Particulate matter pollutants and risk of type 2 diabetes: a time for concern?

Abstract

The World Health Organization estimates that worldwide in 2012 around 7 million deaths occurred prematurely due to air pollution, which is now the world's largest single environmental health risk. The higher premature mortality associated with air pollution is due to exposure to small particulate matter of 10 microns (PM10) or less in diameter. Exposure to air pollution has also been suggested as a contributing to diabetes incidence and progression. There are a number of possible biological pathways linking air pollutants to diabetes, including endothelial dysfunction, dysregulation of the visceral adipose tissue through inflammation, hepatic insulin resistance, elevated hemoglobin A1c level, elevated blood pressure, and alterations in autonomic tone, which may increase insulin resistance. The risk of future diabetes associated with exposure to 10 μg/m(3) increase of PM2.5 has been quantified in the range of 10 to 27%; the risk of diabetes mortality associated with PM2.5 appears to be quite lower, around 1% for each increment exposure of 10 μg/m(3) of both PM2.5 and PM10. Limitations of the current epidemiological evidence include the complex mixture of pollutants, the different design of the studies, the limited data available for non Western populations, and the lack of demonstration that improvement of air quality is associated with a decrease incidence of type 2 diabetes. Although the most sources of outdoor air pollution are well beyond the control of individuals, people should be informed that there are means to reduce the burden of air pollutants on diabetes risk, including avoidance of passive smoking, adoption of an healthy diet, and increasing leisure-time physical activity.

Association of Long-Term Near-Highway Exposure to Ultrafine Particles with Cardiovascular Diseases, Diabetes and Hypertension

“…It has been postulated that PM could contribute to diabetes through various pathways including immune activation, the adipose system, hepatic effects and acting on the central nerve system [9,10,11,19,20,21,22]. Nevertheless, there are very few studies testing associations between UFP and diabetes.…”

“…Ultrafine particles (UFP), airborne particles with an aerodynamic diameter <0.1 micron [5], could also plausibly affect cardiovascular health due to their small size and large surface area [6]. Nevertheless, despite evidence regarding associations of PM 2.5 with hypertension [7,8] and diabetes [9,10,11], a limited number of studies have investigated the long-term effects of UFP on cardiovascular risks and clinical outcomes. A longitudinal study recently found an association between long-term exposure to neighborhood-scale (1 × 1 km resolution) UFP exposure and inflammatory and coagulation markers [12].…”

Particulate Air Pollution and Fasting Blood Glucose in Nondiabetic Individuals: Associations and Epigenetic Mediation in the Normative Aging Study, 2000–2011

“…FBG variations in this range are often underappreciated and their potential determinants, especially those not directly related to lifestyle, are understudied. Ambient particulate matter (PM) pollution has recently been suggested as an emerging risk factor for metabolic disorders including impaired glucose regulation (Esposito et al 2016; Rajagopalan and Brook 2012). Cross-sectional and longitudinal studies have revealed that PM is associated with increased risk of diabetes (Andersen et al 2012; Brook et al 2008; Puett et al 2011) and with higher levels of markers of insulin resistance (Kelishadi et al 2009).…”

Particulate Matter Exposure During Perinatal Life Results in Impaired Glucose Metabolism in Adult Male Rat Offspring

“…The most common diseases related to air pollution are those that compromise airways, such as pulmonary deficiency, asthma and changes in lung function [1,2]. Nevertheless, recent studies have reported an association between diabetes and air pollution [3,4].…”