Impacts of ambient air pollution on glucose metabolism in Korean adults: a Korea National Health and Nutrition Examination Survey study

Abstract

Background: Exposure to air pollution was reported to affect glucose metabolism, increasing the risk of diabetes mellitus. We conducted an epidemiological study on glucose metabolism and air pollution by exploring the levels of fasting blood glucose (FBG) and hemoglobin A1c (HbA1c) with changes in ambient air quality, depending on the characteristics of the susceptible population. Methods: We carried out a cross-sectional analysis of a nationally representative sample of 10,014 adults (4267 in male and 5747 in female) from the Korea National Health and Nutrition Examination Survey in 2012 and 2013 along with data from the Korean Air Quality Forecasting System. The analysis was performed using a generalized linear model stratified by sex, age, and presence of diabetes. We assessed the changes in FBG and HbA1c associated with exposures to particulate matter (PM 10), fine particulate matter (PM 2.5), and nitrogen dioxide (NO 2) after controlling for confounders. Results: There were 1110 participants with diabetes (557 in male and 553 in female). Overall, the FBG level increased by 7.83 mg/dL (95% confidence interval [CI]: 2.80-12.87) per interquartile range (IQR) increment of NO 2 , 5.32 mg/dL (95% CI: 1.22-9.41) per IQR increment of PM 10 at a moving average of 0-6 days, and 4.69 mg/dL (95% CI: 0.48-8.91) per IQR increment of PM 2.5 at a moving average of 0-5 days. HbA1c increased by 0.57% (95% CI: 0.04-1.09) per IQR increment of PM 10 at a moving average of 0-60 days and 0.34% (95% CI: 0.04-0.63) per IQR increment of PM 2.5 at a moving average of 0-75 days. The change in FBG and HbA1c increased more in the diabetic group, especially in males aged 65 years or more. There was a strong association between elevation in diabetes-related parameters and exposure to air pollution. Conclusions: Our study provides scientific evidence supporting that short-and mid-term exposure to air pollution is associated with changes in biological markers related to diabetes. This finding suggests that the impact of air pollution should be reflected in chronic disease management when establishing local health care policies.

PM2.5 and Diabetes in the Japanese Population

“…We found that the strongest effect estimates occurred at a time point of about five years. We also observed that FPG had a stronger effect estimate at earlier time points than HbA 1c , which is consistent with a previous study in which FPG showed a stronger association than HbA 1c in early exposure time windows [ 21 ]. HbA 1c represents the plasma glucose levels and effects thereon occurring within a few months of exposure, while FPG does the same within a much shorter time frame, e.g., a change in diet can decrease the plasma glucose level in a short period.…”

Acute Effect of Particulate Matter Pollution on Hospital Admissions for Stroke among Patients with type 2 Diabetes in Beijing, China, from 2014 to 2018

“…Hwang and colleagues demonstrated that the sex-speci c effects could be explained by biological differences as well as differences in social exposures (Hwang et al, 2020). Generally, lung size, gas-blood barrier permeability and in ammation all vary by sex.…”

Effects of exposure to ambient air pollution on pulmonary function impairment in Korea: the 2007-2017 Korea National Health and Nutritional Examination Survey

“…There are no specific air pollution data at the city or district level because of the limited number of air-quality monitoring stations. Thus, to estimate air pollution data of the administrative districts in Korea, we used a prediction model based on data from the Korean Air Quality Forecasting System (KAQFS) [ 13 ]. The KAQFS included the Sparse Matrix Operator Kernel Emissions version 2.7 and Community Multiscale Air Quality version 4.7.1, which used emission inventories, including the Multi-Resolution Emission Inventory for China, Regional Emission Inventory in Asia, and Clean Air Policy Support System [ 14 ].…”