Long-term exposure to air pollution and type 2 diabetes mellitus in a multiethnic cohort.

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.

[1]  P. Vokonas,et al.  Effects of Air Pollution on Heart Rate Variability: The VA Normative Aging Study , 2004, Environmental health perspectives.

[2]  J. Shaw,et al.  Follow-up report on the diagnosis of diabetes mellitus. , 2003, Diabetes care.

[3]  Walter C Willett,et al.  Balancing Life-Style and Genomics Research for Disease Prevention , 2002, Science.

[4]  J. Manson,et al.  Biomarkers of endothelial dysfunction and risk of type 2 diabetes mellitus. , 2004, JAMA.

[5]  K. Thayer,et al.  Environmental Chemicals and Type 2 Diabetes: An Updated Systematic Review of the Epidemiologic Evidence , 2013, Current Diabetes Reports.

[6]  S. Park,et al.  Ambient Air Pollution and Type 2 Diabetes Mellitus: A Systematic Review of Epidemiologic Research , 2014, Current Environmental Health Reports.

[7]  P. Sampson,et al.  Pragmatic Estimation of a Spatio-Temporal Air Quality Model With Irregular Monitoring Data , 2011 .

[8]  Thomas Lumley,et al.  Predicting intra‐urban variation in air pollution concentrations with complex spatio‐temporal dependencies , 2009, Environmetrics.

[9]  Ana V Diez Roux,et al.  Assessing the measurement properties of neighborhood scales: from psychometrics to ecometrics. , 2007, American journal of epidemiology.

[10]  L. Sheppard,et al.  Long-term exposure to air pollution and incidence of cardiovascular events in women. , 2007, The New England journal of medicine.

[11]  Michael C. Ostrowski,et al.  Ambient Air Pollution Exaggerates Adipose Inflammation and Insulin Resistance in a Mouse Model of Diet-Induced Obesity , 2009, Circulation.

[12]  Wolfgang Rathmann,et al.  Traffic-Related Air Pollution and Incident Type 2 Diabetes: Results from the SALIA Cohort Study , 2010, Environmental health perspectives.

[13]  Bert Brunekreef,et al.  Long-term Exposure to Traffic-related Air Pollution and Type 2 Diabetes Prevalence in a Cross-sectional Screening-study in the Netherlands , 2011, Environmental health : a global access science source.

[14]  S. Adar,et al.  Air Pollution and Individual and Neighborhood Socioeconomic Status: Evidence from the Multi-Ethnic Study of Atherosclerosis (MESA) , 2013, Environmental health perspectives.

[15]  S. Rajagopalan,et al.  Airborne particulate matter selectively activates endoplasmic reticulum stress response in the lung and liver tissues. , 2010, American journal of physiology. Cell physiology.

[16]  P. Koutrakis,et al.  Spatial variation in particulate concentrations within metropolitan Philadelphia , 1996 .

[17]  R. Burnett,et al.  Air Pollution and Incidence of Hypertension and Diabetes Mellitus in Black Women Living in Los Angeles , 2012, Circulation.

[18]  Lianne Sheppard,et al.  Approach to estimating participant pollutant exposures in the Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air). , 2009, Environmental science & technology.

[19]  Sabit Cakmak,et al.  Long-Term Fine Particulate Matter Exposure and Mortality From Diabetes in Canada , 2013, Diabetes Care.

[20]  Michael Jerrett,et al.  The Relationship Between Diabetes Mellitus and Traffic-Related Air Pollution , 2008, Journal of occupational and environmental medicine.

[21]  J. Schwartz,et al.  Are Particulate Matter Exposures Associated with Risk of Type 2 Diabetes? , 2010, Environmental health perspectives.

[22]  Sanjay Rajagopalan,et al.  Air Pollution and Type 2 Diabetes , 2012, Diabetes.

[23]  J. Lamarque,et al.  Global premature mortality due to anthropogenic outdoor air pollution and the contribution of past climate change , 2013 .

[24]  R. Kronmal,et al.  Multi-Ethnic Study of Atherosclerosis: objectives and design. , 2002, American journal of epidemiology.

[25]  B. Gomišček,et al.  Spatial and temporal variations of PM1, PM2.5, PM10 and particle number concentration during the AUPHEP—project , 2004 .

[26]  Michael A. Gallo,et al.  Role of Environmental Chemicals in Diabetes and Obesity: A National Toxicology Program Workshop Review , 2012, Environmental health perspectives.

[27]  A. Tjønneland,et al.  Long-term exposure to traffic-related air pollution and diabetes-associated mortality: a cohort study , 2012, Diabetologia.

[28]  J. Clougherty.  A growing role for gender analysis in air pollution epidemiology. , 2011, Ciencia & saude coletiva.

[29]  C. Sioutas,et al.  Circulating Biomarkers of Inflammation, Antioxidant Activity, and Platelet Activation Are Associated with Primary Combustion Aerosols in Subjects with Coronary Artery Disease , 2008, Environmental health perspectives.

[30]  A. Folsom,et al.  Prospective Investigation of Autonomic Nervous System Function and the Development of Type 2 Diabetes: The Atherosclerosis Risk In Communities Study, 1987–1998 , 2003, Circulation.

[31]  A. D. Diez Roux,et al.  Neighborhood resources for physical activity and healthy foods and incidence of type 2 diabetes mellitus: the Multi-Ethnic study of Atherosclerosis. , 2009, Archives of internal medicine.

[32]  Michael C. Ostrowski,et al.  Insulin Resistance in a Mouse Model of Diet-Induced Obesity , 2009 .

[33]  Joanne Green,et al.  Air Quality in Latin America : An Overview , 2013 .

[34]  S. Rajagopalan,et al.  Ambient particulate air pollution induces oxidative stress and alterations of mitochondria and gene expression in brown and white adipose tissues , 2011, Particle and Fibre Toxicology.

[35]  Karol Watson,et al.  Association of Long-term Air Pollution With Ventricular Conduction and Repolarization Abnormalities , 2011, Epidemiology.

[36]  Paul J. Villeneuve,et al.  Risk of Incident Diabetes in Relation to Long-term Exposure to Fine Particulate Matter in Ontario, Canada , 2013, Environmental health perspectives.

[37]  S. Rajagopalan,et al.  Long-term exposure to ambient fine particulate pollution induces insulin resistance and mitochondrial alteration in adipose tissue. , 2011, Toxicological sciences : an official journal of the Society of Toxicology.

[38]  Joel Schwartz,et al.  Diabetes, Obesity, and Hypertension May Enhance Associations between Air Pollution and Markers of Systemic Inflammation , 2006, Environmental health perspectives.

[39]  A. Tjønneland,et al.  Diabetes Incidence and Long-Term Exposure to Air Pollution , 2011, Diabetes Care.

[40]  Deepthiman Gowda,et al.  Relation between neighborhood environments and obesity in the Multi-Ethnic Study of Atherosclerosis. , 2008, American journal of epidemiology.

[41]  S. Rajagopalan,et al.  Epidemiological and Experimental Links between Air Pollution and Type 2 Diabetes , 2013, Toxicologic pathology.