Adverse associations of different obesity measures and the interactions with long-term exposure to air pollutants with prevalent type 2 diabetes mellitus: The Henan Rural Cohort study

Ning Kang; Gongbo Chen; Runqi Tu; Wei Liao; Xiaotian Liu; Xiaokang Dong; Ruiying Li; Mingming Pan; Shanshan Yin; Kai Hu; Zhenxing Mao; Wenqian Huo; Yuming Guo; Shanshan Li; Jian Hou; Chongjian Wang

doi:10.1016/j.envres.2021.112640

Adverse associations of different obesity measures and the interactions with long-term exposure to air pollutants with prevalent type 2 diabetes mellitus: The Henan Rural Cohort study

Environ Res. 2022 May 1:207:112640. doi: 10.1016/j.envres.2021.112640. Epub 2022 Jan 3.

Authors

Ning Kang¹, Gongbo Chen², Runqi Tu¹, Wei Liao¹, Xiaotian Liu¹, Xiaokang Dong¹, Ruiying Li¹, Mingming Pan¹, Shanshan Yin³, Kai Hu³, Zhenxing Mao¹, Wenqian Huo¹, Yuming Guo⁴, Shanshan Li⁵, Jian Hou⁶, Chongjian Wang¹

Affiliations

¹ Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
² Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
³ Department of Health Policy Research, Henan Academy of Medical Sciences, Zhengzhou, China.
⁴ Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
⁵ Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
⁶ Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China. Electronic address: 13667176505@163.com.

PMID: 34990613
DOI: 10.1016/j.envres.2021.112640

Abstract

Background: Obesity and ambient air pollution are independent risk factors of type 2 diabetes mellitus (T2DM), however, the evidence regarding their joint associations on T2DM was sparsely studied in low-middle income countries.

Methods: A total of 38,841 participants were selected from Henan Rural Cohort study which was carried out during 2015-2017. Obesity was identified by body mass index (BMI), WC (waist circumstance), WHR (waist-to-hip ratio), WHtR (waist-to-height ratio), BFP (body fat percent), and VFI (visceral fat index). Three-year averaged-concentrations of NO₂, PM₁, PM_2.5, and PM₁₀ were assessed by using the method of spatiotemporal model incorporated into the satellites data. The independent associations of obesity indicators and exposure to air pollutants on fasting blood glucose (FBG) and T2DM were assessed by generalized linear and logistic regression model, respectively, and their interaction associations on T2DM were quantified by using relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (S).

Results: Positive associations of six obesity measures and four air pollutants with FBG levels and prevalent T2DM were observed. Obese participants measured by BMI plus high exposure to NO₂, PM₁, PM_2.5 and PM₁₀ were related to a 2.96-fold (2.66-3.29), 2.87-fold (2.58-3.20), 2.98-fold (2.67-3.32) and 3.01-fold (2.70-3.35) increased risk for prevalent T2DM, respectively; similarity of joint associations of the other obesity measures and air pollutants on T2DM were observed. The additive associations of different obesity measures and air pollutants with prevalent T2DM were further found.

Conclusions: The synergistic associations of obesity and air pollutants on FBG levels and prevalent T2DM were observed, indicating that obese participants were at high risk for prevalent T2DM in highly polluted rural regions.

Keywords: Air pollutants; Obesity; Rural population; Synergistic association; Type 2 diabetes mellitus.

Publication types

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

MeSH terms

Air Pollutants* / analysis
Air Pollutants* / toxicity
Air Pollution* / analysis
Air Pollution* / statistics & numerical data
China / epidemiology
Cohort Studies
Diabetes Mellitus, Type 2* / chemically induced
Diabetes Mellitus, Type 2* / epidemiology
Environmental Exposure / analysis
Environmental Exposure / statistics & numerical data
Humans
Obesity / chemically induced
Particulate Matter / analysis
Particulate Matter / toxicity

Substances

Air Pollutants
Particulate Matter

Associated data

ChiCTR/ChiCTR–OOC–15006699