactive oxygen species (ROS)-dependent pathways has been suggested in systemic inflammatory responses and vascular dysfunction at the molecular level. Accumulating lines of evidence suggest that fine particles affect fetal development, giving rise to low birth weight and a reduction in fetal growth, and also affect the immune, cardiovascular, and central nervous systems. Oxidative stress plays an important role in fine particles toxicity; pre-treatment with antioxidants partially suppresses the developmental toxicity of fine particles. On the other hand, Nuclear factor erythroid-derived 2-like 2 (Nfe2l2), also known as NRF2, is a transcription factor essential for inducible and/or constitutive expression of phase II and antioxidant enzymes. Studies using Nrf2-knockout mice revealed that NRF2 dysfunction is intimately involved in the pathogenesis of various human diseases. Multiple single nucleotide polymorphisms (SNPs) have been detected in human NRF2 locus. An NRF2 gene SNP (−617C > A; rs6721961), located in the upstream promoter region, affects the transcriptional level of NRF2 and thereby the protein level and downstream gene expression. It has been reported that the SNP-617 is associated with various diseases. The onset and exacerbation of the diseases are regulated by genetic predisposition and environmental factors; some people live in the air-polluted environment but are not affected and remain healthy, suggesting the presence of individual differences in the susceptibility to air pollutants. NRF2 polymorphisms may also be associated with the fetal effects of fine particles exposure. Screening high-risk pregnant women genetically susceptible to oxidative stress and prevention by antioxidant interventions to protect fetal development in air-polluted areas should be considered. This article reviews the recent advances in our understanding of the fetal health effects of fine particles and describes potential chemoprevention via the NRF2 pathway to prevent the developmental and reproductive toxicity of fine particles.
Collapse
Affiliation(s)
- Ying-Ji Li
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
| | - Ken Takeda
- Faculty of Pharmaceutical Sciences, Sanyo-onoda City University, Sanyo-Onoda, Japan
| | - Masayuki Yamamoto
- Medical Biochemistry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
| |
Collapse
|
2
|
Yu Y, Jerrett M, Paul KC, Su J, Shih IF, Wu J, Lee E, Inoue K, Haan M, Ritz B. Ozone Exposure, Outdoor Physical Activity, and Incident Type 2 Diabetes in the SALSA Cohort of Older Mexican Americans. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:97004. [PMID: 34494856 PMCID: PMC8425281 DOI: 10.1289/ehp8620] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 05/28/2023]
Abstract
BACKGROUND Type 2 diabetes is a leading contributor to the global burden of morbidity and mortality. Ozone (O3) exposure has previously been linked to diabetes. OBJECTIVE We studied the impact of O3 exposure on incident diabetes risk in elderly Mexican Americans and investigated whether outdoor physical activity modifies the association. METHODS We selected 1,090 Mexican American participants from the Sacramento Area Latino Study on Aging conducted from 1998 to 2007. Ambient O3 exposure levels were modeled with a land-use regression built with saturation monitoring data collected at 49 sites across the Sacramento metropolitan area. Using Cox proportional hazard models, we estimated the risk of developing incident diabetes based on average O3 exposure modeled for 5-y prior to incident diabetes diagnosis or last follow-up. Further, we estimated outdoor leisure-time physical activity at baseline and investigated whether higher vs. lower levels modified the association between O3 exposure and diabetes. RESULTS In total, 186 incident diabetes cases were identified during 10-y follow-up. Higher levels of physical activity were negatively associated with incident diabetes [hazard ratio (HR)=0.64 (95% CI: 0.43, 0.95)]. The estimated HRs for incident diabetes was 1.13 (95% CI: 1.00, 1.28) per 10-ppb increment of 5-y average O3 exposure; also, this association was stronger among those physically active outdoors [HR=1.52 (95% CI: 1.21, 1.90)], and close to null for those reporting lower levels of outdoor activity [HR=1.04 (95% CI: 0.90, 1.20), pinteraction=0.01]. CONCLUSIONS Our findings suggest that ambient O3 exposure contributes to the development of type 2 diabetes, particularly among those with higher levels of leisure-time outdoor physical activity. Policies and strategies are needed to reduce O3 exposure to guarantee that the health benefits of physical activity are not diminished by higher levels of O3 pollution in susceptible populations such as older Hispanics. https://doi.org/10.1289/EHP8620.
Collapse
Affiliation(s)
- Yu Yu
- Department of Epidemiology, University of California at Los Angeles (UCLA) Fielding School of Public Health, Los Angeles, California, USA
- Department of Environmental Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Michael Jerrett
- Department of Environmental Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Kimberly C. Paul
- Department of Epidemiology, University of California at Los Angeles (UCLA) Fielding School of Public Health, Los Angeles, California, USA
| | - Jason Su
- Division of Environmental Health Sciences, University of California, Berkley School of Public Health, Berkeley, California, USA
| | - I-Fan Shih
- Department of Epidemiology, University of California at Los Angeles (UCLA) Fielding School of Public Health, Los Angeles, California, USA
| | - Jun Wu
- Department of Environmental and Occupational Health, Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, California, USA
| | - Eunice Lee
- Department of Environmental Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Kosuke Inoue
- Department of Epidemiology, University of California at Los Angeles (UCLA) Fielding School of Public Health, Los Angeles, California, USA
| | - Mary Haan
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Beate Ritz
- Department of Epidemiology, University of California at Los Angeles (UCLA) Fielding School of Public Health, Los Angeles, California, USA
- Department of Environmental Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
- Department of Neurology, UCLA David Geffen School of Medicine, Los Angeles, California, USA
| |
Collapse
|
3
|
Systematic review and meta-analysis of cohort studies of long term outdoor nitrogen dioxide exposure and mortality. PLoS One 2021; 16:e0246451. [PMID: 33539450 PMCID: PMC7861378 DOI: 10.1371/journal.pone.0246451] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 01/10/2021] [Indexed: 01/04/2023] Open
Abstract
Objective To determine whether long term exposure to outdoor nitrogen dioxide (NO2) is associated with all-cause or cause-specific mortality. Methods MEDLINE, Embase, CENTRAL, Global Health and Toxline databases were searched using terms developed by a librarian. Screening, data extraction and risk of bias assessment were completed independently by two reviewers. Conflicts were resolved through consensus and/or involvement of a third reviewer. Pooling of results across studies was conducted using random effects models, heterogeneity among included studies was assessed using Cochran’s Q and I2 measures, and sources of heterogeneity were evaluated using meta-regression. Sensitivity of pooled estimates to individual studies was examined and publication bias was evaluated using Funnel plots, Begg’s and Egger’s tests, and trim and fill. Results Seventy-nine studies based on 47 cohorts, plus one set of pooled analyses of multiple European cohorts, met inclusion criteria. There was a consistently high degree of heterogeneity. After excluding studies with probably high or high risk of bias in the confounding domain (n = 12), pooled hazard ratios (HR) indicated that long term exposure to NO2 was significantly associated with mortality from all/ natural causes (pooled HR 1.047, 95% confidence interval (CI), 1.023–1.072 per 10 ppb), cardiovascular disease (pooled HR 1.058, 95%CI 1.026–1.091), lung cancer (pooled HR 1.083, 95%CI 1.041–1.126), respiratory disease (pooled HR 1.062, 95%CI1.035–1.089), and ischemic heart disease (pooled HR 1.111, 95%CI 1.079–1.144). Pooled estimates based on multi-pollutant models were consistently smaller than those from single pollutant models and mostly non-significant. Conclusions For all causes of death other than cerebrovascular disease, the overall quality of the evidence is moderate, and the strength of evidence is limited, while for cerebrovascular disease, overall quality is low and strength of evidence is inadequate. Important uncertainties remain, including potential confounding by co-pollutants or other concomitant exposures, and limited supporting mechanistic evidence. (PROSPERO registration number CRD42018084497)
Collapse
|
4
|
Chen C, Liu X, Wang X, Qu W, Li W, Dong L. Effect of air pollution on hospitalization for acute exacerbation of chronic obstructive pulmonary disease, stroke, and myocardial infarction. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:3384-3400. [PMID: 31845265 DOI: 10.1007/s11356-019-07236-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 12/02/2019] [Indexed: 05/03/2023]
Abstract
This study aims to analyze the acute effects of PM2.5, PM10, SO2, NO2, and O3 on hospitalizations for acute exacerbation of chronic obstructive pulmonary disease (AECOPD), stroke, and myocardial infarction (MI) from 2014 to 2017 in Shenyang, China. Hospitalization records for AECOPD (17,655), stroke (276,736) and MI (26,235) and air pollutions concentration data (PM2.5, PM10, SO2, NO2, and O3) were collected. A generalized additive model (GAM) was utilized to determine the impact of air pollutants on the relative risk (RR) of hospitalization for AECOPD, stroke, and MI. Stratified analysis for AECOPD was based on gender and age. It was based on gender, age, hypertension, and diabetes for stroke, and for MI it was based on gender, age, and coronary atherosclerosis. The lag effect for AECOPD in terms of gender analysis occurred at lag3-lag5. The hospitalization risk for stroke with hypertension due to SO2 and NO2 was greater than that of stroke without hypertension. The risk of hospitalization for stroke with hypertension as a comorbidity due to O3 was lower than without hypertension. The risk of hospitalization for MI combined with coronary atherosclerosis due to PM2.5, PM10, or NO2 was higher than that of hospitalizations for MI without coronary atherosclerosis. Air pollution increased the rate of hospitalization for AECOPD. SO2 and O3 appeared protective for stroke patients with coronary atherosclerosis. PM2.5, PM10, and NO2 had no influence on total hospitalization for myocardial infarction.
Collapse
Affiliation(s)
- Cai Chen
- Biomedical Engineering Institute, School of Control Science and Engineering, Shandong University, Jinan, 250061, China
| | - Xuejian Liu
- The First General Internal Medicine, Shengjing Hospital, China Medical University, No.16 Puhe Road, Shenbei New District, Shenyang City, 110000, Liaoning Province, China
| | - Xianfeng Wang
- PFLMET Experimental Center, Shandong University, Jinan, People's Republic of China
| | - Wenxiu Qu
- The First General Internal Medicine, Shengjing Hospital, China Medical University, No.16 Puhe Road, Shenbei New District, Shenyang City, 110000, Liaoning Province, China.
| | - Wei Li
- Biomedical Engineering Institute, School of Control Science and Engineering, Shandong University, Jinan, 250061, China.
| | - Leilei Dong
- Biomedical Engineering Institute, School of Control Science and Engineering, Shandong University, Jinan, 250061, China
| |
Collapse
|
5
|
Abstract
Supplemental Digital Content is available in the text. Background: Concentrations of outdoor nitrogen dioxide (NO2) have been associated with increased mortality. Hazard ratios (HRs) from cohort studies are used to assess population health impact and burden. We undertook meta-analyses to derive concentration–response functions suitable for such evaluations and assessed their sensitivity to study selection based upon cohort characteristics. Methods: We searched online databases and existing reviews for cohort studies published to October 2016 that reported HRs for NO2 and mortality. We calculated meta-analytic summary estimates using fixed/random-effects models. Results: We identified 48 articles analyzing 28 cohorts. Meta-analysis of HRs found positive associations between NO2 and all cause (1.02 [95% confidence interval (CI): 1.01, 1.03]; prediction interval [PI]: [0.99, 1.06] per 10 µg/m3 increment in NO2), cardiovascular (1.03 [95% CI: 1.02, 1.05]; PI: [0.98, 1.08]), respiratory (1.03 [95% CI: 1.01, 1.05]; PI: [0.97, 1.10]), and lung cancer mortality (1.05 [95% CI: 1.02, 1.08]; PI: [0.94, 1.17]) with evidence of substantial heterogeneity between studies. In subgroup analysis, summary HRs varied by age at cohort entry, spatial resolution of pollution estimates, and adjustment for smoking and body mass index at the individual level; for some subgroups, the HR was close to unity, with lower confidence limits below 1. Conclusions: Given the many uncertainties inherent in the assessment of this evidence base and the sensitivity of health impact calculations to small changes in the magnitude of the HRs, calculation of the impact on health of policies to reduce long-term exposure to NO2 should use prediction intervals and report ranges of impact rather than focusing upon point estimates.
Collapse
|
6
|
Schraufnagel DE, Balmes JR, Cowl CT, De Matteis S, Jung SH, Mortimer K, Perez-Padilla R, Rice MB, Riojas-Rodriguez H, Sood A, Thurston GD, To T, Vanker A, Wuebbles DJ. Air Pollution and Noncommunicable Diseases: A Review by the Forum of International Respiratory Societies' Environmental Committee, Part 2: Air Pollution and Organ Systems. Chest 2019; 155:417-426. [PMID: 30419237 PMCID: PMC6904854 DOI: 10.1016/j.chest.2018.10.041] [Citation(s) in RCA: 368] [Impact Index Per Article: 73.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/28/2018] [Accepted: 10/31/2018] [Indexed: 12/30/2022] Open
Abstract
Although air pollution is well known to be harmful to the lung and airways, it can also damage most other organ systems of the body. It is estimated that about 500,000 lung cancer deaths and 1.6 million COPD deaths can be attributed to air pollution, but air pollution may also account for 19% of all cardiovascular deaths and 21% of all stroke deaths. Air pollution has been linked to other malignancies, such as bladder cancer and childhood leukemia. Lung development in childhood is stymied with exposure to air pollutants, and poor lung development in children predicts lung impairment in adults. Air pollution is associated with reduced cognitive function and increased risk of dementia. Particulate matter in the air (particulate matter with an aerodynamic diameter < 2.5 μm) is associated with delayed psychomotor development and lower child intelligence. Studies link air pollution with diabetes mellitus prevalence, morbidity, and mortality. Pollution affects the immune system and is associated with allergic rhinitis, allergic sensitization, and autoimmunity. It is also associated with osteoporosis and bone fractures, conjunctivitis, dry eye disease, blepharitis, inflammatory bowel disease, increased intravascular coagulation, and decreased glomerular filtration rate. Atopic and urticarial skin disease, acne, and skin aging are linked to air pollution. Air pollution is controllable and, therefore, many of these adverse health effects can be prevented.
Collapse
Affiliation(s)
- Dean E Schraufnagel
- Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago, Chicago, IL.
| | - John R Balmes
- Department of Medicine, University of California, San Francisco, Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA
| | - Clayton T Cowl
- Divisions of Preventive, Occupational, and Aerospace Medicine and Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
| | - Sara De Matteis
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Soon-Hee Jung
- Department of Pathology, Wonju Colleage of Medicine, Yonsei University, Seoul, South Korea
| | - Kevin Mortimer
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | - Mary B Rice
- Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | | | - Akshay Sood
- Pulmonary, Critical Care, and Sleep Medicine, University of New Mexico School of Medicine, Albuquerque, NM
| | - George D Thurston
- Departments of Environmental Medicine and Population Health, New York University School of Medicine, New York, NY
| | - Teresa To
- The Hospital for Sick Children, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Anessa Vanker
- Department of Paediatrics and Child Health & MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Donald J Wuebbles
- School of Earth, Society, and Environment, Department of Atmospheric Sciences, University of Illinois, Urbana, IL
| |
Collapse
|
7
|
Abstract
PURPOSE OF REVIEW The objective of this review is to highlight the evidence on the association between contextual characteristics of residential environments and type 2 diabetes, to provide an overview of the methodological challenges and to outline potential topics for future research in this field. RECENT FINDINGS The link between neighborhood socioeconomic status or deprivation and diabetes prevalence, incidence, and control is robust and has been replicated in numerous settings, including in experimental and quasi-experimental studies. The association between characteristics of the built environment that affect physical activity, other aspects of the built environment, and diabetes risk is robust. There is also evidence for an association between food environments and diabetes risk, but some conflicting results have emerged in this area. While the evidence base on the association of neighborhood socioeconomic status and built and physical environments and diabetes is large and robust, challenges remain related to confounding due to neighborhood selection. Moreover, we also outline five paths forward for future research on the role of neighborhood environments on diabetes.
Collapse
Affiliation(s)
- Usama Bilal
- Urban Health Collaborative, Drexel Dornsife School of Public Health, 3600 Market St, 7th floor, Philadelphia, PA, 19104, USA.
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, 3215 Market St, Philadelphia, PA, 19104, USA.
| | - Amy H Auchincloss
- Urban Health Collaborative, Drexel Dornsife School of Public Health, 3600 Market St, 7th floor, Philadelphia, PA, 19104, USA
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, 3215 Market St, Philadelphia, PA, 19104, USA
| | - Ana V Diez-Roux
- Urban Health Collaborative, Drexel Dornsife School of Public Health, 3600 Market St, 7th floor, Philadelphia, PA, 19104, USA
- Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, 3215 Market St, Philadelphia, PA, 19104, USA
| |
Collapse
|
8
|
Ward-Caviness CK, Nwanaji-Enwerem JC, Wolf K, Wahl S, Colicino E, Trevisi L, Kloog I, Just AC, Vokonas P, Cyrys J, Gieger C, Schwartz J, Baccarelli AA, Schneider A, Peters A. Long-term exposure to air pollution is associated with biological aging. Oncotarget 2018; 7:74510-74525. [PMID: 27793020 PMCID: PMC5342683 DOI: 10.18632/oncotarget.12903] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 10/13/2016] [Indexed: 11/28/2022] Open
Abstract
Long-term exposure to air pollution is associated with age-related diseases. We explored the association between accelerated biological aging and air pollution, a potential mechanism linking air pollution and health. We estimated long-term exposure to PM10, PM2.5, PM2.5 absorbance/black carbon (BC), and NOx via land-use regression models in individuals from the KORA F4 cohort. Accelerated biological aging was assessed using telomere length (TeloAA) and three epigenetic measures: DNA methylation age acceleration (DNAmAA), extrinsic epigenetic age acceleration (correlated with immune cell counts, EEAA), and intrinsic epigenetic age acceleration (independent of immune cell counts, IEAA). We also investigated sex-specific associations between air pollution and biological aging, given the published association between sex and aging measures. In KORA an interquartile range (0.97 μg/m3) increase in PM2.5 was associated with a 0.33 y increase in EEAA (CI = 0.01, 0.64; P = 0.04). BC and NOx (indicators or traffic exposure) were associated with DNAmAA and IEAA in women, while TeloAA was inversely associated with BC in men. We replicated this inverse BC-TeloAA association in the Normative Aging Study, a male cohort based in the USA. A multiple phenotype analysis in KORA F4 combining all aging measures showed that BC and PM10 were broadly associated with biological aging in men. Thus, we conclude that long-term exposure to air pollution is associated with biological aging measures, potentially in a sex-specific manner. However, many of the associations were relatively weak and further replication of overall and sex-specific associations is warranted.
Collapse
Affiliation(s)
- Cavin K Ward-Caviness
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Bavaria, Germany
| | | | - Kathrin Wolf
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Bavaria, Germany
| | - Simone Wahl
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Bavaria, Germany.,Research Unit Molecular Epidemiology, Helmholtz Zentrum München, Neuherberg, Bavaria, Germany
| | - Elena Colicino
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Letizia Trevisi
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pantel Vokonas
- VA Normative Aging Study, Veterans Affairs Boston Healthcare System and the Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Josef Cyrys
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Bavaria, Germany
| | - Christian Gieger
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Bavaria, Germany.,Research Unit Molecular Epidemiology, Helmholtz Zentrum München, Neuherberg, Bavaria, Germany
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Alexandra Schneider
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Bavaria, Germany
| | - Annette Peters
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Bavaria, Germany
| |
Collapse
|
9
|
Exposure to Night-Time Traffic Noise, Melatonin-Regulating Gene Variants and Change in Glycemia in Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14121492. [PMID: 29194408 PMCID: PMC5750910 DOI: 10.3390/ijerph14121492] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 11/24/2017] [Accepted: 11/29/2017] [Indexed: 11/16/2022]
Abstract
Traffic noise has been linked to diabetes, with limited understanding of its mechanisms. We hypothesize that night-time road traffic noise (RTN) may impair glucose homeostasis through circadian rhythm disturbances. We prospectively investigated the relationship between residential night-time RTN and subsequent eight-year change in glycosylated hemoglobin (ΔHbA1c) in 3350 participants of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA), adjusting for diabetes risk factors and air pollution levels. Annual average RTN (Lnight) was assigned to participants in 2001 using validated Swiss noise models. HbA1c was measured in 2002 and 2011 using liquid chromatography. We applied mixed linear models to explore RTN–ΔHbA1c association and its modification by a genetic risk score of six common circadian-related MTNR1B variants (MGRS). A 10 dB difference in RTN was associated with a 0.02% (0.003–0.04%) increase in mean ΔHbA1c in 2142 non-movers. RTN–ΔHbA1c association was modified by MGRS among diabetic participants (Pinteraction = 0.001). A similar trend in non-diabetic participants was non-significant. Among the single variants, we observed strongest interactions with rs10830963, an acknowledged diabetes risk variant also implicated in melatonin profile dysregulation. Night-time RTN may impair glycemic control, especially in diabetic individuals, through circadian rhythm disturbances. Experimental sleep studies are needed to test whether noise control may help individuals to attain optimal glycemic levels.
Collapse
|
10
|
Residential Proximity to Major Roadways and Risk of Type 2 Diabetes Mellitus: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 14:ijerph14010003. [PMID: 28025522 PMCID: PMC5295254 DOI: 10.3390/ijerph14010003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 12/12/2016] [Accepted: 12/12/2016] [Indexed: 12/19/2022]
Abstract
Research indicates that higher levels of traffic-related pollution exposure increase the risk of diabetes, but the association between road proximity and diabetes risk remains unclear. To assess and quantify the association between residential proximity to major roadways and type 2 diabetes, a systematic review and meta-analysis was performed. Embase, Medline, and Web of Science were searched for eligible studies. Using a random-effects meta-analysis, the summary relative risks (RRs) were calculated. Bayesian meta-analysis was also performed. Eight studies (6 cohort and 2 cross-sectional) with 158,576 participants were finally included. The summary unadjusted RR for type 2 diabetes associated with residential proximity to major roadways was 1.24 (95% confidence interval [CI]: 1.07–1.44, p = 0.001, I2 = 48.1%). The summary adjusted RR of type 2 diabetes associated with residential proximity to major roadways was 1.12 (95% CI: 1.03–1.22, p = 0.01, I2 = 17.9%). After excluding two cross-sectional studies, the summary results suggested that residential proximity to major roadways could increase type 2 diabetes risk (Adjusted RR = 1.13; 95% CI: 1.02–1.27, p = 0.025, I2 = 36.6%). Bayesian meta-analysis showed that the unadjusted RR and adjusted RR of type 2 diabetes associated with residential proximity to major roadways were 1.22 (95% credibility interval: 1.06–1.55) and 1.13 (95% credibility interval: 1.01–1.31), respectively. The meta-analysis suggested that residential proximity to major roadways could significantly increase risk of type 2 diabetes, and it is an independent risk factor of type 2 diabetes. More well-designed studies are needed to further strengthen the evidence.
Collapse
|
11
|
Bell K. Bread and Roses: A Gender Perspective on Environmental Justice and Public Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13101005. [PMID: 27754351 PMCID: PMC5086744 DOI: 10.3390/ijerph13101005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 09/20/2016] [Accepted: 09/26/2016] [Indexed: 12/19/2022]
Abstract
Gender continues to be a relatively marginal issue in environmental justice debates and yet it remains an important aspect of injustice. To help redress the balance, this article explores women’s experience of environmental justice through a review of the existing literature and the author’s prior qualitative research, as well as her experience of environmental activism. The analysis confirms that women tend to experience inequitable environmental burdens (distributional injustice); and are less likely than men to have control over environmental decisions (procedural injustice), both of which impact on their health (substantive injustice). It is argued that these injustices occur because women generally have lower incomes than men and are perceived as having less social status than their male counterparts as a result of entwined and entrenched capitalist and patriarchal processes. In the light of this analysis, it is proposed that environmental justice research, teaching, policy and practice should be made more gender aware and feminist orientated. This could support cross-cutting debates and activities in support of the radical social change necessary to bring about greater social and environmental justice more generally.
Collapse
Affiliation(s)
- Karen Bell
- School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK.
| |
Collapse
|
12
|
Tahmasebi A, Amin MM, Poursafa P, Iraj B, Sadeghiyan H, Kelishadi R, Sadeghian B. Association of geographical distribution of air quality index and type 2 diabetes mellitus in Isfahan, Iran. Pak J Med Sci 2015; 31:369-73. [PMID: 26101493 PMCID: PMC4476344 DOI: 10.12669/pjms.312.6762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 01/15/2015] [Indexed: 12/22/2022] Open
Abstract
Objectives: Air pollution is a hazardous environmental problem with several adverse health effects including its impact on the development of chronic diseases as diabetes mellitus. This study aimed to investigate the association of geographical distribution of air quality index (AQI) and type 2 diabetes mellitus in an air-polluted city by using geographic information system (GIS). Methods: This cross-sectional study was conducted in Isfahan, Iran. The records that have been registered from 2009 to 2012 in major referral public diabetes clinics were gathered; they included data of 1467 diabetic patients. Their living area was represented with spots in the city map. AQI data were also interpolated from monitoring stations spreading around the city. The GIS maps of air pollutants and diabetes were developed and the associations were determined. Results: The density of diabetic population was higher in highly polluted areas compared with areas with the lower levels of air pollution. No significant correlation was documented between the distribution of diabetic patients and air pollution level throughout the city. Conclusion: Although the density of diabetic patients was higher in areas with higher air pollution, but the lack of association between AQI and the prevalence of diabetes might be because the air of different parts of the city was highly polluted, and we could not compare the prevalence of diabetes in areas with clean and polluted air.
Collapse
Affiliation(s)
- Azadeh Tahmasebi
- Azadeh Tahmasebi, Environmental Health Engineering Department, Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Mehdi Amin
- Mohammad Mehdi Amin, Environmental Health Engineering Department, Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parinaz Poursafa
- Parinaz Poursafa, Environmental Health Engineering Department, Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bijan Iraj
- Bijan Iraj, Isfahan Endocrine and Metabolism Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Sadeghiyan
- Hamidreza Sadeghiyan, Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primary Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Roya Kelishadi, Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primary Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | | |
Collapse
|
13
|
Rao X, Montresor-Lopez J, Puett R, Rajagopalan S, Brook RD. Ambient air pollution: an emerging risk factor for diabetes mellitus. Curr Diab Rep 2015; 15:603. [PMID: 25894943 DOI: 10.1007/s11892-015-0603-8] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Growing evidence supports that air pollution has become an important risk factor for developing diabetes mellitus. Understanding the contributing effect of air pollution in population studies, elucidating the potential mechanisms involved, and identifying the most responsible pollutants are all required in order to promulgate successful changes in policy and to help formulate preventive measures in an effort to reduce the risk for diabetes. This review summarizes recent findings from epidemiologic studies and mechanistic insights that provide links between exposure to air pollution and a heightened risk for diabetes.
Collapse
Affiliation(s)
- Xiaoquan Rao
- Division of Cardiovascular Medicine, University of Maryland, Baltimore, MD, USA
| | | | | | | | | |
Collapse
|
14
|
Peters A, Hampel R, Cyrys J, Breitner S, Geruschkat U, Kraus U, Zareba W, Schneider A. Elevated particle number concentrations induce immediate changes in heart rate variability: a panel study in individuals with impaired glucose metabolism or diabetes. Part Fibre Toxicol 2015; 12:7. [PMID: 25888845 PMCID: PMC4379544 DOI: 10.1186/s12989-015-0083-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 02/17/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The health effects of short-term exposure to ambient ultrafine particles in micro-environments are still under investigation. METHODS Sixty-four individuals with type 2 diabetes and impaired glucose tolerance recorded ambulatory electrocardiograms over five to six hours on 191 occasions in a panel study in Augsburg, Germany. Personal exposure to particle number concentrations (PNC) was monitored for each individual on 5-minute basis concurrently and particulate matter with an aerodynamic diameter<2.5 μm (PM2.5) was acquired from a central monitoring site on an hourly basis. RESULTS More than 11,000 5-minute intervals were available for heart rate and measures of heart rate variability including SDNN (standard deviation of NN intervals). A concurrent decrease in 5-minute SDNN of -0.56% (95% confidence limits (CI): -1.02%; -0.09%) and a 5-minute delayed increase in heart rate of 0.23 % (95% CI: 0.11%; 0.36%) was observed with an increase in personal PNC of 16,000 per cm3 in additive mixed models. Models evaluating the association of concurrent 5-minute personal PNC and of 1-hour PM2.5 showed independent effects on SDNN. CONCLUSION The data suggest that freshly emitted ultrafine particles and aged fine particulate matter are both associated with changes in cardiac function in individuals with type 2 diabetes and impaired glucose tolerance in urban areas.
Collapse
Affiliation(s)
- Annette Peters
- Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, 87564, Neuherberg, Germany. .,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.
| | - Regina Hampel
- Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, 87564, Neuherberg, Germany.
| | - Josef Cyrys
- Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, 87564, Neuherberg, Germany. .,University of Augsburg, Environmental Science Center, Augsburg, Germany.
| | - Susanne Breitner
- Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, 87564, Neuherberg, Germany.
| | - Uta Geruschkat
- Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, 87564, Neuherberg, Germany.
| | - Ute Kraus
- Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, 87564, Neuherberg, Germany.
| | - Wojciech Zareba
- Cardiology Division, University of Rochester Medical Center, Rochester, NY, USA.
| | - Alexandra Schneider
- Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, 87564, Neuherberg, Germany.
| |
Collapse
|
15
|
Park SK, Adar SD, O'Neill MS, Auchincloss AH, Szpiro A, Bertoni AG, Navas-Acien A, Kaufman JD, Diez-Roux AV. Long-term exposure to air pollution and type 2 diabetes mellitus in a multiethnic cohort. Am J Epidemiol 2015; 181:327-36. [PMID: 25693777 DOI: 10.1093/aje/kwu280] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Although air pollution has been suggested as a possible risk factor for type 2 diabetes mellitus (DM), results from existing epidemiologic studies have been inconsistent. We investigated the associations of prevalence and incidence of DM with long-term exposure to air pollution as estimated using annual average concentrations of particulate matter with an aerodynamic diameter of 2.5 μm or less (PM₂.₅) and nitrogen oxides at baseline (2000) in the Multi-Ethnic Study of Atherosclerosis. All participants were aged 45-84 years at baseline and were recruited from 6 US sites. There were 5,839 participants included in the study of prevalent DM and 5,135 participants without DM at baseline in whom we studied incident DM. After adjustment for potential confounders, we found significant associations of prevalent DM with PM₂.₅ (odds ratio (OR) = 1.09, 95% confidence interval (CI): 1.00, 1.17) and nitrogen oxides (OR = 1.18, 95% CI: 1.01, 1.38) per each interquartile-range increase (2.43 µg/m(3) and 47.1 ppb, respectively). Larger but nonsignificant associations were observed after further adjustment for study site (for PM₂.₅, OR = 1.16, 95% CI: 0.94, 1.42; for nitrogen oxides, OR = 1.29, 95% CI: 0.94, 1.76). No air pollution measures were significantly associated with incident DM over the course of the 9-year follow-up period. Results were partly consistent with a link between long-term exposure to air pollution and the risk of type 2 DM. Additional studies with a longer follow-up time and a greater range of air pollution exposures, including high levels, are warranted to evaluate the hypothesized association.
Collapse
|
16
|
Park SK, Wang W. Ambient Air Pollution and Type 2 Diabetes: A Systematic Review of Epidemiologic Research. Curr Environ Health Rep 2014; 1:275-286. [PMID: 25170433 DOI: 10.1007/s40572-014-0017-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Recent experimental and epidemiologic studies have suggested air pollution as a new risk factor for type 2 diabetes mellitus (T2DM). We conducted a systematic review of the epidemiologic studies on the association of air pollution with T2DM and related outcomes published by December 2013. We identified 22 studies: 6 prospective studies on incident T2DM; 2 prospective study on diabetes mortality; 4 cross-sectional studies on prevalent T2DM; 7 ecological studies on mortality or morbidity from diabetes; and 3 studies on glucose or insulin levels. The evidence of the association between long-term exposure to fine particles (PM2.5) and the risk of T2DM is suggestive. The summary hazard ratio of the association between long-term PM2.5 exposure and incident T2DM was 1.11 (95% CI, 1.03-1.19) for a 10 μg/m3 increase. The evidence on the association between long-term traffic-related exposure (measured by nitrogen dioxide or nitrogen oxides) and the risk of T2DM was also suggestive although most studies were conducted in women. For short-term effects of air pollution on diabetes mortality or hospital/emergency admissions, we conclude that the evidence is not sufficient to infer a causal relationship. Because most studies were conducted in North America or in Europe where exposure levels are relatively low, more studies are needed in recently urbanized areas in Asia and Latin America where air pollution levels are much higher and T2DM is an emerging public health concern.
Collapse
Affiliation(s)
- Sung Kyun Park
- Departments of Epidemiology and Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, U.S.A
| | - Weiye Wang
- Departments of Epidemiology and Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, U.S.A
| |
Collapse
|
17
|
Janghorbani M, Momeni F, Mansourian M. Systematic review and metaanalysis of air pollution exposure and risk of diabetes. Eur J Epidemiol 2014; 29:231-42. [PMID: 24791705 DOI: 10.1007/s10654-014-9907-2] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 04/23/2014] [Indexed: 12/22/2022]
Abstract
The present systematic review and metaanalysis of published observational studies was conducted to assess the health effects of exposure to air pollution on diabetes risk. Online databases were searched through January 2013, and the reference lists of pertinent articles reporting observational studies in humans were examined. Pooled relative risks and 95 % confidence intervals were calculated with a random-effects model. Exposure to air pollution was associated with slight increase in risk of diabetes and susceptibility of people with diabetes to air pollution. These results were consistent between time-series, case-crossover and cohort studies and between studies conducted in North America and Europe. The association between exposure to air pollution and diabetes was stronger for gaseous pollutants than for particulate matter. Our metaanalysis suggests that exposure to air pollution may be a risk factor for diabetes and increase susceptibility of people with diabetes to air pollution.
Collapse
Affiliation(s)
- Mohsen Janghorbani
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran,
| | | | | |
Collapse
|
18
|
Hoek G, Raaschou-Nielsen O. Impact of fine particles in ambient air on lung cancer. CHINESE JOURNAL OF CANCER 2014; 33:197-203. [PMID: 24636231 PMCID: PMC3975185 DOI: 10.5732/cjc.014.10039] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Recently, the International Agency for Research on Cancer (IARC) has classified outdoor air pollution and the particulate matter component of outdoor air pollution as class I carcinogen. Air pollution is consistently associated with lung cancer in epidemiologic and experimental studies. The IARC assessment is specifically designed as hazard identification, and it does not quantify the magnitude of the cancer risk. This article addresses the magnitude of the lung cancer risk in the population due to ambient air pollution exposure.
Collapse
Affiliation(s)
- Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
| | | |
Collapse
|
19
|
Tamayo T, Rathmann W, Krämer U, Sugiri D, Grabert M, Holl RW. Is particle pollution in outdoor air associated with metabolic control in type 2 diabetes? PLoS One 2014; 9:e91639. [PMID: 24619127 PMCID: PMC3950252 DOI: 10.1371/journal.pone.0091639] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 02/12/2014] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND There is growing evidence that air pollutants are associated with the risk of type 2 diabetes. Subclinical inflammation may be a mechanism linking air pollution with diabetes. Information is lacking whether air pollution also contributes to worse metabolic control in newly diagnosed type 2 diabetes. We examined the hypothesis that residential particulate matter (PM10) is associated with HbA1c concentration in newly diagnosed type 2 diabetes. METHODS Nationwide regional levels of particulate matter with a diameter of ≤ 10 µm (PM10) were obtained in 2009 from background monitoring stations in Germany (Federal Environmental Agency) and assigned to place of residency of 9,102 newly diagnosed diabetes patients registered in the DPV database throughout Germany (age 65.5 ± 13.5 yrs; males: 52.1%). Mean HbA1c (%) levels stratified for air pollution quartiles (PM10 in µg/m(3)) were estimated using linear regression models adjusting for age, sex, BMI, diabetes duration, geographic region, year of ascertainment, and social indicators. FINDINGS In both men and women, adjusted HbA1c was significantly lower in the lowest quartile of PM10 exposure in comparison to quartiles Q2-Q4. Largest differences in adjusted HbA1c (95% CI) were seen comparing lowest quartiles of exposure with highest quartiles (men %: -0.42 (-0.62; -0.23)/mmol/mol: -28.11 (-30.30; -26.04), women, %: -0.28 (-0.47; -0.09)/mmol/mol: -0.28 (-0.47; -0.09)). INTERPRETATION Air pollution may be associated with higher HbA1c levels in newly diagnosed type 2 diabetes patients. Further studies are warranted to examine this association.
Collapse
Affiliation(s)
- Teresa Tamayo
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- * E-mail:
| | - Wolfgang Rathmann
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Ursula Krämer
- Institute for Environmental Medicine (IUF), Leibniz Center at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Dorothea Sugiri
- Institute for Environmental Medicine (IUF), Leibniz Center at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Matthias Grabert
- Institute for Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
| | - Reinhard W. Holl
- Institute for Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
| |
Collapse
|
20
|
Brook RD, Cakmak S, Turner MC, Brook JR, Crouse DL, Peters PA, van Donkelaar A, Villeneuve PJ, Brion O, Jerrett M, Martin RV, Rajagopalan S, Goldberg MS, Pope CA, Burnett RT. Long-term fine particulate matter exposure and mortality from diabetes in Canada. Diabetes Care 2013; 36:3313-20. [PMID: 23780947 PMCID: PMC3781571 DOI: 10.2337/dc12-2189] [Citation(s) in RCA: 129] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Recent studies suggest that chronic exposure to air pollution can promote the development of diabetes. However, whether this relationship actually translates into an increased risk of mortality attributable to diabetes is uncertain. RESEARCH DESIGN AND METHODS We evaluated the association between long-term exposure to ambient fine particulate matter (PM2.5) and diabetes-related mortality in a prospective cohort analysis of 2.1 million adults from the 1991 Canadian census mortality follow-up study. Mortality information, including ∼5,200 deaths coded as diabetes being the underlying cause, was ascertained by linkage to the Canadian Mortality Database from 1991 to 2001. Subject-level estimates of long-term exposure to PM2.5 were derived from satellite observations. The hazard ratios (HRs) for diabetes-related mortality were related to PM2.5 and adjusted for individual-level and contextual variables using Cox proportional hazards survival models. RESULTS Mean PM2.5 exposure levels for the entire population were low (8.7 µg/m3; SD, 3.9 µg/m3; interquartile range, 6.2 µg/m3). In fully adjusted models, a 10-µg/m3 elevation in PM2.5 exposure was associated with an increase in risk for diabetes-related mortality (HR, 1.49; 95% CI, 1.37-1.62). The monotonic change in risk to the population persisted to PM2.5 concentration<5 µg/m3. CONCLUSIONS Long-term exposure to PM2.5, even at low levels, is related to an increased risk of mortality attributable to diabetes. These findings have considerable public health importance given the billions of people exposed to air pollution and the worldwide growing epidemic of diabetes.
Collapse
|
21
|
Thiering E, Cyrys J, Kratzsch J, Meisinger C, Hoffmann B, Berdel D, von Berg A, Koletzko S, Bauer CP, Heinrich J. Long-term exposure to traffic-related air pollution and insulin resistance in children: results from the GINIplus and LISAplus birth cohorts. Diabetologia 2013; 56:1696-704. [PMID: 23666166 PMCID: PMC3699704 DOI: 10.1007/s00125-013-2925-x] [Citation(s) in RCA: 130] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 04/12/2013] [Indexed: 12/29/2022]
Abstract
AIMS/HYPOTHESIS Epidemiological studies that have examined associations between long-term exposure to traffic-related air pollution and type 2 diabetes mellitus in adults are inconsistent, and studies on insulin resistance are scarce. We aimed to assess the association between traffic-related air pollution and insulin resistance in children. METHODS Fasting blood samples were collected from 397 10-year-old children in two prospective German birth cohort studies. Individual-level exposures to traffic-related air pollutants at the birth address were estimated by land use regression models. The association between air pollution and HOMA of insulin resistance (HOMA-IR) was analysed using a linear model adjusted for several covariates including birthweight, pubertal status and BMI. Models were also further adjusted for second-hand smoke exposure at home. Sensitivity analyses that assessed the impact of relocating, study design and sex were performed. RESULTS In all crude and adjusted models, levels of insulin resistance were greater in children with higher exposure to air pollution. Insulin resistance increased by 17.0% (95% CI 5.0, 30.3) and 18.7% (95% CI 2.9, 36.9) for every 2SDs increase in ambient NO2 and particulate matter ≤10 μm in diameter, respectively. Proximity to the nearest major road increased insulin resistance by 7.2% (95% CI 0.8, 14.0) per 500 m. CONCLUSIONS/INTERPRETATION Traffic-related air pollution may increase the risk of insulin resistance. Given the ubiquitous nature of air pollution and the high incidence of insulin resistance in the general population, the associations examined here may have potentially important public health effects despite the small/moderate effect sizes observed.
Collapse
Affiliation(s)
- E. Thiering
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
- German Center for Diabetes Research (DZD), Munich, Germany
| | - J. Cyrys
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Environmental Science Center, University of Augsburg, Augsburg, Germany
| | - J. Kratzsch
- Institute of Laboratory Medicine, Clinical Chemistry, and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
| | - C. Meisinger
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Central Hospital of Augsburg, MONICA/KORA Myocardial Infarction Registry, Augsburg, Germany
| | - B. Hoffmann
- IUF Leibniz Research Institute for Environmental Medicine and Medical Faculty, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - D. Berdel
- Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany
| | - A. von Berg
- Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany
| | - S. Koletzko
- Dr von Hauner Children’s Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - C.-P. Bauer
- Department of Pediatrics, Technical University of Munich, Munich, Germany
| | - J. Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| |
Collapse
|
22
|
|