Qingli Zhang1, Cong Liu1, Yafeng Wang2, Jinquan Gong2, Gewei Wang2, Wenzhen Ge3, Renjie Chen4, Xia Meng5, Yaohui Zhao6, Haidong Kan1. 1. School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China. 2. Institute of Social Surveys, Peking University, Beijing, China. 3. Regeneron Pharmaceuticals Inc., New York, 10591, USA. 4. School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China; Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, 200030, China. Electronic address: chenrenjie@fudan.edu.cn. 5. School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China; Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, 200030, China. Electronic address: mengxia@fudan.edu.cn. 6. National School of Development, Peking University, Beijing, China.
Abstract
BACKGROUND: The associations between ambient NO2 and diabetes and dyslipidemia have been controversial, and data is especially lacking in developing countries. OBJECTIVE: This study aimed to assess the associations of long-term exposure to NO2 with diabetes and dyslipidemia in China. METHODS: We conducted a cross-sectional study including 13,013 participants from the China Health and Retirement Longitudinal Study (CHRLS). The annual average concentrations of NO2 were estimated based on the residential addresses of participants. We applied logistic regression models to evaluate the associations of NO2 with diabetes and dyslipidemia, and linear regression models to assess the associations with blood biomarkers. RESULTS: A total of 1933 diabetes cases (14.85%) and 1935 (14.87%) dyslipidemia cases were identified. Significant associations were observed between NO2 and risk of diabetes and dyslipidemia independent of PM2.5 and O3. For an interquartile range (IQR) increase in NO2 (12.39 μg/m3), we observed a 13% [odds ratio (OR): 1.13; 95% confidence interval (CI): 1.01, 1.26] increased risk of diabetes, 1.48% (95%CI: 0.51%, 2.46%) increase in glucose, 0.74% (95%CI: 0.19%, 1.29%) increase in glycosylated hemoglobin (HbA1c), 17% (OR: 1.17; 95% CI: 1.05, 1.31) increased risk of dyslipidemia, 4.62% (95%CI: 2.49%, 6.79%) increase in triglyceride, and a decrease of 2.96% (95%CI: 2.13%, 3.79%) in high-density lipoprotein. The associations of NO2 with glucose disorders were stronger among smokers. CONCLUSIONS: Our study indicated long-term exposure to NO2 might contribute to the development of diabetes and dyslipidemia, and the associations were potentially independent of O3 and PM2.5.
BACKGROUND: The associations between ambient NO2 and diabetes and dyslipidemia have been controversial, and data is especially lacking in developing countries. OBJECTIVE: This study aimed to assess the associations of long-term exposure to NO2 with diabetes and dyslipidemia in China. METHODS: We conducted a cross-sectional study including 13,013 participants from the China Health and Retirement Longitudinal Study (CHRLS). The annual average concentrations of NO2 were estimated based on the residential addresses of participants. We applied logistic regression models to evaluate the associations of NO2 with diabetes and dyslipidemia, and linear regression models to assess the associations with blood biomarkers. RESULTS: A total of 1933 diabetes cases (14.85%) and 1935 (14.87%) dyslipidemia cases were identified. Significant associations were observed between NO2 and risk of diabetes and dyslipidemia independent of PM2.5 and O3. For an interquartile range (IQR) increase in NO2 (12.39 μg/m3), we observed a 13% [odds ratio (OR): 1.13; 95% confidence interval (CI): 1.01, 1.26] increased risk of diabetes, 1.48% (95%CI: 0.51%, 2.46%) increase in glucose, 0.74% (95%CI: 0.19%, 1.29%) increase in glycosylated hemoglobin (HbA1c), 17% (OR: 1.17; 95% CI: 1.05, 1.31) increased risk of dyslipidemia, 4.62% (95%CI: 2.49%, 6.79%) increase in triglyceride, and a decrease of 2.96% (95%CI: 2.13%, 3.79%) in high-density lipoprotein. The associations of NO2 with glucose disorders were stronger among smokers. CONCLUSIONS: Our study indicated long-term exposure to NO2 might contribute to the development of diabetes and dyslipidemia, and the associations were potentially independent of O3 and PM2.5.
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