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

Jan 6, 2022Environmental research

How body fat and long-term air pollution together relate to type 2 diabetes in rural Henan

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Abstract

Obese individuals exposed to high levels of nitrogen dioxide and particulate matter may have up to a 3.01-fold increased risk of prevalent type 2 diabetes mellitus.

Six different obesity measures are positively associated with fasting blood glucose levels and the prevalence of type 2 diabetes mellitus.
High exposure to nitrogen dioxide, PM2.5, PM10, and PM1 is linked to increased risks for type 2 diabetes in obese individuals.
Obesity measured by body mass index and exposure to air pollutants shows similar joint associations with the prevalence of type 2 diabetes.
Additive associations between various obesity indicators and air pollution levels with type 2 diabetes prevalence were identified.
Findings suggest that obesity and air pollution may synergistically contribute to the risk of type 2 diabetes in rural areas with high pollution levels.

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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 NO, PM, PM, and PMwere 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). 2 1 2.5 10

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 NO, PM, PMand PMwere 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. 2 1 2.5 10

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.

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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

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