Background

The prevalence of diabetes is on rise worldwide and environmental factors are being increasingly recognized to be involved in this rise. An emerging body of evidence has evaluated the impact of long-term exposure to noise on diabetes mellitus, highlighting the need to synthesize this evidence.

Objectives

To systematically review and conduct meta-analysis of the available evidence on the association between long-term exposure to transport and occupational noise exposure and diabetes mellitus.

Methods

Selected databases were searched for available evidence published till September 13th, 2017 following MOOSE guidelines. The quality of articles was assessed using the Newcastle–Ottawa Scale. Random effects meta-analysis was applied to abstract combined estimates for diabetes mellitus per 5 dB increase in noise exposure. We evaluated the heterogeneity applying Cochran's Q test and quantified it using I² statistic. Meta-regressions were conducted to identify sources of heterogeneity. Publication bias was evaluated using funnel plot and Egger's test.

Results

Fifteen studies met our inclusion criteria of which nine including five prospective cohorts, two cross-sectional and two case-control studies with a total number of 444460 adult participants and 17430 diabetes mellitus cases included in meta-analyses. We observed a 6% (95% confidence interval (CI): 3%, 9%) increase in the risk of diabetes mellitus per 5 dB increase in noise exposure regardless of its source. Source-specific analyses were suggestive for stronger associations for air traffic noise (combined odds ratio: 1.17; 95% CI: 1.06, 1.29 per 5 dB increase in exposure) flowed by road traffic noise (combined odds ratio: 1.07; 95% CI: 1.02, 1.12). We observed some indications of publication bias; however the findings were robust after trim and fill test. Meta-regression analyses showed that the adjustment in general, and not specifically related to air pollution, could predict the between-study heterogeneity in reported associations.

Conclusions

The results indicate an increased risk of diabetes mellitus associated with noise exposure, mainly related to air and road traffic.

中文翻译：

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噪声暴露与糖尿病之间的关联：系统评价和荟萃分析

背景

在世界范围内，糖尿病的患病率正在上升，并且越来越多的环境因素被认为与糖尿病的发生有关。越来越多的证据已经评估了长期暴露于噪声对糖尿病的影响，强调了综合这一证据的必要性。

目标

要系统地审查和进行关于长期接触运输和职业噪声与糖尿病之间的联系的现有证据的荟萃分析。

方法

根据MOOSE指南，搜索选定的数据库以获取直到2017年9月13日发布的可用证据。文章的质量使用纽卡斯尔-渥太华量表进行评估。随机效应荟萃分析被用于对噪声暴露每增加5 dB的糖尿病进行综合评估。我们使用Cochran's Q检验评估了异质性，并使用I ²统计量对其进行了量化。进行了元回归来确定异质性的来源。使用漏斗图和Egger检验评估出版偏倚。

结果

15项研究符合我们的纳入标准，其中9项包括5个前瞻性队列研究，2项横断面研究和2例病例对照研究，荟萃分析包括总共444460名成年参与者和17430例糖尿病病例。我们观察到，不论噪声源如何，每增加5 dB的噪声暴露，糖尿病的风险就会增加6％（95％置信区间（CI）：3％，9％）。特定于源的分析表明，道路交通噪声（综合优势比：1.07; 95％CI :)与空中交通噪声（综合比值比：1.17; 95％CI：1.06，每增加5 dB暴露增加1.29）有更强的关联性。 1.02、1.12）。我们观察到了一些出版物偏见的迹象；但是，修整和填充测试后的发现是可靠的。荟萃回归分析表明，调整总体上来说，

结论

结果表明，与噪音接触相关的糖尿病风险增加，主要与空中和道路交通有关。