MECHANISMS IN ENDOCRINOLOGY: Effect of long-term exposure to air pollution on type 2 diabetes mellitus risk: a systemic review and meta-analysis of cohort studies

Abstract

Objective: To assess the effect of long-term exposure to air pollution on type 2 diabetes risk, a meta-analysis of prospective cohort studies was performed. Methods: Literature search was conducted with Pubmed, Embase, and Web of Science for prospective cohort studies investigating the association of type 2 diabetes risk with increments in particulate matter (PM, diameter !2.5 mm (PM2.5) or !10 mm (PM10)) or nitrogen dioxide (NO 2 ). We used a random-effects model to calculate the overall relative risk (RR) with 95% CI. Results: Of 808 identified articles, ten cohort studies were finally included, which involved a total of 2 371 907 participants and 21 095 incident cases of type 2 diabetes. Elevated risk of type 2 diabetes was significantly associated with long-term exposures to high levels of PM2.5 (RRZ1.28, 95% CI 1.06-1.55, PZ0.009, I2 Z83.5%), PM10 (RRZ1.15, 95% CI 1.02-1.30, PZ0.022, I2 Z0%), and NO 2 (RRZ1.12, 95% CI 1.02-1.23, PZ0.015, I 2 Z63.5%). When using standardized risk estimates, the RRs of type 2 diabetes were significant for increments in concentrations of PM2.5 (1.39 per 10 mg/m 3 increment, 95% CI 1.14-1.68, PZ0.001), PM10 (1.34 per 10 mg/m 3 increment, 95% CI 1.22-1.47, P!0.001), and NO 2 (1.11 per 10 mg/m 3 increment, 95% CI 1.07-1.16, P!0.001). No obvious evidence of publication bias was observed. Conclusion: Long-term exposure to high levels of main air pollutants is significantly associated with elevated risk of type 2 diabetes mellitus.

Particulate matter pollutants and risk of type 2 diabetes: a time for concern?

“…Where reported [21][22][23], the risk of incident diabetes or diabetes mortality associated with PM 10 was lower than that associated with PM 2.5 . Heterogeneity was absent in some meta-analyses [20,24], or high in other [21,23]. The quality of studies included in the meta-analyses were said to be good on the average, although two meta-analyses acknowledged the possibility for risk of bias [22,24].…”

“…The epidemiological evidence linking particulate matter air pollutants and diabetes has been summarized in many recent systematic reviews with meta-analyses [20][21][22][23][24], published mostly in 2014 and 2015. Obviously, many of these reviews made reference to the same studies; however, depending on inclusion and exclusion criteria, not all metaanalyses included the same studies.…”

“…Table 1 summarizes the results of the five meta-analyses so far published on the relationship between exposure to particulate matter pollutants and diabetes. Risk of future diabetes was assessed specifically in three meta-analyses [20,21,24], while the other two meta-analyses has mortality as outcome, either alone [23] or combined with risk of diabetes [22].…”

“…The risk of future diabetes associated with exposure to each 10 lg/m 3 increase of PM 2.5 has been quantified in the range of 10 % [24] to 27 % [21]; the risk of diabetes mortality associated with PM 2.5 appears to be quite lower, around 1 % for each increment exposure of 10 lg/m 3 of both PM 2.5 and PM 10 [23]. Where reported [21][22][23], the risk of incident diabetes or diabetes mortality associated with PM 10 was lower than that associated with PM 2.5 .…”

The Role of Air Pollution by the Particulate Matter in Pathogenesis of the Chronic Noninfectious Diseases

“…В результате системного анализа многочисленных эпидемиологических исследований была выявлена до-стоверная ассоциация (p=0,022-0,009) между долго-временным воздействием РМ2,5 и РМ10 и случаями СД2 [27][28][29]. Был сделан вывод, что загрязнение воздуха явля-ется новым фактором риска СД этого типа.…”