TY - JOUR
T1 - Diabetes incidence and long-term exposure to air pollution: a cohort study
AU - Andersen, Zorana Jovanovic
AU - Raaschou-Nielsen, Ole
AU - Ketzel, Matthias
AU - Jensen, Steen S
AU - Hvidberg, Martin
AU - Loft, Steffen
AU - Tjønneland, Anne
AU - Overvad, Kim
AU - Sørensen, Mette
PY - 2012/1
Y1 - 2012/1
N2 - OBJECTIVE - Animal and cross-sectional epidemiological studies suggest a link between air pollution and diabetes, whereas the limited prospective data show mixed results. We studied the association between long-term exposure to traffic-related air pollution and incidence of diabetes. RESEARCH DESIGN AND METHODS - We followed 57,053 participants of the Danish Diet, Cancer, and Health cohort in the Danish National Diabetes Register between baseline (1993-1997) and 27 June 2006. We estimated the mean levels of nitrogen dioxide (NO 2) at the residential addresses of the cohort participants since 1971 and modeled the association between NO 2 and diabetes incidence with a Cox regression model, separately for two definitions of diabetes: all cases and a more strict definition where unconfirmed cases were excluded. RESULTS - Over a mean follow-up of 9.7 years of 51,818 eligible subjects, there were 4,040 (7.8%) incident diabetes cases in total and 2,877 (5.5%) with confirmed diagnoses. Air pollution was not associated with all diabetes cases (hazard ratio 1.00 [95%CI 0.97-1.04] per interquartile range of 4.9 μg/m 3 mean NO 2 levels since 1971), but a borderline statistically significant association was detected with confirmed cases of diabetes (1.04 [1.00-1.08]). Among confirmed diabetes cases, effects were significantly enhanced in nonsmokers (1.12 [1.05-1.20]) and physically active people (1.10 [1.03-1.16]). CONCLUSIONS - Long-term exposure to traffic-related air pollution may contribute to the development of diabetes, especially in individuals with a healthy lifestyle, nonsmokers, and physically active individuals.
AB - OBJECTIVE - Animal and cross-sectional epidemiological studies suggest a link between air pollution and diabetes, whereas the limited prospective data show mixed results. We studied the association between long-term exposure to traffic-related air pollution and incidence of diabetes. RESEARCH DESIGN AND METHODS - We followed 57,053 participants of the Danish Diet, Cancer, and Health cohort in the Danish National Diabetes Register between baseline (1993-1997) and 27 June 2006. We estimated the mean levels of nitrogen dioxide (NO 2) at the residential addresses of the cohort participants since 1971 and modeled the association between NO 2 and diabetes incidence with a Cox regression model, separately for two definitions of diabetes: all cases and a more strict definition where unconfirmed cases were excluded. RESULTS - Over a mean follow-up of 9.7 years of 51,818 eligible subjects, there were 4,040 (7.8%) incident diabetes cases in total and 2,877 (5.5%) with confirmed diagnoses. Air pollution was not associated with all diabetes cases (hazard ratio 1.00 [95%CI 0.97-1.04] per interquartile range of 4.9 μg/m 3 mean NO 2 levels since 1971), but a borderline statistically significant association was detected with confirmed cases of diabetes (1.04 [1.00-1.08]). Among confirmed diabetes cases, effects were significantly enhanced in nonsmokers (1.12 [1.05-1.20]) and physically active people (1.10 [1.03-1.16]). CONCLUSIONS - Long-term exposure to traffic-related air pollution may contribute to the development of diabetes, especially in individuals with a healthy lifestyle, nonsmokers, and physically active individuals.
U2 - 10.2337/dc11-1155
DO - 10.2337/dc11-1155
M3 - Journal article
C2 - 22074722
SN - 0149-5992
VL - 35
SP - 92
EP - 98
JO - Diabetes Care
JF - Diabetes Care
IS - 1
ER -
