Dataset Information

Evaluation of associations between estimates of particulate matter exposure and new onset type 2 diabetes in the REGARDS cohort.

ABSTRACT:

Background

Studies of PM_2.5 and type 2 diabetes employ differing methods for exposure assignment, which could explain inconsistencies in this growing literature. We hypothesized associations between PM_2.5 and new onset type 2 diabetes would differ by PM_2.5 exposure data source, duration, and community type.

Methods

We identified participants of the US-based REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort who were free of diabetes at baseline (2003-2007); were geocoded at their residence; and had follow-up diabetes information. We assigned PM_2.5 exposure estimates to participants for periods of 1 year prior to baseline using three data sources, and 2 years prior to baseline for two of these data sources. We evaluated adjusted odds of new onset diabetes per 5 µg/m³ increases in PM_2.5 using generalized estimating equations with a binomial distribution and logit link, stratified by community type.

Results

Among 11,208 participants, 1,409 (12.6%) had diabetes at follow-up. We observed no associations between PM_2.5 and diabetes in higher and lower density urban communities, but within suburban/small town and rural communities, increases of 5 µg/m³ PM_2.5 for 2 years (Downscaler model) were associated with diabetes (OR [95% CI] = 1.65 [1.09, 2.51], 1.56 [1.03, 2.36], respectively). Associations were consistent in direction and magnitude for all three PM_2.5 sources evaluated.

Significance

1- and 2-year durations of PM_2.5 exposure estimates were associated with higher odds of incident diabetes in suburban/small town and rural communities, regardless of exposure data source. Associations within urban communities might be obfuscated by place-based confounding.

SUBMITTER: McAlexander TP

PROVIDER: S-EPMC9012798 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Publications

Evaluation of associations between estimates of particulate matter exposure and new onset type 2 diabetes in the REGARDS cohort.

McAlexander Tara P TP De Silva S Shanika A SSA Meeker Melissa A MA Long D Leann DL McClure Leslie A LA

Journal of exposure science & environmental epidemiology 20211016 4

<h4>Background</h4>Studies of PM<sub>2.5</sub> and type 2 diabetes employ differing methods for exposure assignment, which could explain inconsistencies in this growing literature. We hypothesized associations between PM<sub>2.5</sub> and new onset type 2 diabetes would differ by PM<sub>2.5</sub> exposure data source, duration, and community type.<h4>Methods</h4>We identified participants of the US-based REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort who were free of di ...[more]

PMID: 34657127

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Project description:BackgroundEvidence from various epidemiological studies has shown an association between particulate matter 2.5 (PM2.5) and diabetes mellitus. A prospective study from the United States reported that exposure to PM2.5 alters endothelial function, and leads to insulin resistance and reduction in peripheral glucose uptake. There is a paucity of data on the relation between air pollution and diabetes in low- and middle-income countries.ObjectivesTo estimate the prevalence of type 2 diabetes among people living in areas with higher exposures of suspended PM2.5 compared to people living in areas with lower exposures in Chennai, Tamil Nadu, India.MethodsA cross-sectional study was carried out in two areas of Chennai city. The PM2.5 affecting vulnerable areas were stratified from a list of air quality monitoring stations in Tamil Nadu Pollution Control Board and Central Pollution Control Board. The highest and lowest areas of exposure were selected from the list. Households were randomly selected for the study. A total of 201 (67 male, 134 female) individuals from a high exposure area (HEA) and 209 (76 male 133 female) individuals from a low exposure area (LEA) were recruited for the study. Adults over 18 years of age were screened for random capillary blood glucose (RCBG) by glucometer (OneTouch Ultra).ResultsThe prevalence of diabetes (34.8% vs 19.6% p =0.001) was 77.5% higher among people living in areas of high particulate matter exposure compared to people living in less exposed areas. Multivariable logistic regression analysis showed that age, gender, residential area, and family history of diabetes were significantly associated with the prevalence of diabetes (p<0.05).ConclusionsThe present study indicates a link between high levels of exposure to PM2.5 and diabetes mellitus. Further prospective studies on populations exposed to elevated pollution are needed to establish whether this association has a causative link.Participant consentObtained.Ethics approvalThe study was approved by the Ethics Committee of the Prof. M Viswanathan Diabetes Research Centre, Chennai, India.Competing interestsThe authors declare no competing financial interests.

Project description:ObjectiveTo estimate exposure-response associations between chronic exposure to fine particulate matter (PM2.5) and risks of the first hospital admission for major cardiovascular disease (CVD) subtypes.DesignPopulation based cohort study.SettingContiguous US.Participants59 761 494 Medicare fee-for-service beneficiaries aged ≥65 years during 2000-16. Calibrated PM2.5 predictions were linked to each participant's residential zip code as proxy exposure measurements.Main outcome measuresRisk of the first hospital admission during follow-up for ischemic heart disease, cerebrovascular disease, heart failure, cardiomyopathy, arrhythmia, valvular heart disease, thoracic and abdominal aortic aneurysms, or a composite of these CVD subtypes. A causal framework robust against confounding bias and bias arising from errors in exposure measurements was developed for exposure-response estimations.ResultsThree year average PM2.5 exposure was associated with increased relative risks of first hospital admissions for ischemic heart disease, cerebrovascular disease, heart failure, cardiomyopathy, arrhythmia, and thoracic and abdominal aortic aneurysms. For composite CVD, the exposure-response curve showed monotonically increased risk associated with PM2.5: compared with exposures ≤5 µg/m3 (the World Health Organization air quality guideline), the relative risk at exposures between 9 and 10 µg/m3, which encompassed the US national average of 9.7 µg/m3 during the study period, was 1.29 (95% confidence interval 1.28 to 1.30). On an absolute scale, the risk of hospital admission for composite CVD increased from 2.59% with exposures ≤5 µg/m3 to 3.35% at exposures between 9 and 10 µg/m3. The effects persisted for at least three years after exposure to PM2.5. Age, education, accessibility to healthcare, and neighborhood deprivation level appeared to modify susceptibility to PM2.5.ConclusionsThe findings of this study suggest that no safe threshold exists for the chronic effect of PM2.5 on overall cardiovascular health. Substantial benefits could be attained through adherence to the WHO air quality guideline.

Dataset Information

Evaluation of associations between estimates of particulate matter exposure and new onset type 2 diabetes in the REGARDS cohort.

Background

Methods

Results

Significance

Publications

Evaluation of associations between estimates of particulate matter exposure and new onset type 2 diabetes in the REGARDS cohort.

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