BACKGROUND Air pollution has been related to incidence of type 2 diabetes (T2D). We assessed the joint association of various air pollutants with the risk of T2D and examined potential modification by obesity status and genetic susceptibility on the relationship. METHODS AND FINDINGS A total of 449,006 participants from UK Biobank free of T2D at baseline were included. Of all the study population, 90.9% were white and 45.7% were male. The participants had a mean age of 56.6 (SD 8.1) years old and a mean body mass index (BMI) of 27.4 (SD 4.8) kg/m2. Ambient air pollutants, including particulate matter (PM) with diameters ≤2.5 μm (PM2.5), between 2.5 μm and 10 μm (PM2.5-10), nitrogen dioxide (NO2), and nitric oxide (NO) were measured. An air pollution score was created to assess the joint exposure to the 4 air pollutants. During a median of 11 years follow-up, we documented 18,239 incident T2D cases. The air pollution score was significantly associated with a higher risk of T2D. Compared to the lowest quintile of air pollution score, the hazard ratio (HR) (95% confidence interval [CI]) for T2D was 1.05 (0.99 to 1.10, p = 0.11), 1.06 (1.00 to 1.11, p = 0.051), 1.09 (1.03 to 1.15, p = 0.002), and 1.12 (1.06 to 1.19, p < 0.001) for the second to fifth quintile, respectively, after adjustment for sociodemographic characteristics, lifestyle factors, genetic factors, and other covariates. In addition, we found a significant interaction between the air pollution score and obesity status on the risk of T2D (p-interaction < 0.001). The observed association was more pronounced among overweight and obese participants than in the normal-weight people. Genetic risk score (GRS) for T2D or obesity did not modify the relationship between air pollution and risk of T2D. Key study limitations include unavailable data on other potential T2D-related air pollutants and single-time measurement on air pollutants. CONCLUSIONS We found that various air pollutants PM2.5, PM2.5-10, NO2, and NO, individually or jointly, were associated with an increased risk of T2D in the population. The stratified analyses indicate that such associations were more strongly associated with T2D risk among those with higher adiposity.

中文翻译：

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肥胖和联合暴露于环境空气污染物与事件 2 型糖尿病之间的关系：英国生物银行的一项队列研究。

背景空气污染与 2 型糖尿病 (T2D) 的发病率有关。我们评估了各种空气污染物与 T2D 风险的联合关联，并检查了肥胖状况和遗传易感性对这种关系的潜在影响。方法和结果 共有来自英国生物库的 449,006 名基线时没有 T2D 的参与者被纳入研究。在所有研究人群中，90.9% 为白人，45.7% 为男性。参与者的平均年龄为 56.6 (SD 8.1) 岁，平均体重指数 (BMI) 为 27.4 (SD 4.8) kg/m2。测量了环境空气污染物，包括直径≤2.5 μm (PM2.5)、2.5 μm 至 10 μm (PM2.5-10)、二氧化氮 (NO2) 和一氧化氮 (NO) 的颗粒物 (PM)。创建了一个空气污染评分来评估对 4 种空气污染物的联合暴露。在 11 年的中位随访期间，我们记录了 18,239 例 T2D 病例。空气污染评分与较高的 T2D 风险显着相关。与空气污染评分最低的五分之一相比，T2D 的风险比 (HR)（95% 置信区间 [CI]）为 1.05（0.99 至 1.10，p = 0.11）、1.06（1.00 至 1.11，p = 0.051），在调整社会人口学特征、生活方式因素、遗传因素和其他协变量后，第二至第五五分位数分别为 1.09（1.03 至 1.15，p = 0.002）和 1.12（1.06 至 1.19，p < 0.001）。此外，我们发现空气污染评分和肥胖状态对 T2D 风险之间存在显着的交互作用（p-交互作用 < 0.001）。观察到的关联在超重和肥胖的参与者中比在正常体重的人中更明显。T2D 或肥胖的遗传风险评分 (GRS) 并未改变空气污染与 T2D 风险之间的关系。主要研究限制包括其他潜在的 T2D 相关空气污染物的数据不可用和空气污染物的单次测量。结论 我们发现，各种空气污染物 PM2.5、PM2.5-10、NO2 和 NO 单独或共同与人群中 T2D 风险增加相关。分层分析表明，在肥胖程度较高的人群中，这种关联与 T2D 风险的相关性更强。5-10、NO2 和 NO 单独或共同与人群中 T2D 风险增加相关。分层分析表明，在肥胖程度较高的人群中，这种关联与 T2D 风险的相关性更强。5-10、NO2 和 NO 单独或共同与人群中 T2D 风险增加相关。分层分析表明，在肥胖程度较高的人群中，这种关联与 T2D 风险的相关性更强。