Air Pollution, Oxidative Stress, and Diabetes: a Life Course Epidemiologic Perspective
Purpose of Review
Ambient air pollution is strongly linked to cardiovascular and respiratory diseases. We summarize available published evidence regarding similar associations with diabetes across the life course.
We performed a life-course survey of the recent literature, including prenatal, gestational, childhood/adolescence, and adult exposures to air pollution. Oxidative stress is identified as a key factor in both metabolic dysfunction and the effects of air pollution exposure, especially from fossil fuel combustion products, providing a plausible mechanism for air pollution-diabetes associations. The global burden of diabetes attributed to air pollution exposure is substantial, with a recent estimate that ambient fine particulate matter (PM2.5) exposure contributes to more than 200,000 deaths from diabetes annually.
There is a growing body of literature linking air pollution exposure during childhood and adulthood with diabetes etiology and related cardiometabolic biomarkers. A small number of studies found that exposure to air pollution during pregnancy is associated with elevated gestational diabetes risk among mothers. Studies examining prenatal air pollution exposure and diabetes risk among the offspring, as well as potential transgenerational effects of air pollution exposure, are very limited thus far. This review provides insight into how air pollutants affect diabetes and other metabolic dysfunction-related diseases across the different life stages.
KeywordsAir pollution Diabetes Particulate matter Oxidative stress
Compliance with Ethical Standards
Sources of Funding
The work was supported by the National Institutes of Health through a National Institute of Environmental Health Sciences Center of Excellence (ES00260).
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 3.Hutcheson R, Rocic P. The metabolic syndrome, oxidative stress, environment, and cardiovascular disease: the great exploration. Exp Diabetes Res. 2012;2012:1–13.Google Scholar
- 5.Puett RC, Quirós-Alcalá L, Montresor-López JA, Tchangalova N, Dutta A, Payne-Sturges D, et al. Long-term exposure to ambient air pollution and type 2 diabetes in adults. Curr Epidemiol Rep. 2019;6:67–79.Google Scholar
- 6.•• Bowe B, Xie Y, Li T, Yan Y, Xian H, al-Aly Z. The 2016 Global and National Burden of Diabetes Mellitus Attributable to PM 2·5 Air Pollution. Lancet Planet Health. 2018;2(7):e301–122 This study estimated the number of diabetes incidence and mortality attributable to fine particulate matter globally. PubMedGoogle Scholar
- 8.Madhloum N, et al. Cord Plasma Insulin and in Utero Exposure to Ambient Air Pollution. Environ Int. 2016, Elsevier;105:126–32.Google Scholar
- 9.Kim JS, et al. Longitudinal associations of in utero and early life near-roadway air pollution with trajectories of childhood body mass index. Environl Health: Global Access Sci Source. 2018;17(1):1, Environmental Health–10.Google Scholar
- 12.Fleisch AF, et al. Prenatal Exposure to Traffic Pollution and Childhood Body Mass Index Trajectory. Front Endocrinol. 2019;9:1–9.Google Scholar
- 15.Breton CV, et al. Associations with newborn LINE1 and Alu methylation and childhood blood pressure and carotid intima-media thickness in the children’ s health study, vol. 124; 2016. p. 1905–12.Google Scholar
- 24.Fleisch AF, et al. Air pollution exposure and gestational diabetes mellitus among pregnant women in Massachusetts: a cohort study. Environl Health: Global Access Sci Source. 2016;15(1):1, Environmental Health–9.Google Scholar
- 25.Di C. Agostino. “Type I diabetes in Paediatric age in Apulia (Italy): incidence and associations with outdoor air pollutants.” diabetes research and clinical practice. Elsevier Ireland Ltd. 2016;111:36–43.Google Scholar
- 31.•• Alderete TL, Habre R, Toledo-Corral CM, Berhane K, Chen Z, Lurmann FW, et al. Longitudinal Associations between Ambient Air Pollution with Insulin Sensitivity, Beta;-Cell Function, and Adiposity in Los Angeles Latino Children. Diabetes. 2017;66(7):1789–96. https://doi.org/10.2337/db16-1416 This study is one of the few longitudinal investigations examining associations between air pollution exposure and cardiometabolic biomarkers; long-term exposure to air pollutants accelerated declines in insulin sensitivity and beta-cell function among overweight and obese children. PubMedPubMedCentralGoogle Scholar
- 39.Weinmayr G, et al. Long-term exposure to fine particulate matter and incidence of type 2 diabetes mellitus in a cohort study: effects of Total and traffic-specific air pollution. Environl Health: Global Access Sci Source. 2015;14(1):1–8.Google Scholar
- 48.Wolf K, et al. Association between long-term exposure to air pollution and biomarkers related to insulin resistance, subclinical inflammation and Adipokines. Diabetes. 2016;65(November):db151567.Google Scholar
- 56.Yang B-Y, Qian Z(M), Li S, Chen G, Bloom MS, Elliott M, et al. Ambient air pollution in relation to diabetes and glucose-homoeostasis markers in China: a cross-sectional study with findings from the 33 communities Chinese health study. Lancet Planet Health. 2018;2(2, The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license):e64–73.PubMedGoogle Scholar
- 58.Yitshak-Sade M, et al. Air pollution and serum glucose levels. Medicine (United States). 2015;94(27):e1093.Google Scholar
- 65.Jørgensen JT, et al. Long-term exposure to road traffic noise and incidence of diabetes in the Danish nurse cohort. Environ Health Perspect. 2019;127(5):057006.Google Scholar
- 69.Schraufnagel DE, Balmes JR, Cowl CT, De Matteis S, Jung SH, Mortimer K, Perez-Padilla R, Rice MB, Riojas-Rodriguez H, Sood A, Thurston GD, To T, Vanker A, Wuebbles DJ. Air pollution and noncommunicable diseases: a review by the forum of international respiratory Societies' environmental committee, part 1: the damaging effects of air pollution. 2018;155:417–426Google Scholar