Effect of long-term exposure to PM2.5 on the risk of type 2 diabetes and arthritis in type 2 diabetes patients: Evidence from a national cohort in China

Chaoqun Liu; Ganxiang Cao; Jieying Li; Shaoyan Lian; Ke Zhao; Ying Zhong; Jiahong Xu; Yumeng Chen; Jun Bai; Hao Feng; Guanhao He; Xiaomei Dong; Pan Yang; Fangfang Zeng; Ziqiang Lin; Sui Zhu; Xinqi Zhong; Wenjun Ma; Tao Liu

doi:10.1016/j.envint.2023.107741

Effect of long-term exposure to PM_2.5 on the risk of type 2 diabetes and arthritis in type 2 diabetes patients: Evidence from a national cohort in China

Environ Int. 2023 Jan:171:107741. doi: 10.1016/j.envint.2023.107741. Epub 2023 Jan 6.

Authors

Chaoqun Liu¹, Ganxiang Cao², Jieying Li¹, Shaoyan Lian¹, Ke Zhao¹, Ying Zhong¹, Jiahong Xu¹, Yumeng Chen², Jun Bai³, Hao Feng¹, Guanhao He¹, Xiaomei Dong¹, Pan Yang¹, Fangfang Zeng¹, Ziqiang Lin¹, Sui Zhu¹, Xinqi Zhong⁴, Wenjun Ma⁵, Tao Liu⁶

Affiliations

¹ Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510080, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China.
² School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510080, China; Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
³ Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan 528000, China.
⁴ Department of Neonatology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, Guangdong, China.
⁵ Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510080, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China. Electronic address: mawj@gdiph.org.cn.
⁶ Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510080, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China. Electronic address: gztt_2002@163.com.

PMID: 36628860
DOI: 10.1016/j.envint.2023.107741

Abstract

Background: It remains unclear whether type 2 diabetes and the complication of arthritis are causally related to the PM_2.5 pollutant. Therefore, we aimed to investigate the associations of long-term PM_2.5 exposure with type 2 diabetes and with arthritis in type 2 diabetes patients.

Materials and methods: This study used data from the China Health and Retirement Longitudinal Survey (CHARLS) implemented during 2011-2018. The associations were analyzed by Cox proportional hazards regression models, and the population-attributable fraction (PAF) was calculated to assess the burden of type 2 diabetes and arthritis-attributable to PM_2.5.

Results: A total of 21,075 participants were finally included, with 19,121 analyzed for PM_2.5 and type 2 diabetes risk and 12,427 analyzed for PM_2.5 and arthritis risk, of which 1,382 with newly-diagnosed type 2 diabetes and 1,328 with arthritis during the follow-up. Overall, each 10 μg/m³ increment in PM_2.5 concentration was significantly associated with an increase in the risk of type 2 diabetes (HR = 1.26, 95 %CI1.22 to 1.31), and the PAF of type 2 diabetes attributable to PM_2.5 was 13.54 %. In type 2 diabetes patients, each 10 μg/m³ increment in PM_2.5 exposure was associated with an increase in arthritis (HR = 1.42, 95 %CI: 1.28 to 1.57), and the association was significantly greater than that (H = 1.23, 95 %CI: 1.19 to 1.28) in adults without type 2 diabetes. The PAFs of arthritis-attributable to PM_2.5 in participants with and without type 2 diabetes were 18.54 % and 10.69 %, respectively.

Conclusion: Long-term exposure to PM_2.5 may increase the risk of type 2 diabetes and make type 2 diabetes patients susceptible to arthritis.

Keywords: Air pollution; Arthritis; Disease burden; PM(2.5); Type 2 diabetes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Air Pollutants* / adverse effects
Air Pollutants* / analysis
Air Pollution*
China / epidemiology
Diabetes Mellitus, Type 2* / epidemiology
Diabetes Mellitus, Type 2* / etiology
Environmental Exposure / analysis
Humans
Particulate Matter / adverse effects
Particulate Matter / analysis

Substances

Air Pollutants
Particulate Matter