Long-term Exposure to Traffic-related Air Pollution and Type 2 Diabetes Prevalence in a Cross-sectional Screening-study in the Netherlands

Abstract

BackgroundAir pollution may promote type 2 diabetes by increasing adipose inflammation and insulin resistance. This study examined the relation between long-term exposure to traffic-related air pollution and type 2 diabetes prevalence among 50- to 75-year-old subjects living in Westfriesland, the Netherlands.MethodsParticipants were recruited in a cross-sectional diabetes screening-study conducted between 1998 and 2000. Exposure to traffic-related air pollution was characterized at the participants' home-address. Indicators of exposure were land use regression modeled nitrogen dioxide (NO2) concentration, distance to the nearest main road, traffic flow at the nearest main road and traffic in a 250 m circular buffer. Crude and age-, gender- and neighborhood income adjusted associations were examined by logistic regression.Results8,018 participants were included, of whom 619 (8%) subjects had type 2 diabetes. Smoothed plots of exposure versus type 2 diabetes supported some association with traffic in a 250 m buffer (the highest three quartiles compared to the lowest also showed increased prevalence, though non-significant and not increasing with increasing quartile), but not with the other exposure metrics. Modeled NO2-concentration, distance to the nearest main road and traffic flow at the nearest main road were not associated with diabetes. Exposure-response relations seemed somewhat more pronounced for women than for men (non-significant).ConclusionsWe did not find consistent associations between type 2 diabetes prevalence and exposure to traffic-related air pollution, though there were some indications for a relation with traffic in a 250 m buffer.

Preconception and early pregnancy air pollution exposures and risk of gestational diabetes mellitus

“…Although not all studies of the association between air pollution and diabetes mellitus are confirmatory (Puett et al 2011; Dijkema et al 2011), our results are in agreement with the majority that have found associations between type 2 diabetes mellitus incidence and prevalence with exposure to particulate matter and traffic-related air pollution (NO X , nitrogen dioxide, and distance from roads) (Kramer et al 2010; Coogan et al 2012; Andersen et al 2012; Pearson et al 2010). Studies with both particulate matter and traffic-related air pollution data also confirm that the latter may largely account for the association between air pollution and diabetes (Puett et al 2011; Kramer et al 2010; Coogan et al 2012; Andersen et al 2012).…”

Associations between long-term exposure to air pollution, glycosylated hemoglobin and diabetes

“…Small positive associations for prevalence of DM have been observed with nitrogen dioxide (NO 2 ) (Andersen et al, 2012; Brook et al, 2008; Coogan et al, 2012; Eze et al, 2014; Kramer et al, 2010; Park et al, 2015) and fine particulate matter (PM 2.5 ) (Chen et al, 2013; Eze et al, 2014; Kramer et al, 2010; Liu et al, 2016; Park et al, 2015; Pearson et al, 2010) while other studies have found no significant associations (Brook et al, 2008; Dijkema et al, 2011; Puett et al, 2011). Associations between air pollution and serum glucose, a measure of glucose homeostasis used to assess diabetes status, have been investigated in a few studies which have reported links between short-term NO 2 exposure and small increases in serum glucose (0.40%, 95% CI: 0.31%, 0.50%) (Sade et al, 2015), with larger associations observed for short-term PM 2.5 exposures and serum glucose in diabetic individuals (2.93%, 95% CI: 0.35%, 5.59%) (Yitshak Sade et al, 2016).…”

Association between traffic-related air pollution, subclinical inflammation and impaired glucose metabolism: Results from the SALIA study

“…Recent reports underline the toxicological potential and importance of PM 2.5 [4] for a decrease of insulin sensitivity even after sub-acute exposure to low levels of 5-10 µg/m 3 PM 2.5 [12]. However, it has to be noted that other studies were not able to confirm the association between nitrogen oxides or PM and IGM [5,16]. These studies were performed in rural areas with comparatively low pollution levels, which may be the cause of the non-significant findings, because lower effect sizes for lower exposure levels require considerably larger cohorts to obtain the same statistical power as a study with larger effect sizes at higher exposure levels.…”

“…Several epidemiological studies and animal models support this hypothesis by linking elevated levels of several pollutants, like particulate matter (PM) and nitrogen oxides (NO x ), to increased diabetes incidence rates [6,[8][9][10][11] and the development of insulin resistance [12][13][14][15]. However, the data are still controversial, because not all studies observed associations between air pollution and risk of T2D [16].…”