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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.

Project description:ObjectiveTo investigate the role of air pollutants in risk of dementia, considering differences by study factors that could influence findings.DesignSystematic review and meta-analysis.Data sourcesEMBASE, PubMed, Web of Science, Psycinfo, and OVID Medline from database inception through July 2022.Eligibility criteria for selecting studiesStudies that included adults (≥18 years), a longitudinal follow-up, considered US Environmental Protection Agency criteria air pollutants and proxies of traffic pollution, averaged exposure over a year or more, and reported associations between ambient pollutants and clinical dementia. Two authors independently extracted data using a predefined data extraction form and assessed risk of bias using the Risk of Bias In Non-randomised Studies of Exposures (ROBINS-E) tool. A meta-analysis with Knapp-Hartung standard errors was done when at least three studies for a given pollutant used comparable approaches.Results2080 records identified 51 studies for inclusion. Most studies were at high risk of bias, although in many cases bias was towards the null. 14 studies could be meta-analysed for particulate matter <2.5 µm in diameter (PM2.5). The overall hazard ratio per 2 μg/m3 PM2.5 was 1.04 (95% confidence interval 0.99 to 1.09). The hazard ratio among seven studies that used active case ascertainment was 1.42 (1.00 to 2.02) and among seven studies that used passive case ascertainment was 1.03 (0.98 to 1.07). The overall hazard ratio per 10 μg/m3 nitrogen dioxide was 1.02 ((0.98 to 1.06); nine studies) and per 10 μg/m3 nitrogen oxide was 1.05 ((0.98 to 1.13); five studies). Ozone had no clear association with dementia (hazard ratio per 5 μg/m3 was 1.00 (0.98 to 1.05); four studies).ConclusionPM2.5 might be a risk factor for dementia, as well as nitrogen dioxide and nitrogen oxide, although with more limited data. The meta-analysed hazard ratios are subject to limitations that require interpretation with caution. Outcome ascertainment approaches differ across studies and each exposure assessment approach likely is only a proxy for causally relevant exposure in relation to clinical dementia outcomes. Studies that evaluate critical periods of exposure and pollutants other than PM2.5, and studies that actively assess all participants for outcomes are needed. Nonetheless, our results can provide current best estimates for use in burden of disease and regulatory setting efforts.Systematic review registrationPROSPERO CRD42021277083.

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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