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Physical activity attenuated the association of ambient ozone with type 2 diabetes mellitus and fasting blood glucose among rural Chinese population

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Abstract

The association of ozone with type 2 diabetes mellitus (T2DM) is uncertain. Moreover, the moderating effect of physical activity on this association is largely unknown. This study aims to evaluate the independent and combined effects of ozone and physical activity on T2DM and fasting blood glucose (FBG) in a Chinese rural adult population. A total of 39,192 participants were enrolled in the Henan Rural Cohort Study. Individual ozone exposure was assessed by using a satellite-based random forest model. The logistic regression and generalized linear models were used to evaluate the associations of ozone and physical activity with T2DM and FBG, respectively. Interaction plots were used to visualize the interaction effects of ozone and physical activity on T2DM or FBG. An interquartile range (IQR) increase in ozone exposure concentration was related to a 53.3% (odds ratio (OR),1.533; 95% confidence interval (CI), 1.426, 1.648) increase in odds of T2DM and a 0.292 mmol/L (95%CI, 0.263, 0.321) higher FBG level, respectively. The effects of ozone on T2DM and FBG generally decreased as physical activity levels increased. Negative additive interactions between ozone and physical activity on T2DM risk were observed (relative excess risk due to interaction (RERI), −0.261; 95%CI, −0.473, −0.048; attributable proportion due to interaction (AP), −0.203; 95%CI, −0.380, −0.027; synergy index (S), 0.520; 95%CI, 0.299, 0.904). The larger effects of ozone were observed among elderly and men on T2DM and FBG than young and women. Long-term exposure to ozone was associated with higher odds of T2DM and higher FBG levels, and these associations might be attenuated by increasing physical activity levels. In addition, there was a negative additive interaction (antagonistic effect) between ozone exposure and physical activity level on T2DM risk, suggesting that physical activity might be an effective method to reduce the burden of T2DM attributed to ozone exposure. Trail registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (registration number: ChiCTR-OOC-15006699). Date of registration: 06 July 2015, http://www.chictr.org.cn/showproj.aspx?proj=11375

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Acknowledgements

We sincerely thank all the participants, research staff, and administrators for supporting this study. Additionally, the authors would like to thank Dr. Tanko Abdulai for his critical reading of the manuscript.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Funding

This work was supported by the Foundation of National Key Program of Research and Development of China (Grant No. 2016YFC0900803), the National Natural Science Foundation of China (Grant No. 82003543, 81602925), the Science and Technology Innovation Team Support Plan of Colleges and Universities in Henan Province (Grant No. 21IRTSTHN029), the Henan Science and Technology Development Funds (Grant No. 182207310001), and the Foundation of Medical Science and Technology of Henan province (No. 201702367, 2017T02098). The funders had no role in the study design, data collection, and analysis, decision to publish, or preparation of the manuscript.

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  1. Xiaotian Liu and Xiaokang Dong contributed equally to this work.

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China

    Xiaotian Liu, Xiaokang Dong, Ruiying Li, Yaling He, Jian Hou, Zhenxing Mao, Wenqian Huo, Yuming Guo & Chongjian Wang

  2. Physical Examination Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China

    Xiaoqin Song

  3. Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia

    Yuming Guo & Shanshan Li

  4. Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China

    Gongbo Chen

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Contributions

All authors contributed to the study conception and design. Xiaotian Liu, investigation, data curation, methodology, formal analysis, visualization, and writing—original draft. Xiaokang Dong, investigation, data curation, methodology, and writing—review and editing. Xiaoqin Song, investigation, validation, and writing—review and editing. Ruiying Li, investigation and writing—review and editing. Yaling He, investigation and writing—review and editing. Jian Hou, investigation and writing—review and editing. Zhenxing Mao, investigation and writing—review and editing. Wenqian Huo, investigation, data curation, and writing—review and editing. Yuming Guo, conceptualization, methodology, and writing—review and editing. Shanshan Li, data curation, methodology, and writing—review and editing. Gongbo Chen, conceptualization, methodology, supervision, and writing—reviewing and editing. Chongjian Wang, conceptualization, methodology, investigation, validation, supervision, funding acquisition, project administration.

Corresponding author

Correspondence to Chongjian Wang.

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Ethics approval was obtained from the “Zhengzhou University Life Science Ethics Committee” (Ethics approval code: [2015] MEC (S128)), and written informed consent was obtained from all participants before this study.

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Liu, X., Dong, X., Song, X. et al. Physical activity attenuated the association of ambient ozone with type 2 diabetes mellitus and fasting blood glucose among rural Chinese population. Environ Sci Pollut Res 29, 90290–90300 (2022). https://doi.org/10.1007/s11356-022-22076-y

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