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Associations of Exposure to Air Pollution with Insulin Resistance: A Systematic Review and Meta-Analysis.

ABSTRACT: In this article, we review the available evidence and explore the association between air pollution and insulin resistance (IR) using meta-analytic techniques. Cohort studies published before January 2018 were selected through English-language literature searches in nine databases. Six cohort studies were included in our sample, which assessed air pollutants including PM_2.5 (particulate matter with an aerodynamic diameter less than or equal to 2.5 ?m), NO?(nitrogen dioxide), and PM₁₀ (particulate matter with an aerodynamic diameter less than 10 ?m). Percentage change in insulin or insulin resistance associated with air pollutants with corresponding 95% confidence interval (CI) was used to evaluate the risk. A pooled effect (percentage change) was observed, with a 1 ?g/m³ increase in NO? associated with a significant 1.25% change (95% CI: 0.67, 1.84; I² = 0.00%, p = 0.07) in the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and a 0.60% change (95% CI: 0.17, 1.03; I² = 30.94%, p = 0.27) in insulin. Similar to the analysis of NO?, a 1 ?g/m³ increase in PM₁₀ was associated with a significant 2.77% change (95% CI: 0.67, 4.87; I² = 94.98%, p < 0.0001) in HOMA-IR and a 2.75% change in insulin (95% CI: 0.45, 5.04; I² = 58.66%, p = 0.057). No significant associations were found between PM_2.5 and insulin resistance biomarkers. We conclude that increased exposure to air pollution can lead to insulin resistance, further leading to diabetes and cardiometabolic diseases. Clinicians should consider the environmental exposure of patients when making screening and treatment decisions for them.

SUBMITTER: Dang J

PROVIDER: S-EPMC6266153 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Associations of Exposure to Air Pollution with Insulin Resistance: A Systematic Review and Meta-Analysis.

Dang Jiajia J Yang Mengtong M Zhang Xinge X Ruan Haotian H Qin Guiyu G Fu Jialin J Shen Ziqiong Z Tan Anran A Li Rui R Moore Justin J

International journal of environmental research and public health 20181120 11

In this article, we review the available evidence and explore the association between air pollution and insulin resistance (IR) using meta-analytic techniques. Cohort studies published before January 2018 were selected through English-language literature searches in nine databases. Six cohort studies were included in our sample, which assessed air pollutants including PM<sub>2.5</sub> (particulate matter with an aerodynamic diameter less than or equal to 2.5 μm), NO₂(nitrogen dioxide), and PM<su ...[more]

PMID: 30463387

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Project description:BackgroundParticulate air pollution's physical health effects are well known, but associations between particulate matter (PM) exposure and mental illness have not yet been established. However, there is increasing interest in emerging evidence supporting a possible etiological link.ObjectivesThis systematic review aims to provide a comprehensive overview and synthesis of the epidemiological literature to date by investigating quantitative associations between PM and multiple adverse mental health outcomes (depression, anxiety, bipolar disorder, psychosis, or suicide).MethodsWe undertook a systematic review and meta-analysis. We searched Medline, PsycINFO, and EMBASE from January 1974 to September 2017 for English-language human observational studies reporting quantitative associations between exposure to PM <1.0?m in aerodynamic diameter (ultrafine particles) and PM <2.5 and <10?m in aerodynamic diameter (PM2.5 and PM10, respectively) and the above psychiatric outcomes. We extracted data, appraised study quality using a published quality assessment tool, summarized methodological approaches, and conducted meta-analyses where appropriate.ResultsOf 1,826 citations identified, 22 met our overall inclusion criteria, and we included 9 in our primary meta-analyses. In our meta-analysis of associations between long-term (>6?months) PM2.5 exposure and depression (n=5 studies), the pooled odds ratio was 1.102 per 10-?g/m3 PM2.5 increase (95% CI: 1.023, 1.189; I2=0.00%). Two of the included studies investigating associations between long-term PM2.5 exposure and anxiety also reported statistically significant positive associations, and we found a statistically significant association between short-term PM10 exposure and suicide in meta-analysis at a 0-2 d cumulative exposure lag.DiscussionOur findings support the hypothesis of an association between long-term PM2.5 exposure and depression, as well as supporting hypotheses of possible associations between long-term PM2.5 exposure and anxiety and between short-term PM10 exposure and suicide. The limited literature and methodological challenges in this field, including heterogeneous outcome definitions, exposure assessment, and residual confounding, suggest further high-quality studies are warranted to investigate potentially causal associations between air pollution and poor mental health. https://doi.org/10.1289/EHP4595.

Dataset Information

Associations of Exposure to Air Pollution with Insulin Resistance: A Systematic Review and Meta-Analysis.

Publications

Associations of Exposure to Air Pollution with Insulin Resistance: A Systematic Review and Meta-Analysis.

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