TY - JOUR
T1 - The association between air pollution and type 2 diabetes in a large cross-sectional study in Leicester
T2 - The CHAMPIONS Study
AU - O'Donovan, Gary
AU - Chudasama, Yogini
AU - Grocock, Samuel
AU - Leigh, Roland
AU - Dalton, Alice M.
AU - Gray, Laura J.
AU - Yates, Thomas
AU - Edwardson, Charlotte
AU - Hill, Sian
AU - Henson, Joe
AU - Webb, David
AU - Khunti, Kamlesh
AU - Davies, Melanie J.
AU - Jones, Andrew P.
AU - Bodicoat, Danielle H.
AU - Wells, Alan
N1 - Funding Information:
GOD, YC, DHB, LJG, TY, CE, SH, JH, DRW, KK and MJD acknowledge support from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care – East Midlands (NIHR CLAHRC – EM), Leicester Clinical Trials Unit, and the NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, which is a partnership between University Hospitals of Leicester NHS Trust, Loughborough University and the University of Leicester. AW acknowledges support provided by the Satellite Applications Catapult Regional Centre of Excellence-EMBRACE. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. No funding was sought for the present analysis. The ADDITION-Leicester study was funded for support and treatment costs by NHS Department of Health Support for Science and project grants. The Let's Prevent Diabetes study was funded by a National Institute for Health Research Programme Grant (RP-PG-0606-1272). The Walking Away from Diabetes study was supported by funding from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Leicestershire, Northamptonshire and Rutland (LNR CLRN 10343). The funders of these studies had no role in the collection, analysis or interpretation of the data, in the writing of the paper, or in the decision to submit the article for publication.
Publisher Copyright:
© 2017 Elsevier Ltd
PY - 2017
Y1 - 2017
N2 - Background Observational evidence suggests there is an association between air pollution and type 2 diabetes; however, there is high risk of bias. Objective To investigate the association between air pollution and type 2 diabetes, while reducing bias due to exposure assessment, outcome assessment, and confounder assessment. Methods Data were collected from 10,443 participants in three diabetes screening studies in Leicestershire, UK. Exposure assessment included standard, prevailing estimates of outdoor nitrogen dioxide and particulate matter concentrations in a 1 × 1 km area at the participant's home postcode. Three-year exposure was investigated in the primary analysis and one-year exposure in a sensitivity analysis. Outcome assessment included the oral glucose tolerance test for type 2 diabetes. Confounder assessment included demographic factors (age, sex, ethnicity, smoking, area social deprivation, urban or rural location), lifestyle factors (body mass index and physical activity), and neighbourhood green space. Results Nitrogen dioxide and particulate matter concentrations were associated with type 2 diabetes in unadjusted models. There was no statistically significant association between nitrogen dioxide concentration and type 2 diabetes after adjustment for demographic factors (odds: 1.08; 95% CI: 0.91, 1.29). The odds of type 2 diabetes was 1.10 (95% CI: 0.92, 1.32) after further adjustment for lifestyle factors and 0.91 (95% CI: 0.72, 1.16) after yet further adjustment for neighbourhood green space. The associations between particulate matter concentrations and type 2 diabetes were also explained away by demographic factors. There was no evidence of exposure definition bias. Conclusions Demographic factors seemed to explain the association between air pollution and type 2 diabetes in this cross-sectional study. High-quality longitudinal studies are needed to improve our understanding of the association.
AB - Background Observational evidence suggests there is an association between air pollution and type 2 diabetes; however, there is high risk of bias. Objective To investigate the association between air pollution and type 2 diabetes, while reducing bias due to exposure assessment, outcome assessment, and confounder assessment. Methods Data were collected from 10,443 participants in three diabetes screening studies in Leicestershire, UK. Exposure assessment included standard, prevailing estimates of outdoor nitrogen dioxide and particulate matter concentrations in a 1 × 1 km area at the participant's home postcode. Three-year exposure was investigated in the primary analysis and one-year exposure in a sensitivity analysis. Outcome assessment included the oral glucose tolerance test for type 2 diabetes. Confounder assessment included demographic factors (age, sex, ethnicity, smoking, area social deprivation, urban or rural location), lifestyle factors (body mass index and physical activity), and neighbourhood green space. Results Nitrogen dioxide and particulate matter concentrations were associated with type 2 diabetes in unadjusted models. There was no statistically significant association between nitrogen dioxide concentration and type 2 diabetes after adjustment for demographic factors (odds: 1.08; 95% CI: 0.91, 1.29). The odds of type 2 diabetes was 1.10 (95% CI: 0.92, 1.32) after further adjustment for lifestyle factors and 0.91 (95% CI: 0.72, 1.16) after yet further adjustment for neighbourhood green space. The associations between particulate matter concentrations and type 2 diabetes were also explained away by demographic factors. There was no evidence of exposure definition bias. Conclusions Demographic factors seemed to explain the association between air pollution and type 2 diabetes in this cross-sectional study. High-quality longitudinal studies are needed to improve our understanding of the association.
KW - Air pollutants
KW - Cross-sectional studies
KW - Diabetes mellitus, type 2
UR - http://www.scopus.com/inward/record.url?scp=85017402355&partnerID=8YFLogxK
U2 - 10.1016/j.envint.2017.03.027
DO - 10.1016/j.envint.2017.03.027
M3 - Article
C2 - 28411585
AN - SCOPUS:85017402355
SN - 0160-4120
VL - 104
SP - 41
EP - 47
JO - Environment International
JF - Environment International
ER -
