Objective: To explore the effect of long-term exposure to ambient particulate matter (PM10) on the prevalence of diabetes and fasting plasma glucose (FPG). Methods: The subjects of the study were from the baseline population of "Jinchang Cohort", and 24 285 subjects were finally included after excluding incomplete home address information and diabetic diagnosis information. The demographic characteristics, lifestyle and health status of the survey subjects were collected through questionnaire, physical examination and laboratory tests. ArcGIS software was used to match the nearest environmental monitoring stations for each subject according to residential address. Two-year average concentrations of PM10 were calculated to estimate exposure level. The logistic regression and the multiple linear regression were conducted to assess the effects of ambient PM10 on the prevalence of diabetes and FPG. The restricted cubic spline was used to quantify the dose-response relationship. Stratified analysis and effect modification analysis were also performed. Results: The age of 24 285 participants was (49.32±8.60) years, and the BMI was (24.22±6.09) kg/m2. There were 13 950 (57.44%) males and 2 066 (8.51%) diabetic patients. After adjusting for confounders, for every 10 μg/m3 increase in the average PM10 concentration in the first two years of the survey, the prevalence of diabetes increased [OR (95%CI) =1.05 (1.01-1.09)]and the FPG level elevated [β (95%CI) = 0.061 (0.047-0.076) mmol/L]. The results of the restricted cubic spline analysis showed a nonlinear relationship between PM10 concentration and FPG level (P<0.001). Further subgroup analysis showed that female [OR (95%CI) =1.10 (1.03-1.18)], people over 50 years old [OR (95%CI) =1.06 (1.02-1.11) ], subjects with family history of diabetes [OR (95%CI) = 1.13 (1.04-1.23) ], and with hypertension [OR (95%CI) = 1.07 (1.02-1.12) ] had a stronger association between the prevalence of diabetes and PM10 exposure (all P interaction values were<0.05). The effects of PM10 on FPG were more significant in people older than 50 years[β (95%CI) = 0.080 (0.050-0.109) mmol/L], with family history of diabetes [β (95%CI) = 0.087 (0.036-0.137) mmol/L], and hypertension [β (95%CI) = 0.077 (0.046-0.108) mmol/L] (all P interaction values were<0.05). Conclusions: Long-term exposure to ambient PM10 increases the diabetes prevalence and FPG. People older than 50 years old, with family history of diabetes and hypertension could be more sensitive to the effects of PM10 exposure.
目的： 探讨长期大气PM10暴露对糖尿病患病风险和空腹血糖（FPG）的影响。 方法： 研究对象来源于“金昌队列”基线人群，剔除家庭住址信息和糖尿病诊断信息不完整者，最终纳入24 285名调查对象。通过问卷调查、体格检查和实验室检测，收集调查对象人口学特征、生活方式和健康状况等信息。运用ArcGIS软件根据家庭住址匹配距离最近的环境监测站点，以调查前2年PM10平均浓度作为暴露估计值。采用logistic回归模型和多重线性回归模型评估大气PM10对糖尿病患病风险和FPG的影响，限制性立方样条拟合两者之间剂量-反应关系，并进行分层分析和效应修饰分析。 结果： 24 285名研究对象年龄（49.32±8.60）岁，体重指数（24.22±6.09）kg/m2，男性13 950名（57.44%），患糖尿病者2 066名（8.51%）。调整混杂因素后，调查前2年PM10平均浓度每升高10 μg/m3，糖尿病患病风险增加［OR （95%CI）值为1.05（1.01~1.09）］，FPG升高0.061（95%CI：0.047~0.076）mmol/L。限制性立方样条分析结果显示，PM10浓度与FPG水平之间存在非线性关联（P<0.001）（图1）。进一步进行亚组分析，结果显示：女性［OR（95%CI）：1.10（1.03~1.18）］、年龄>50岁［OR（95%CI）：1.06（1.02~1.11）］、有糖尿病家族史［OR（95%CI）：1.13（1.04~1.23）］和患高血压［OR（95%CI）：1.07（1.02~1.12）］者糖尿病患病风险与PM10暴露之间的关联更强（P交互值均<0.05）；PM10对FPG的影响在年龄>50岁［β（95%CI）：0.080（0.050~0.109）mmol/L］、有糖尿病家族史［β（95%CI）：0.087（0.036~0.137）mmol/L］和患高血压［β（95%CI）：0.077（0.046~0.108）mmol/L］者更显著（P交互值均<0.05）。 结论： 大气PM10长期暴露增加糖尿病患病风险和FPG水平；年龄>50岁、有糖尿病家族史及患高血压者是敏感人群。.