Air Pollution Exposure and Type-2 Diabetes Prevalence and Severity

摘要

The number of people in the U.S. with diabetes has reached epidemic proportions-- increasing from 5.6 million affected in 1980 to 20.9 million in 2010. Development and exacerbation of type-2 diabetes has been linked to a combination of genetic, behavioral and environmental factors. Recent studies suggest increased air pollution exposure may play a role in insulin resistance and type-2 diabetes development. This study investigates whether prevalence and severity of type-2 diabetes are related to increased criteria pollutant exposures. Using 2005 California Health Interview Survey (CHIS) data and Geographic Information System software, we linked adults' residential addresses to government monitors for NO2, O3, PM10 and PM2.5. We estimated individual 3-year average exposures. We used logistic regression analyses to evaluate the relationship between pollutant exposures and increased odds of receiving a type-2 diabetes diagnosis, as well as increased odds of medication use (pills, insulin, or both) to treat type-2 diabetes, controlling for age, sex, race, and poverty level. Among CHIS 2005 respondents, increases in PM10 and NO2 were associated with 3% and 8% respective increases in odds of receiving a type-2 diabetes diagnosis. Among adults with type-2 diabetes, increases in O3, PM10, and PM2.5 were associated with 40%, 56%, and 50% respective increases in odds of taking any medication; 33%, 31%, and 41% respective increases in odds of taking pills only; 43%, 53%, and 46% respective increases in odds of taking insulin only; and 70%, 60%, and 88% respective increases in odds of taking insulin and pills. These findings add to growing evidence that pollutant exposures may be linked to type-2 diabetes prevalence and severity. The findings highlight the importance of intervening against modifiable and pervasive environmental factors, such as air pollution, contributing to type-2 diabetes.