The few cohort studies that have investigated the association between exposure to air pollution and occurrence of diabetes have reported conflicting results. We aimed to evaluate the association of long-term exposure to particulate matter (PM), nitrogen oxides (NO_x) and ozone (O₃), with baseline prevalence and incidence of type 2 diabetes in a large administrative cohort in Rome, Italy. A total of 1,425,580 subjects aged 35 + years (January 1st, 2008) were assessed and followed for six years. We estimated PM₁₀, PM_2.5–10, PM_2.5, NO₂, and NO_x exposures at residence using land use regression models, and summer O₃ exposure using dispersion modeling. To estimate the association between air pollutant exposures and prevalence and incidence of diabetes, we used logistic and Cox regression models, considering individual, environmental (noise and green areas), and contextual characteristics. We identified 106,387 prevalent cases at baseline and 65,955 incident cases during the follow-up period. We found positive associations between nitrogen oxides exposures and prevalence of diabetes with odds ratios (ORs) up to 1.010 (95% CI: 1.002, 1.017) and 1.015 (1.009, 1.021) for NO₂ and NOx, respectively, per fixed increases (per 10 μg/m³ and 20 μg/m³, respectively). We also found some evidence of an association between NOx and O₃ and incidence of diabetes, with hazard ratios (HRs) of 1.011 (95%CI: 1.003–1.019) and 1.015 (1.002–1.027) per 20 and 10 μg/m³ increases, respectively. The association with O₃ with incident diabetes was stronger in women than in men and among those aged < 50 years. In sum, long-term exposure to nitrogen oxides was associated with prevalent diabetes while NOx and O₃ exposures were associated with incident diabetes.

少数研究空气污染与糖尿病发生之间关系的队列研究报告了相互矛盾的结果。我们旨在评估长期接触颗粒物（PM），氮氧化物（NO _x）和臭氧（O ₃）与基线流行率和意大利罗马一个大型行政队列中2型糖尿病发生率的相关性。评估了35岁以上（2008年1月1日）的1,425,580名受试者，并对其进行了为期6年的随访。我们使用土地利用回归模型和夏季O ₃估算了居民处的PM ₁₀，PM _2.5-10，PM _2.5，NO ₂和NO _x暴露量使用色散建模进行曝光。为了估计空气污染物暴露与糖尿病患病率和发病率之间的关联，我们使用了逻辑和Cox回归模型，并考虑了个体，环境（噪声和绿色区域）和背景特征。我们在基线期间确定了106,387例流行病例，在随访期间发现了65,955例事件病例。我们发现氮氧化物暴露与糖尿病患病率之间呈正相关，每固定增加（每增加一次），NO ₂和NOx的比值比（OR）分别高达1.010（95％CI：1.002，1.017）和1.015（1.009，1.021）。分别为10μg/ m ³和20μg/ m ³）。我们还发现了一些证据表明NOx和O ₃之间存在关联和糖尿病的发病率，每20和10μg/ m ^3的危险比（HRs）分别增加1.011（95％CI：1.003-1.019）和1.015（1.002-1.027）。女性和O 50岁以下人群中O ₃与糖尿病的关联性强于男性。总而言之，长期暴露于氮氧化物与流行的糖尿病有关，而NOx和O ₃暴露与发生糖尿病有关。