Association between long-term exposure to fine particulate matter and diabetic retinopathy among diabetic patients: A national cross-sectional study in China

Shan, Anqi; Chen, Xi; Yang, Xueli; Yao, Baoqun; Liang, Fengchao; Yang, Ze; Liu, Fangchao; Chen, Song; Yan, Xiaochang; Huang, Jianfeng; Bo, Shaoye; Tang, Naijun; Gu, Dongfeng; Yan, Hua

doi:10.1016/j.envint.2021.106568

Cited by 30 publications

(24 citation statements)

References 53 publications

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“…Coarse and fine particulates differ in not only their physical properties and size but also their chemical components. PM 10 primarily consists of geological materials, in comparison to PM 2.5 and PM 1.0 , which have larger fragments of elemental and organic carbon [52]. These variations in PM chemical composition are related to different toxicity profiles and can be used as tracers of vehicular emanations.…”

Section: Outdoor Air Pollutionmentioning

confidence: 99%

The Adverse Effects of Air Pollution on the Eye: A Review

Lin

Chiu

Lee

et al. 2022

IJERPH

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Air pollution is inevitably the result of human civilization, industrialization, and globalization. It is composed of a mixture of gases and particles at harmful levels. Particulate matter (PM), nitrogen oxides (NOx), and carbon dioxides (CO2) are mainly generated from vehicle emissions and fuel consumption and are the main materials causing outdoor air pollution. Exposure to polluted outdoor air has been proven to be harmful to human eyes. On the other hand, indoor air pollution from environmental tobacco smoking, heating, cooking, or poor indoor ventilation is also related to several eye diseases, including conjunctivitis, glaucoma, cataracts, and age-related macular degeneration (AMD). In the past 30 years, no updated review has provided an overview of the impact of air pollution on the eye. We reviewed reports on air pollution and eye diseases in the last three decades in the PubMed database, Medline databases, and Google Scholar and discussed the effect of various outdoor and indoor pollutants on human eyes.

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Section: Outdoor Air Pollutionmentioning

confidence: 99%

The Adverse Effects of Air Pollution on the Eye: A Review

Lin

Chiu

Lee

et al. 2022

IJERPH

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“…In the Global Study, longer DM duration, higher HbA1c levels, and higher blood pressure have been recognized as key risk factors for DR in people with DM. Some studies showed that dyslipidemia; age of onset of diabetes; faster heart rate; higher blood urea nitrogen; elevated serum creatinine level, creatinine clearance rate, and uric acid; and long-term exposure to fine particulate matter (PM2.5) were risk factors for DR. 16,[32][33][34][35][36] Other systemic and lifestyle factors, including obesity, alcohol consumption, markers of anemia, hypothyroidism, and inflammation or endothelial dysfunction are associated with the increased risk of DR among diabetic patients. [37][38][39][40][41] This study confirmed that poor glycemic control and longer duration of DM are commonly accepted risk factors for DR.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence and Risk Factors of Diabetic Retinopathy: Screening and Prophylaxis Project in 6 Provinces of China

Liu¹,

Hu²,

Qiu³

et al. 2022

DMSO

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Purpose To investigate the prevalence and associated factors of diabetic retinopathy (DR) and advanced DR in Chinese adults with diabetes mellitus (DM). Patients and Methods A cross-sectional study was performed on 4831 diabetic patients from 24 hospitals from April 2018 to July 2020. Non-mydriatic fundus of patients were interpreted by an artificial intelligence (AI) system. Fundus photos that were unsuitable for AI interpretation were interpreted by two ophthalmologists trained by one expert ophthalmologist at Beijing Tongren Hospital. Medical history, height, weight, body mass index (BMI), glycosylated hemoglobin (HbA1c), blood pressure, and laboratory examinations were recorded. Results A total of 4831 DM patients were included in this study. The prevalence of DR and advanced DR in the diabetic population was 31.8% and 6.6%, respectively. In multiple logistic regression analysis, male (odds ratio [OR], 1.39), duration of diabetes (OR, 1.05), HbA1c (OR, 1.11), farmer (OR, 1.39), insulin treatment (OR, 1.61), region (northern, OR, 1.78; rural, OR, 6.96), and presence of other diabetic complications (OR: 2.03) were associated with increased odds of DR. The factors associated with increased odds of advanced DR included poor glycemic control (HbA1c >7.0%) (OR, 2.58), insulin treatment (OR, 1.73), longer duration of diabetes (OR, 3.66), rural region (OR, 4.84), and presence of other diabetic complications (OR, 2.36), but overweight (BMI > 25 kg/m 2 ) (OR, 0.61) was associated with reduced odds of advanced DR. Conclusion This study shows that the prevalence of DR is very high in Chinese adults with DM, highlighting the necessity of early diabetic retinal screening.

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“…Shan et al reported an adjusted OR of 1.41 (95% CI 1.27, 1.57) for diabetic retinopathy for each 10 μg/m 3 increase in PM 2.5 , using data from a national crosssectional survey conducted in rural China. 8 Pan et al used data from a retrospective nested case-control study in Chinese Taiwan and found that among participants with diabetes, the odds ratio (OR) (95% CI) of diabetic retinopathy for each 10 μg/m 3 increase in PM 2.5 and PM 2.5−10 was 1.29 (1.11, 1.50) and 1.37 (1.17, 1.61), respectively. 9 The above studies, however, may not be directly comparable with our nonsignificant results.…”

Section: ■ Discussionmentioning

confidence: 99%

“…7 Despite this, epidemiological studies investigating the association between air pollutants and risk of microvascular disease are limited. Existing evidence, however, has been mainly focused on specific microvascular disease such as retinopathy, 8,9 peripheral neuropathy, 10 or chronic kidney disease, 11−13 or is restricted to a particularly high-risk population (e.g., patients with diabetes). 8,9 Thus, the associations of various air pollutants with risk of overall microvascular disease among the general population are far from being fully elucidated.…”

Section: ■ Introductionmentioning

confidence: 99%

“…Despite this, epidemiological studies investigating the association between air pollutants and risk of microvascular disease are limited. Existing evidence, however, has been mainly focused on specific microvascular disease such as retinopathy, , peripheral neuropathy, or chronic kidney disease, − or is restricted to a particularly high-risk population (e.g., patients with diabetes). , Thus, the associations of various air pollutants with risk of overall microvascular disease among the general population are far from being fully elucidated. Moreover, ambient air pollution is complex with various compositions, while many current studies, however, investigating the links between air pollution and the risk of adverse outcomes reported single air pollutant only (e.g., PM 2.5 ); − and very few prospective cohort studies have simultaneously explored multiple air pollutants in relation to the risk of microvascular disease.…”

Section: Introductionmentioning

confidence: 99%

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Ambient Air Pollutants and Incident Microvascular Disease: A Cohort Study

Zhu

Liao

et al. 2022

Environ. Sci. Technol.

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Little is known about the links between long-term exposure to air pollution and risk of incident microvascular disease (retinopathy, peripheral neuropathy, and chronic kidney disease). This study included 396 014 UK residents free of microvascular disease and macrovascular disease at baseline. Annual means of PM 2.5 , PM 2.5−10 , PM 10 , NO 2 , and NO x were assessed by land use regression models for each participant. A weighted air pollution score was generated from PM 10 and NO x . Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During a median follow-up of 11.7 years, 14 327 composite microvascular disease occurred. While none of the air pollutants showed any statistically significant association with the risk of retinopathy, all the air pollutants were linked to the risk of peripheral neuropathy and chronic kidney disease. The adjusted-HRs (95% CIs) for each interquartile range increase in air pollution score were 1.07 (1.05, 1.09), 1.01 (0.94, 1.07), 1.13 (1.08, 1.19), and 1.07 (1.05, 1.10) for overall microvascular disease, retinopathy, peripheral neuropathy, and chronic kidney disease, respectively. In conclusion, long-term exposure to overall air pollution was associated with higher risks of peripheral neuropathy and chronic kidney disease among the general UK population.

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Association between long-term exposure to fine particulate matter and diabetic retinopathy among diabetic patients: A national cross-sectional study in China

Cited by 30 publications

References 53 publications

The Adverse Effects of Air Pollution on the Eye: A Review

The Adverse Effects of Air Pollution on the Eye: A Review

The Prevalence and Risk Factors of Diabetic Retinopathy: Screening and Prophylaxis Project in 6 Provinces of China

Ambient Air Pollutants and Incident Microvascular Disease: A Cohort Study

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