Diabetes incidence and long-term exposure to air pollution: a cohort study.

Diabetes incidence and long-term exposure to air pollution: a cohort study.
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DOI:
10.2337/dc11-1155
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发表时间:
2012-01
期刊:
影响因子:
16.2
通讯作者:
Sørensen M
Sørensen M
中科院分区:
医学1区
文献类型:
--
作者:
Andersen ZJ;Raaschou-Nielsen O;Ketzel M;Jensen SS;Hvidberg M;Loft S;Tjønneland A;Overvad K;Sørensen M

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动物和横断面流行病学研究表明空气污染和糖尿病之间存在联系,而有限的前瞻性数据显示结果喜忧参半。我们研究了长期暴露在与交通相关的空气污染与糖尿病发病率之间的联系。在基线(1993-1997年)至2006年6月27日期间,我们跟踪了丹麦国家糖尿病登记中的57,053名丹麦饮食、癌症和健康队列的参与者。我们估计了自1971年以来队列参与者住处二氧化氮(NO2)的平均水平,并使用Cox回归模型对NO2与糖尿病发病率之间的关系进行了建模,分别针对糖尿病的两种定义:所有病例和更严格的定义,即排除未确诊病例。在对51,818名符合条件的受试者进行的平均9.7年的随访中,总共有4,040例(7.8%)发生糖尿病病例,2877例(5.5%)确诊。空气污染并不与所有糖尿病病例相关(自1971年以来,每四分位数范围内平均二氧化氮水平为4.9μg/m~3的危险比为1.00[95%可信区间0.97-1.04]),但与确诊的糖尿病病例(1.04[1.00-1.08])存在边缘统计学意义上的相关性。在确诊的糖尿病病例中,不吸烟者(1.12[1.05-1.20])和经常运动的人(1.10[1.03-1.16])的影响显著增强。长期暴露在与交通相关的空气污染中可能会导致糖尿病的发展,特别是在生活方式健康的人、不吸烟的人和经常锻炼的人中。
Animal and cross-sectional epidemiological studies suggest a link between air pollution and diabetes, whereas the limited prospective data show mixed results. We studied the association between long-term exposure to traffic-related air pollution and incidence of diabetes. We followed 57,053 participants of the Danish Diet, Cancer, and Health cohort in the Danish National Diabetes Register between baseline (1993–1997) and 27 June 2006. We estimated the mean levels of nitrogen dioxide (NO2) at the residential addresses of the cohort participants since 1971 and modeled the association between NO2 and diabetes incidence with a Cox regression model, separately for two definitions of diabetes: all cases and a more strict definition where unconfirmed cases were excluded. Over a mean follow-up of 9.7 years of 51,818 eligible subjects, there were 4,040 (7.8%) incident diabetes cases in total and 2,877 (5.5%) with confirmed diagnoses. Air pollution was not associated with all diabetes cases (hazard ratio 1.00 [95% CI 0.97–1.04] per interquartile range of 4.9 μg/m3 mean NO2 levels since 1971), but a borderline statistically significant association was detected with confirmed cases of diabetes (1.04 [1.00–1.08]). Among confirmed diabetes cases, effects were significantly enhanced in nonsmokers (1.12 [1.05–1.20]) and physically active people (1.10 [1.03–1.16]). Long-term exposure to traffic-related air pollution may contribute to the development of diabetes, especially in individuals with a healthy lifestyle, nonsmokers, and physically active individuals.
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