Obesity and the relation between joint exposure to ambient air pollutants and incident type 2 diabetes: A cohort study in UK Biobank.
Obesity and the relation between joint exposure to ambient air pollutants and incident type 2 diabetes: A cohort study in UK Biobank.
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DOI：
10.1371/journal.pmed.1003767
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发表时间：
2021-08
期刊：
影响因子：
15.8
通讯作者：
Qi L
中科院分区：
文献类型：
--
作者：
Li X;Wang M;Song Y;Ma H;Zhou T;Liang Z;Qi L
空气污染与 2 型糖尿病 (T2D) 的发病率有关。我们评估了各种空气污染物与 T2D 风险的联合关联，并研究了肥胖状况和遗传易感性对这种关系的潜在影响。英国生物银行总共纳入了 449,006 名基线时未患 T2D 的参与者。在所有研究人群中，90.9% 是白人，45.7% 是男性。参与者的平均年龄为 56.6 (SD 8.1) 岁，平均体重指数 (BMI) 为 27.4 (SD 4.8) kg/m2。测量了环境空气污染物，包括直径≤2.5μm的颗粒物（PM2.5）、2.5μm至10μm之间的颗粒物（PM2.5-10）、二氧化氮（NO2）和一氧化氮（NO）。创建空气污染评分是为了评估 4 种空气污染物的联合暴露情况。在平均 11 年的随访期间，我们记录了 18,239 例 T2D 病例。空气污染评分与较高的 T2D 风险显着相关。与空气污染得分最低五分位数相比，T2D 的风险比 (HR)（95% 置信区间 [CI]）为 1.05（0.99 至 1.10，p = 0.11）、1.06（1.00 至 1.11，p = 0.051）、1.09（1.03 至 1.15，p = 0.002），以及调整社会人口特征、生活方式因素、遗传因素和其他协变量后，第二至第五五分位数分别为 1.12（1.06 至 1.19，p < 0.001）。此外，我们发现空气污染评分和肥胖状况对 T2D 风险存在显着的交互作用（p 交互作用 < 0.001）。观察到的关联在超重和肥胖的参与者中比在正常体重的人中更为明显。 T2D 或肥胖的遗传风险评分 (GRS) 并未改变空气污染与 T2D 风险之间的关系。主要研究局限性包括无法获得其他潜在 T2D 相关空气污染物的数据以及空气污染物的单次测量数据。我们发现，各种空气污染物 PM2.5、PM2.5-10、NO2 和 NO，单独或共同与人群中 T2D 风险增加相关。分层分析表明，在肥胖程度较高的人群中，这种关联与 T2D 风险的相关性更强。李翔及其同事研究了肥胖对空气污染物与 2 型糖尿病发病率之间关联的潜在影响。最近的证据表明环境空气污染与 2 型糖尿病 (T2D) 有关。但大多数都主要分别针对一到两种空气污染物。此外，据报道，肥胖人群中空气污染与 T2D 之间的关联性增强。个体通常同时暴露于多种空气污染物；人们越来越认识到从整体上评估多种空气污染物暴露的重要性。因此，在本研究中，我们旨在分析包含各种空气污染物的空气污染评分与 T2D 风险之间的关联。我们还特别研究了肥胖的潜在改变。我们建立了空气污染评分，纳入了 PM2.5、PM2.5-10、二氧化氮 (NO2) 和一氧化氮 (NO)，并分析了英国生物银行 449,006 名参与者的空气污染评分与 T2D 风险的关联。 2010 年对空气污染物进行了测量。在 11 年的中位随访时间内，记录了 18,239 例 T2D 病例。我们发现，长期单独或共同接触各种空气污染物与 T2D 风险增加相关。此外，这种关联在肥胖人群中更为明显。我们的研究结果强调了全面评估各种空气污染物对于预防 T2D 的重要性。鉴于空气污染对T2D的不利影响，应重视减少和缓解空气污染。我们的结果还强调了肥胖管理的优点。
Air pollution has been related to incidence of type 2 diabetes (T2D). We assessed the joint association of various air pollutants with the risk of T2D and examined potential modification by obesity status and genetic susceptibility on the relationship. A total of 449,006 participants from UK Biobank free of T2D at baseline were included. Of all the study population, 90.9% were white and 45.7% were male. The participants had a mean age of 56.6 (SD 8.1) years old and a mean body mass index (BMI) of 27.4 (SD 4.8) kg/m2. Ambient air pollutants, including particulate matter (PM) with diameters ≤2.5 μm (PM2.5), between 2.5 μm and 10 μm (PM2.5–10), nitrogen dioxide (NO2), and nitric oxide (NO) were measured. An air pollution score was created to assess the joint exposure to the 4 air pollutants. During a median of 11 years follow-up, we documented 18,239 incident T2D cases. The air pollution score was significantly associated with a higher risk of T2D. Compared to the lowest quintile of air pollution score, the hazard ratio (HR) (95% confidence interval [CI]) for T2D was 1.05 (0.99 to 1.10, p = 0.11), 1.06 (1.00 to 1.11, p = 0.051), 1.09 (1.03 to 1.15, p = 0.002), and 1.12 (1.06 to 1.19, p < 0.001) for the second to fifth quintile, respectively, after adjustment for sociodemographic characteristics, lifestyle factors, genetic factors, and other covariates. In addition, we found a significant interaction between the air pollution score and obesity status on the risk of T2D (p-interaction < 0.001). The observed association was more pronounced among overweight and obese participants than in the normal-weight people. Genetic risk score (GRS) for T2D or obesity did not modify the relationship between air pollution and risk of T2D. Key study limitations include unavailable data on other potential T2D-related air pollutants and single-time measurement on air pollutants. We found that various air pollutants PM2.5, PM2.5–10, NO2, and NO, individually or jointly, were associated with an increased risk of T2D in the population. The stratified analyses indicate that such associations were more strongly associated with T2D risk among those with higher adiposity. Xiang Li and co-workers study the potential influence of obesity on associations between air pollutants and incidence of type 2 diabetes. Recent evidence has linked ambient air pollution with type 2 diabetes (T2D). However, most of them were mainly focused on 1 or 2 air pollutants separately. In addition, it has been reported that the association between air pollution and T2D was augmented among people with increased adiposity. Individuals are usually exposed to various air pollutants simultaneously; and the importance of assessing multi-air pollutant exposures as a whole has been increasingly recognized. Thus, in this study, we aimed to analyze the association between the air pollution score that incorporates various air pollutants with the risk of T2D. We also particularly examined the potential modification by obesity. We built an air pollution score, incorporating PM2.5, PM2.5–10, nitrogen dioxide (NO2), and nitric oxide (NO), and analyzed its association with the risk of T2D among 449,006 participants from UK Biobank. Air pollutants were measured in 2010. During a median follow-up time of 11 years, 18,239 T2D cases were documented. We found that long-term exposure to various air pollutants, individually or jointly, was associated with an increased risk of T2D. Moreover, such association was more pronounced among people with increased adiposity. Our findings highlight the importance of comprehensively assessing various air pollutants as a whole in the prevention of T2D. Given the adverse impact of air pollution on T2D, attention should be paid to reducing and mitigating air pollution. Our results also emphasize the merit of obesity management.
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DOI：
10.1097/ede.0b013e31824523f0
发表时间：
2012-03
期刊：
Epidemiology (Cambridge, Mass.)
影响因子：
--
作者：
Bind MA;Baccarelli A;Zanobetti A;Tarantini L;Suh H;Vokonas P;Schwartz J
通讯作者：
Schwartz J
影响因子：
10.4
作者：
Hennig F;Fuks K;Moebus S;Weinmayr G;Memmesheimer M;Jakobs H;Bröcker-Preuss M;Führer-Sakel D;Möhlenkamp S;Erbel R;Jöckel KH;Hoffmann B;Heinz Nixdorf Recall Study Investigative Group
通讯作者：
Heinz Nixdorf Recall Study Investigative Group
影响因子：
4.1
作者：
Chen W;Han Y;Wang Y;Chen X;Qiu X;Li W;Yao Y;Zhu T
通讯作者：
Zhu T
影响因子：
16.2
作者：
Andersen ZJ;Raaschou-Nielsen O;Ketzel M;Jensen SS;Hvidberg M;Loft S;Tjønneland A;Overvad K;Sørensen M
通讯作者：
Sørensen M
影响因子：
10.4
作者：
Hoffmann B;Moebus S;Dragano N;Stang A;Möhlenkamp S;Schmermund A;Memmesheimer M;Bröcker-Preuss M;Mann K;Erbel R;Jöckel KH
通讯作者：
Jöckel KH