Effect of long-term exposure to PM2.5 on the risk of type 2 diabetes and arthritis in type 2 diabetes patients: Evidence from a national cohort in China.

BACKGROUND It remains unclear whether type 2 diabetes and the complication of arthritis are causally related to the PM2.5 pollutant. Therefore, we aimed to investigate the associations of long-term PM2.5 exposure with type 2 diabetes and with arthritis in type 2 diabetes patients. MATERIALS AND METHODS This study used data from the China Health and Retirement Longitudinal Survey (CHARLS) implemented during 2011-2018. The associations were analyzed by Cox proportional hazards regression models, and the population-attributable fraction (PAF) was calculated to assess the burden of type 2 diabetes and arthritis-attributable to PM2.5. RESULTS A total of 21,075 participants were finally included, with 19,121 analyzed for PM2.5 and type 2 diabetes risk and 12,427 analyzed for PM2.5 and arthritis risk, of which 1,382 with newly-diagnosed type 2 diabetes and 1,328 with arthritis during the follow-up. Overall, each 10 μg/m3 increment in PM2.5 concentration was significantly associated with an increase in the risk of type 2 diabetes (HR = 1.26, 95 %CI1.22 to 1.31), and the PAF of type 2 diabetes attributable to PM2.5 was 13.54 %. In type 2 diabetes patients, each 10 μg/m3 increment in PM2.5 exposure was associated with an increase in arthritis (HR = 1.42, 95 %CI: 1.28 to 1.57), and the association was significantly greater than that (H = 1.23, 95 %CI: 1.19 to 1.28) in adults without type 2 diabetes. The PAFs of arthritis-attributable to PM2.5 in participants with and without type 2 diabetes were 18.54 % and 10.69 %, respectively. CONCLUSION Long-term exposure to PM2.5 may increase the risk of type 2 diabetes and make type 2 diabetes patients susceptible to arthritis.

[1]  Leiming Zhang,et al.  Source apportionment of carbonaceous aerosols using hourly data and implications for reducing PM2.5 in the Pearl River Delta region of South China. , 2022, Environmental research.

[2]  H. Kan,et al.  Association of ambient PM1 with hospital admission and recurrence of stroke in China. , 2022, The Science of the total environment.

[3]  R. Kukreti,et al.  Mechanistic Insight into Oxidative Stress-Triggered Signaling Pathways and Type 2 Diabetes , 2022, Molecules.

[4]  B. Brunekreef,et al.  Long-term exposure to low ambient air pollution concentrations and mortality among 28 million people: results from seven large European cohorts within the ELAPSE project. , 2022, The Lancet. Planetary health.

[5]  E. Huang,et al.  2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2022. , 2021, Diabetes care.

[6]  Yu-xiang Yan,et al.  Association of household solid fuel use and long-term exposure to PM2.5 with arthritis in middle-aged and older population in China: A cohort study. , 2021, Ecotoxicology and environmental safety.

[7]  O. Raaschou-Nielsen,et al.  Long-Term Exposure to Transportation Noise and Risk for Type 2 Diabetes in a Nationwide Cohort Study from Denmark , 2021, Environmental health perspectives.

[8]  Tao Liu,et al.  Urban-rural disparity of the short-term association of PM2.5 with mortality and its attributable burden , 2021, Innovation.

[9]  F. Liang,et al.  Long-term impacts of ambient fine particulate matter exposure on overweight or obesity in Chinese adults: The China-PAR project. , 2021, Environmental research.

[10]  B. Luo,et al.  Type 2 diabetes attributable to PM2.5: A global burden study from 1990 to 2019. , 2021, Environment international.

[11]  Mihye Lee,et al.  PM2.5 and Diabetes in the Japanese Population , 2021, International journal of environmental research and public health.

[12]  H. Kan,et al.  Fine particulate matter constituents and sub-clinical outcomes of cardiovascular diseases: A multi-center study in China. , 2020, The Science of the total environment.

[13]  H. Kan,et al.  Associations of long-term exposure to ambient nitrogen dioxide with indicators of diabetes and dyslipidemia in China: A nationwide analysis. , 2020, Chemosphere.

[14]  Donghong Xie,et al.  Comparison of self-reports and biomedical measurements on hypertension and diabetes among older adults in China , 2020, BMC Public Health.

[15]  J. Porras,et al.  Inflammatory effects of particulate matter air pollution , 2020, Environmental Science and Pollution Research.

[16]  César Martín,et al.  Pathophysiology of Type 2 Diabetes Mellitus , 2020, International journal of molecular sciences.

[17]  M. Brauer,et al.  Global Estimates and Long-Term Trends of Fine Particulate Matter Concentrations (1998-2018). , 2020, Environmental science & technology.

[18]  Boya Zhang,et al.  Levels and inhalation health risk of neonicotinoid insecticides in fine particulate matter (PM2.5) in urban and rural areas of China. , 2020, Environment international.

[19]  T. Alderete,et al.  Exposure to air pollutants and the gut microbiota: a potential link between exposure, obesity, and type 2 diabetes , 2020, Gut microbes.

[20]  G. Ning,et al.  Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study , 2020, BMJ.

[21]  Yuming Guo,et al.  Associations of long-term exposure to PM1, PM2.5, NO2 with type 2 diabetes mellitus prevalence and fasting blood glucose levels in Chinese rural populations , 2019, Environment international.

[22]  R. Burnett,et al.  The impact of air pollution on the incidence of diabetes and survival among prevalent diabetes cases. , 2019, Environment international.

[23]  D. Gatti,et al.  Osteoporosis in Rheumatic Diseases , 2019, International journal of molecular sciences.

[24]  Yongli Zhang,et al.  Dynamic effect analysis of meteorological conditions on air pollution: A case study from Beijing. , 2019, The Science of the total environment.

[25]  J. Shaw,et al.  Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th edition. , 2019, Diabetes research and clinical practice.

[26]  E. Solá,et al.  Relationship between Oxidative Stress, ER Stress, and Inflammation in Type 2 Diabetes: The Battle Continues , 2019, Journal of clinical medicine.

[27]  Feifei Liu,et al.  Associations between long-term exposure to ambient air pollution and risk of type 2 diabetes mellitus: A systematic review and meta-analysis. , 2019, Environmental pollution.

[28]  F. Liang,et al.  Long-term exposure to ambient fine particulate matter and incidence of diabetes in China: A cohort study. , 2019, Environment international.

[29]  Li-ting Zhou,et al.  Effects of Different Components of PM2.5 on the Expression Levels of NF-κB Family Gene mRNA and Inflammatory Molecules in Human Macrophage , 2019, International journal of environmental research and public health.

[30]  A. Woodward,et al.  Ambient fine particulate pollution associated with diabetes mellitus among the elderly aged 50 years and older in China. , 2018, Environmental pollution.

[31]  Benjamin Bowe,et al.  The 2016 global and national burden of diabetes mellitus attributable to PM2·5 air pollution. , 2018, The Lancet. Planetary health.

[32]  Dritana Marko,et al.  The Association Between PM2.5 and Ozone and the Prevalence of Diabetes Mellitus in the United States, 2002 to 2008 , 2018, Journal of occupational and environmental medicine.

[33]  J. Shaw,et al.  IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. , 2018, Diabetes research and clinical practice.

[34]  C. Wong,et al.  Long-term exposure to fine particulate matter air pollution and type 2 diabetes mellitus in elderly: A cohort study in Hong Kong. , 2018, Environment international.

[35]  Frank B. Hu,et al.  Global aetiology and epidemiology of type 2 diabetes mellitus and its complications , 2018, Nature Reviews Endocrinology.

[36]  Jun Tao,et al.  A review of current knowledge concerning PM 2. 5 chemical composition, aerosol optical properties and their relationships across China , 2017 .

[37]  Petros Koutrakis,et al.  Association of PM2.5 with diabetes, asthma, and high blood pressure incidence in Canada: A spatiotemporal analysis of the impacts of the energy generation and fuel sales. , 2017, The Science of the total environment.

[38]  Congbo Song,et al.  Health burden attributable to ambient PM2.5 in China. , 2017, Environmental pollution.

[39]  H. Leino‐Kilpi,et al.  Foot health in patients with rheumatoid arthritis—a scoping review , 2017, Rheumatology International.

[40]  C. Helmick,et al.  Vital Signs: Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation — United States, 2013–2015 , 2017, MMWR. Morbidity and mortality weekly report.

[41]  J. Shaw,et al.  IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. , 2011, Diabetes research and clinical practice.

[42]  W. Rathmann,et al.  Association Between Long-term Exposure to Air Pollution and Biomarkers Related to Insulin Resistance, Subclinical Inflammation, and Adipokines , 2016, Diabetes.

[43]  Chung Y. Hsu,et al.  Air pollution exposure increases the risk of rheumatoid arthritis: A longitudinal and nationwide study. , 2016, Environment international.

[44]  Z. Andersen,et al.  Long-term exposure to fine particulate matter and incidence of diabetes in the Danish Nurse Cohort , 2016 .

[45]  Ruijin Li,et al.  Progression and inflammation of human myeloid leukemia induced by ambient PM2.5 exposure , 2016, Archives of Toxicology.

[46]  P. Parmar,et al.  Gait characteristics associated with the foot and ankle in inflammatory arthritis: a systematic review and meta-analysis , 2015, BMC Musculoskeletal Disorders.

[47]  Yi Li,et al.  Ambient temperature enhanced acute cardiovascular-respiratory mortality effects of PM2.5 in Beijing, China , 2015, International Journal of Biometeorology.

[48]  R. Brook,et al.  Ambient Air Pollution: An Emerging Risk Factor for Diabetes Mellitus , 2015, Current Diabetes Reports.

[49]  Changwei Li,et al.  Prevalence and risk factors of arthritis in a middle-aged and older Chinese population: the China health and retirement longitudinal study. , 2015, Rheumatology.

[50]  S. Rajagopalan,et al.  Air pollution as a risk factor for type 2 diabetes. , 2015, Toxicological sciences : an official journal of the Society of Toxicology.

[51]  S. Rajagopalan,et al.  Exaggerated effects of particulate matter air pollution in genetic type II diabetes mellitus , 2014, Particle and Fibre Toxicology.

[52]  John Strauss,et al.  Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS). , 2014, International journal of epidemiology.

[53]  Bin Zhao,et al.  Investigating the geographical heterogeneity in PM10-mortality associations in the China Air Pollution and Health Effects Study (CAPES): A potential role of indoor exposure to PM10 of outdoor origin , 2013 .

[54]  Lianne Sheppard,et al.  A National Prediction Model for PM2.5 Component Exposures and Measurement Error–Corrected Health Effect Inference , 2013, Environmental health perspectives.

[55]  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.

[56]  Shilu Tong,et al.  Ambient air pollution, climate change, and population health in China. , 2012, Environment international.

[57]  C. Caspersen,et al.  Prevalence of Diagnosed Arthritis and Arthritis-Attributable Activity Limitation Among Adults With and Without Diagnosed Diabetes: United States, 2008–2010 , 2012, Diabetes Care.

[58]  R. Burnett,et al.  Confounding and exposure measurement error in air pollution epidemiology , 2011, Air Quality, Atmosphere & Health.

[59]  N. Z. Zur Nieden,et al.  Hyperglycemia impairs skeletogenesis from embryonic stem cells by affecting osteoblast and osteoclast differentiation. , 2011, Stem cells and development.

[60]  C. Gordon.  Role of environmental stress in the physiological response to chemical toxicants. , 2003, Environmental research.

[61]  N. Schenker,et al.  On Judging the Significance of Differences by Examining the Overlap Between Confidence Intervals , 2001 .

[62]  P. Grambsch,et al.  Proportional hazards tests and diagnostics based on weighted residuals , 1994 .