Seong Rae Kim1, Daein Choi2, Seulggie Choi3, Kyuwoong Kim4, Gyeongsil Lee5, Joung Sik Son5, Kyae Hyung Kim6, Sang Min Park7. 1. Department of Medicine, Seoul National University College of Medicine, Seoul, South Korea. 2. Department of Medicine, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, NY, USA; Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea. 3. Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea. 4. National Cancer Control Institute, National Cancer Center, Goyang, South Korea. 5. Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. 6. Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea; Institute for Public Health and Medical Service, Seoul National University Hospital, Seoul, South Korea. 7. Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea; Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: smpark.snuh@gmail.com.
Abstract
BACKGROUND: Physical activity (PA), especially outdoor PA, may have twofold effects on diabetes risk: the health benefits of PA and the potential detrimental effects caused by augmented exposure to air pollution. We examined the association of combined effects of PA and air pollution with diabetes in older adults. METHODS: The study participants consisted of 1,259,871 older adults aged 58 years or more from the Korean National Health Insurance Service database. The exposure to air pollution was estimated by the average ambient levels of particulate matter (PM) of the participants' residence area. Cox proportional hazards models were used to evaluate the adjusted hazard ratios and 95% confidence intervals of developing diabetes according to the combined effect of moderate to vigorous physical activity (MVPA) and air pollution exposure. RESULTS: Engaging in 5 or more times of MVPA/week was associated with decreased risk of diabetes within groups with both high and low/moderate levels of exposure to PM10 (low/moderate PM10 aHR 0.91, 95% CI 0.89-0.93; high PM10 aHR 0.97, 95% CI 0.94-0.99) or PM2.5 (low/moderate PM2.5 aHR 0.88, 95% CI 0.85-0.90; high PM10 aHR 0.95, 95% CI 0.91-0.99) exposure. The risk-reducing effects upon MVPA tended to be slightly attenuated, which showed the reverse J-shaped association, but still significant, among those who were exposed to a high level of air pollution. The association was consistent among stratified analyses according to the possible confounders. CONCLUSION: MVPA may be inversely associated with the risk of diabetes development within groups with both high and low/moderate levels of exposure to PM10 or PM2.5 in older adults. Future studies are necessary to validate whether the positive health effects of MVPA outweigh the potential detrimental effects due to augmented exposure to air pollution during MVPA.
BACKGROUND: Physical activity (PA), especially outdoor PA, may have twofold effects on diabetes risk: the health benefits of PA and the potential detrimental effects caused by augmented exposure to air pollution. We examined the association of combined effects of PA and air pollution with diabetes in older adults. METHODS: The study participants consisted of 1,259,871 older adults aged 58 years or more from the Korean National Health Insurance Service database. The exposure to air pollution was estimated by the average ambient levels of particulate matter (PM) of the participants' residence area. Cox proportional hazards models were used to evaluate the adjusted hazard ratios and 95% confidence intervals of developing diabetes according to the combined effect of moderate to vigorous physical activity (MVPA) and air pollution exposure. RESULTS: Engaging in 5 or more times of MVPA/week was associated with decreased risk of diabetes within groups with both high and low/moderate levels of exposure to PM10 (low/moderate PM10 aHR 0.91, 95% CI 0.89-0.93; high PM10 aHR 0.97, 95% CI 0.94-0.99) or PM2.5 (low/moderate PM2.5 aHR 0.88, 95% CI 0.85-0.90; high PM10 aHR 0.95, 95% CI 0.91-0.99) exposure. The risk-reducing effects upon MVPA tended to be slightly attenuated, which showed the reverse J-shaped association, but still significant, among those who were exposed to a high level of air pollution. The association was consistent among stratified analyses according to the possible confounders. CONCLUSION: MVPA may be inversely associated with the risk of diabetes development within groups with both high and low/moderate levels of exposure to PM10 or PM2.5 in older adults. Future studies are necessary to validate whether the positive health effects of MVPA outweigh the potential detrimental effects due to augmented exposure to air pollution during MVPA.
Authors: In Young Hwang; Daein Choi; Jihoon Andrew Kim; Seulggie Choi; Jooyoung Chang; Ae Jin Goo; Ahryoung Ko; Gyeongsil Lee; Kyae Hyung Kim; Joung Sik Son; Sang Min Park Journal: Sci Rep Date: 2022-05-19 Impact factor: 4.996