Ambient and Traffic-Related Air Pollution Exposures as Novel Risk Factors for Metabolic Dysfunction and Type 2 Diabetes

Abstract

Purpose of Review Diabetes mellitus is a top contributor to the global burden of mortality and disability in adults. There has also been a slow, but steady rise in prediabetes and type 2 diabetes in youth. The current review summarizes recent findings regarding the impact of increased exposure to air pollutants on the type 2 diabetes epidemic. Recent Findings Human and animal studies provide strong evidence that exposure to ambient and traffic-related air pollutants such as particulate matter (PM), nitrogen dioxide (NO2), and nitrogen oxides (NOx) play an important role in metabolic dysfunction and type 2 diabetes etiology. This work is supported by recent findings that have observed similar effect sizes for increased exposure to air pollutants on clinical measures of risk for type 2 diabetes in children and adults. Further, studies indicate that these effects may be more pronounced among individuals with existing risk factors, including obesity and prediabetes. Summary Current epidemiological evidence suggests that increased air pollution exposure contributes to alterations in insulin signaling, glucose metabolism, and beta (β)-cell function. Future work is needed to identify the specific detrimental pollutants that alter glucose metabolism. Additionally, advanced tools and new areas of investigation present unique opportunities to study the underlying mechanisms, including intermediate pathways, that link increased air pollution exposure with type 2 diabetes onset.

A future for the world's children? A WHO–UNICEF–Lancet Commission

“…Exposure to polluted air prenatally and during early postnatal life is associated with an increased risk of acute respiratory diseases in childhood, with considerable morbidity and mortality. 92,93 Furthermore, air pollution exposure impairs lung growth and reduces lung function; 92 increases the risk of cardiovascular disease, 94 obesity, 95 type 2 diabetes, and metabolic syndrome; 96 slows brain maturation; and impairs growth in cognitive function in schoolchildren. 97,98 Emerging evidence also suggests statistically significant effects of air pollution on intelligence quotient (IQ); 99 one study reports a fourpoint drop in IQ by the age of 5years in a sample of children exposed to polluted air in utero.…”

How Harmful Is Particulate Matter Emitted from Biomass Burning? A Thailand Perspective

“…dementia, cognitive impairment) and metabolic (e.g. diabetes) diseases and that PM can cause reproductive and developmental toxicity [12,[16][17][18][19][20][21][22] (Fig. 1).…”

Association of Prenatal and Perinatal Exposures to Particulate Matter With Changes in Hemoglobin A1c Levels in Children Aged 4 to 6 Years

“…Although there is growing literature on associations between air pollution components, including PM 2.5 , and glucose dysregulation and type 2 diabetes, 5,[7][8][9]12,[26][27][28][29][30][31][32][33][34] exposure in association with childhood HbA 1c changes. We characterized alterations in HbA 1c levels in children as young as 4 years, and our results suggested that the changes PM 2.5 may induce may be different prior to age 4 years compared with those after age 4 years as well as by sex.…”