Abstract
Studies on the effects of short-term air pollution exposure on hospitalization for type 2 diabetes mellitus (T2DM) are relatively scarce in developing regions. The time-series study was used to explore the acute effects of air pollutants on hospitalization for T2DM in Lanzhou, China. A distribution lag nonlinear model based on the generalized additive model was used to analyze the hospitalization impact of air pollution on T2DM. Stratified analysis by gender, age and season was obtained. The results were indicated as the relative risk (RR) with 95% confidence interval (CI) for single-day lags (from lag0 to lag7) and cumulative lag days (from lag0-1 to lag0-7). The strongest correlations (RR, 95% CI) of hospitalization for T2DM and PM10 (RR = 1.003, 95% CI 1.000, 1.001) at lag7 and NO2 (RR = 1.022, 95% CI 1.000, 1.045) at lag0-4 were observed for an increase of 10 µg/m3 in the concentrations and CO (RR = 1.091, 95% CI 1.017, 1.170) at lag0-4 for an increase of 1 mg/m3 in the concentration. The hazardous impacts of PM10, NO2 and CO were greater for females, people aged ≥ 65 years and in the cold season. However, there was no significant association between PM2.5, SO2 and O38h and the number of hospitalizations for T2DM.
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04 November 2023
A Correction to this paper has been published: https://doi.org/10.1007/s10653-023-01750-1
References
Ali, M. K., Pearson-Stuttard, J., Selvin, E., & Gregg, E. W. (2022). Interpreting global trends in type 2 diabetes complications and mortality. Diabetologia, 65(1), 3–13. https://doi.org/10.1007/s00125-021-05585-2
Brook, R. D., Jerrett, M., Brook, J. R., Bard, R. L., & Finkelstein, M. M. (2008). The relationship between diabetes mellitus and traffic-related air pollution. Journal of Occupational and Environmental Medicine, 50(1), 32–38. https://doi.org/10.1097/JOM.0b013e31815dba70
Chatterjee, S., Khunti, K., & Davies, M. J. (2017). Type 2 diabetes. Lancet (london, England), 389(10085), 2239–2251. https://doi.org/10.1016/s0140-6736(17)30058-2
Chen, X. W., Ding, G., Xu, L., & Li, P. (2021). A glimpse at the metabolic research in China. Cell Metabolism, 33(11), 2122–2125. https://doi.org/10.1016/j.cmet.2021.09.014
Chen, Z., Salam, M. T., Toledo-Corral, C., Watanabe, R. M., Xiang, A. H., Buchanan, T. A., & Gilliland, F. D. (2016). Ambient air pollutants have adverse effects on insulin and glucose homeostasis in Mexican Americans. Diabetes Care, 39(4), 547–554.
Chuangxin, W., Yan, Y., Chen, X., Gong, J., Guo, Y., Zhao, Y., Yang, N., Dai, J., Zhang, F., & Xiang, H. (2021). Short-term exposure to ambient air pollution and type 2 diabetes mortality: A population-based time series study. Environmental Pollution, 289, 117886. https://doi.org/10.1016/j.envpol.2021.117886
Du, N., Ji, A. L., Liu, X. L., Tan, C. L., Huang, X. L., Xiao, H., & Cai, T. J. (2022). Association between short-term ambient nitrogen dioxide and type 2 diabetes outpatient visits: A large hospital-based study. Environmental Research, 215, 114395. https://doi.org/10.1016/j.envres.2022.114395
Eze, I. C., Hemkens, L. G., Bucher, H. C., Hoffmann, B., Schindler, C., Künzli, N., Schikowski, T., & Probst-Hensch, N. M. (2015). Association between ambient air pollution and diabetes mellitus in Europe and North America: Systematic review and meta-analysis. Environmental Health Perspectives, 123(5), 381–389. https://doi.org/10.1289/ehp.1307823
Eze, I. C., Schaffner, E., Fischer, E., Schikowski, T., Adam, M., Imboden, M., Tsai, M., Carballo, D., von Eckardstein, A., Künzli, N., Schindler, C., & Probst-Hensch, N. (2014). Long-term air pollution exposure and diabetes in a population-based Swiss cohort. Environment International, 70, 95–105. https://doi.org/10.1016/j.envint.2014.05.014
Glencross, D. A., Ho, T. R., Camiña, N., Hawrylowicz, C. M., & Pfeffer, P. E. (2020). Air pollution and its effects on the immune system. Free Radical Biology & Medicine, 151, 56–68. https://doi.org/10.1016/j.freeradbiomed.2020.01.179
Gu, J., Shi, Y., Zhu, Y., Chen, N., Wang, H., Zhang, Z., & Chen, T. (2020). Ambient air pollution and cause-specific risk of hospital admission in China: A nationwide time-series study. PLoS Medicine, 17(8), e1003188. https://doi.org/10.1371/journal.pmed.1003188
Hwang, M. J., Kim, J. H., Koo, Y. S., Yun, H. Y., & Cheong, H. K. (2020). Impacts of ambient air pollution on glucose metabolism in Korean adults: A Korea national health and nutrition examination survey study. Environmental Health : A Global Access Science Source, 19(1), 70. https://doi.org/10.1186/s12940-020-00623-9
Li, H., Duan, D., Xu, J., Feng, X., Astell-Burt, T., He, T., & Han, L. (2019). Ambient air pollution and risk of type 2 diabetes in the Chinese. Environmental Science and Pollution Research, 26, 16261–16273.
Liu, C., Ying, Z., Harkema, J., Sun, Q., & Rajagopalan, S. (2013). Epidemiological and experimental links between air pollution and type 2 diabetes. Toxicologic Pathology, 41(2), 361–373. https://doi.org/10.1177/0192623312464531
Liu, Y. R., & Dong, J. Y. (2021). Effect of air pollution on emergency room visits for respiratory diseases in Lanzhou. Zhongguo Yi Xue Ke Xue Yuan Xue Bao Acta Academiae Medicinae Sinicae, 43(3), 382–394. https://doi.org/10.3881/j.issn.1000-503X.13101
Liu, Y., Dong, J., & Zhai, G. (2022a). Association between air pollution and hospital admissions for hypertension in Lanzhou, China. Environmental Science and Pollution Research International, 29(8), 11976–11989. https://doi.org/10.1007/s11356-021-16577-5
Liu, Y., Wang, Y., Dong, J., Wang, J., Bao, H., & Zhai, G. (2022b). Association between air pollution and emergency department visits for upper respiratory tract infection in Lanzhou, China. Environmental Science and Pollution Research International, 29(19), 28816–28828. https://doi.org/10.1007/s11356-021-17932-2
Luo, H., Liu, C., Chen, X., Lei, J., Zhu, Y., Zhou, L., & Chen, R. (2023). Ambient air pollution and hospitalization for type 2 diabetes in China: A nationwide, individual-level case-crossover study. Environmental Research, 216, 114596. https://doi.org/10.1016/j.envres.2022.114596
O’Donovan, G., et al. (2017). The association between air pollution and type 2 diabetes in a large cross-sectional study in Leicester: The champions study. Environment International, 104, 41–47. https://doi.org/10.1016/j.envint.2017.03.027
Rachdaoui, N. (2020). Insulin: The friend and the foe in the development of type 2 diabetes mellitus. International Journal of Molecular Sciences, 21(5), 1770. https://doi.org/10.3390/ijms21051770
Saklayen, M. G. (2018). The global epidemic of the metabolic syndrome. Current Hypertension Reports, 20(2), 12. https://doi.org/10.1007/s11906-018-0812-z
Song, J., Liu, Y., Zheng, L., Gui, L., Zhao, X., Dongqun, X., & Weidong, W. (2018). Acute effects of air pollution on type II diabetes mellitus hospitalization in Shijiazhuang, China. Environmental Science and Pollution Research, 25(30), 30151–30159. https://doi.org/10.1007/s11356-018-3016-9
Sørensen, M., Poulsen, A. H., Hvidtfeldt, U. A., Frohn, L. M., Ketzel, M., Christensen, J. H., Brandt, J., Geels, C., & Raaschou-Nielsen, O. (2022). Exposure to source-specific air pollution and risk for type 2 diabetes: a nationwide study covering Denmark. International Journal of Epidemiology, 51(4), 1219–1229. https://doi.org/10.1093/ije/dyac040
Strak, M., Janssen, N., Beelen, R., Schmitz, O., Vaartjes, I., Karssenberg, D., van den Brink, C., Bots, M. L., Dijst, M., Brunekreef, B., & Hoek, G. (2017). Long-term exposure to particulate matter, NO2 and the oxidative potential of particulates and diabetes prevalence in a large national health survey. Environment International, 108, 228–236. https://doi.org/10.1016/j.envint.2017.08.017
Thipsawat, S. (2021). Early detection of diabetic nephropathy in patient with type 2 diabetes mellitus: A review of the literature. Diabetes & Vascular Disease Research, 18(6), 14791641211058856. https://doi.org/10.1177/14791641211058856
Tiotiu, A. I., Novakova, P., Nedeva, D., Chong-Neto, H. J., Novakova, S., Steiropoulos, P., & Kowal, K. (2020). Impact of air pollution on asthma outcomes. International Journal of Environmental Research and Public Health, 17(17), 6212. https://doi.org/10.3390/ijerph17176212
Verhoeven, J. I., Allach, Y., Vaartjes, I. C. H., Klijn, C. J. M., & de Leeuw, F. E. (2021). Ambient air pollution and the risk of ischaemic and haemorrhagic stroke. The Lancet Planetary Health, 5(8), e542–e552. https://doi.org/10.1016/s2542-5196(21)00145-5
Viigimaa, M., Sachinidis, A., Toumpourleka, M., Koutsampasopoulos, K., Alliksoo, S., & Titma, T. (2020). Macrovascular complications of type 2 diabetes mellitus. Current Vascular Pharmacology, 18(2), 110–116. https://doi.org/10.2174/1570161117666190405165151
Wang, X., Bao, W., Liu, J., OuYang, Y.-Y., Wang, D., Rong, S., Xiao, X., Shan, Z.-L., Zhang, Y., Yao, P., & Liu, L.-G. (2013). Inflammatory markers and risk of type 2 diabetes. Diabetes Care, 36(1), 166–175. https://doi.org/10.2337/dc12-0702
Wanglin, X., Liu, X., Huang, Z., Yating, D., Zhang, B., Wang, Q., Xiang, J., Yuliang, L., & Lu, M. (2021). Acute Effects of air pollution on ischemic heart disease hospitalizations: A population-based time-series study in Wuhan, China, 2017–2018. International Journal of Environmental Research and Public Health, 18(23), 12527. https://doi.org/10.3390/ijerph182312527
Xu, R., Zhao, Q., Coelho, M. S., Saldiva, P. H., Zoungas, S., Huxley, R. R., & Li, S. (2019). Association between heat exposure and hospitalization for diabetes in Brazil during 2000–2015: A nationwide case-crossover study. Environmental Health Perspectives, 127(11), 117005. https://doi.org/10.1289/ehp5688
Yang, B. Y., Fan, S., Thiering, E., Seissler, J., Nowak, D., Dong, G. H., & Heinrich, J. (2020a). Ambient air pollution and diabetes: A systematic review and meta-analysis. Environmental Research, 180, 108817. https://doi.org/10.1016/j.envres.2019.108817
Yang, J., Zhou, M., Zhang, F., Yin, P., Wang, B., Guo, Y., Tong, S., Wang, H., Zhang, C., Sun, Q., Song, X., & Liu, Q. (2020b). Diabetes mortality burden attributable to short-term effect of PM10 in China. Environmental Science and Pollution Research, 27(15), 18784–18792. https://doi.org/10.1007/s11356-020-08376-1
Yun, J.-S., & Ko, S.-H. (2021). Current trends in epidemiology of cardiovascular disease and cardiovascular risk management in type 2 diabetes. Metabolism, 123, 154838. https://doi.org/10.1016/j.metabol.2021.154838
Zanobetti, A., Franklin, M., Koutrakis, P., & Schwartz, J. (2009). Fine particulate air pollution and its components in association with cause-specific emergency admissions. Environmental Health : A Global Access Science Source, 8, 58. https://doi.org/10.1186/1476-069x-8-58
Zheng, Y., Ley, S. H., & Hu, F. B. (2018). Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nature Reviews Endocrinology, 14(2), 88–98. https://doi.org/10.1038/nrendo.2017.151
Zhouyang, X., Wang, W., Liu, Q., Li, Z., Lei, L., Ren, L., Deng, F., Guo, X., & Shaowei, W. (2022). Association between gaseous air pollutants and biomarkers of systemic inflammation: A systematic review and meta-analysis. Environmental Pollution, 292, 118336. https://doi.org/10.1016/j.envpol.2021.118336
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This study was supported by the Gansu Provincial Science and Technology Program Project (Key R&D Program) (20YF3FA027).
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TT, TL and JD contributed to design the work. WZ, RZ, JL and YR were the principal writers of this paper.
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Zhang, W., Zhang, R., Tian, T. et al. Acute effects of air pollution on type II diabetes mellitus hospitalization in Lanzhou, China. Environ Geochem Health 45, 5927–5941 (2023). https://doi.org/10.1007/s10653-023-01604-w
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DOI: https://doi.org/10.1007/s10653-023-01604-w