Air Pollution, Oxidative Stress, and Diabetes: a Life Course Epidemiologic Perspective

Abstract

Purpose of Review-Ambient air pollution is strongly linked to cardiovascular and respiratory diseases. We summarize available published evidence regarding similar associations with diabetes across the life course. Recent Findings-We performed a life-course survey of the recent literature, including prenatal, gestational, childhood/adolescence, and adult exposures to air pollution. Oxidative stress is identified as a key factor in both metabolic dysfunction and the effects of air pollution exposure, especially from fossil fuel combustion products, providing a plausible mechanism for air pollution-diabetes associations. The global burden of diabetes attributed to air pollution exposure is substantial, with a recent estimate that ambient fine particulate matter (PM 2.5) exposure contributes to more than 200,000 deaths from diabetes annually. Summary-There is a growing body of literature linking air pollution exposure during childhood and adulthood with diabetes etiology and related cardiometabolic biomarkers. A small number of studies found that exposure to air pollution during pregnancy is associated with elevated gestational diabetes risk among mothers. Studies examining prenatal air pollution exposure and diabetes risk among the offspring, as well as potential transgenerational effects of air pollution exposure, are very limited thus far. This review provides insight into how air pollutants affect diabetes and other metabolic dysfunction-related diseases across the different life stages.

Oxidative Stress Biomarkers in the Relationship between Type 2 Diabetes and Air Pollution

“…Future studies should apply comparable models in assigning exposure to participants, in particular multipollutant models including lead, ozone, sulphate, polycyclic aromatic hydrocarbons, ultrafine particles, and possibly noise that was reported to correlate with traffic air pollution [ 31 , 105 , 106 ]. As has already been pointed out, a greater number of studies from developing countries are needed to provide a more accurate assessment of the influence of air pollution on T2D risk and the susceptibility of individuals with T2D to air pollution [ 34 ].…”

“…Among the numerous plausible mechanisms that have been hypothesized, the available data point to endothelial dysfunction, inflammation, and resulting oxidative stress as the major pathways involved in this relationship, albeit the exact mechanisms whereby exposure to air pollution is associated with an increased risk of diabetes remain to be elucidated [ 35 , 106 ].…”

Oxidative stress in air pollution research

“…More than just particle mass: Following the initial observations from the seminal six cities study that both long and short-term exposures to relatively low levels of PM 2.5 were associated with an increased risk of early death, predominantly from cardiopulmonary causes [15], a large number of papers have been published globally https://doi.org/10.1016/j.freeradbiomed.2020.04.031 supporting this initial finding and extending the list of associated diseases to cancer [16], diabetes [17], dementia [18], diseases of the gastrointestinal tract (as reviewed by Feng at al in the current issue [19]), as well as poor birth outcomes [20] and developmental trajectories in children [21]. Whilst overall these associations are consistent across numerous studies, considerable heterogeneity in the effect size estimate exists in the literature, even where data sets have been analysed using similar methods [22][23][24].…”

Air Pollution, Residential Greenness and Metabolic Dysfunction during Early Pregnancy in the INfancia y Medio Ambiente (INMA) Cohort

“…Exposure to ambient air pollution, including fine particulate matter (PM 2.5 ) and nitrogen dioxide (NO 2 ), has been linked to oxidative stress and systemic inflammation [10][11][12], and inflammatory mediators are associated with levels of glucose during pregnancy [13]. Air pollution is also associated with lipid oxidization and altered lipid metabolism in animal models [14].…”