Impact Of Long-term Exposure To Urban Air Pollution On Fasting Blood Glucose Of Physical Examination Population In Shijiazhuang City,China

Objective:To investigate the effect of long-term exposure of six air pollutants(SO₂,NO₂,CO,O₃,PM₁₀,PM_2.5)on fasting blood-glucose of physical examination population in Shijiazhuang.Methods:1.Study Population and Methods:A cross-sectional study was conducted in the present study.The questionnaires and the information of the physical examination population people were collected from April 1,2018 to December31,2018 in three physical examination centers.The age,sex,education level,work unit,smoking status,drinking status,exercise status,labor intensity questionnaire included in the questionnaires.2.Pollutants Data:The air pollutants data during the study period were collected from the official air quality release system of Hebei Environmental Protection Department.The daily average concentration data of six pollutants(SO₂,NO₂,CO,O₃,PM₁₀,PM_2.5)at 51 pollutant monitoring stations in Shijiazhuang City,as well as the longitude and latitude coordinates of the monitoring stations were collected.3.Individual exposure estimation of air pollutants:The daily average concentrations of PM_2.5,PM₁₀and other six kinds of air pollutants in Shijiazhuang from 1 April 2017 to 31 December 2018 were calculated by the empirical Bayesian Kriging model of Arc GIS geographic information system,and the average annual exposure values of individual air pollutants were estimated,and the accuracy of prediction was verified by cross validation method.4.The effects of long-term exposure to air pollutants on fasting blood glucose levels:multiple linear regression analysis and principal component regression analysis were used to explore the relationship between long-term exposure of air pollutants and fasting blood glucose levels.Stratified analysis was conducted on age,gender,BMI and diabetes.Binary Logistic regression model was used to analyze the relationship between long-term exposure to pollutants and hyperglycemia.The analysis was adjusted by confounding factors such as gender,age,BMI,education level,occupation type,smoking,alcohol,blood fat,and exercise.All data were analyzed with SPSS 23.0software,and the significant test level was 0.05（bilateral）.Results:1.Basic characteristics of the study population:A total of 7326 people were included in the study,4172 males（56.95%）and 3154 females（43.05%）.The average age of the population was 45.66±12.98 years,and the average BMI was 24.40±3.43 kg/m².The fasting blood glucose level was 5.51±1.39mmol/L.2.The characteristics of the air pollutants:The average annual concentrations of SO₂,NO₂,CO,O₃,PM₁₀and PM_2.5were 25.82,41.42,1154.66,111.23,133.66,71.23μg/m³respectively.3.The effects of long-term exposure to air pollutants on FBG levels:Long-term exposure to SO₂was positively correlated with FBG levels:the FBG levels increased 0.52 mmol/L per10μg/m³increase increment of SO₂.It was found that long-term exposure to SO₂had a more significant effect on fasting blood glucose levels in men,age≥45 years,BMI<18.5,BMI≥24and diabetes mellitus by stratified analysis.There was a positive correlation between long-term NO₂exposure and FBG levels:FBG levels increased 0.50 mmol/L per 10μg/m³increment of NO₂.It was found that long-term exposure to NO₂had a more significant effect on fasting blood glucose levels in men,age≥45 years,BMI<18.5,BMI≥24and diabetes mellitus by stratified analysis.There was a negative correlation between long-term CO and O₃exposure and FBG levels:the FBG levels decreased 0.03 mmol/L,0.15 mmol/L per10μg/m³increment in CO and O3,respectively.It was found that long-term CO and O₃exposure had a more significant effect on fasting blood glucose levels in women,middle-aged people,people with BMI≥24 and people with diabetes mellitus by stratified analysis.Long-term PM₁₀exposure is positively correlated with FBG levels:the FBG levels increased 0.16 mmol/L per 10μg/m³increment of PM₁₀.It was found that long-term exposure to PM₁₀had a more significant effect on fasting blood glucose levels in women,age≥45 years,BMI<18.5,BMI≥24 and diabetes mellitus by stratified analysis.Long-term PM_2.5exposure is positively correlated with FBG levels:the FBG levels increased 0.40 mmol/L per 10μg/m³increment of PM_2.5.It was found that long-term exposure to PM_2.5had a more significant effect on fasting blood glucose levels in women,middle-aged people,BMI<18.5,BMI≥24and diabetes mellitus by stratified analysis.Principal component 1(the main pollutants are NO₂,SO₂,PM₁₀,PM_2.5)was positively associated with the FBG levels（β:0.13,95%CI:0.11,0.16）.Principal component 2（the main pollutants are CO and O₃）played no significant effect on the FBG levels（P>0.05）.4.Risk Assessment of long-term exposure to air pollutants for hyperglycemiaThe risk of hyperglycemia was increased 12%per an IQR（1.50μg/m³）increment of SO₂,（OR:1.41,95%CI:1.04,1.20）.With reference to the lowest quartile concentration of Q1,the participants exposure to Q2 concentration of SO₂,the risk of hyperglycemia was 1.41 times that of Q1（OR:1.41,95%CI:1.13,1.75）;the risk of hyperglycemia exposure to Q3 concentration of SO₂was 1.67 times that of Q1（OR:1.67,95%CI:1.35,2.06）;the risk of hyperglycemia exposure to Q4 was 1.35 times that of Q1（OR:1.35,95%CI:1.07,1.71）.The risk of hyperglycemia increased 10%per an IQR（2.75μg/m³）increment of NO₂,（OR:1.10,95%CI:1.03,1.18）.Compared with the lowest quartile concentration Q1,the risk of hyperglycemia exposure to Q2,Q3,Q4were 1.44 times（OR:1.44,95%CI:1.32,2.10）,1.66 times（OR:1.66,95%CI:1.34,2.14）,and 1.33 times（OR:1.33,95%CI:1.06,1.66）,respectively.Exposure concentration increased by one IQR,There were no significant changes in the risk of hyperglycemia per IQR increment of exposure to CO,O_3,PM₁₀and PM_2.5（P>0.05）.Conclusions:1.Long term exposure to air pollutants were positively related to the increase of fasting blood glucose.2.Long-term exposure to SO₂and NO₂has more significant effects on fasting blood glucose values in male,middle-aged people,people with BMI<18.5 and BMI≥24,and people with diabetes.3.Long term exposure to PM₁₀and PM_2.5had more significant effects on fasting blood glucose in female,middle-aged people,people with BMI<18.5and BMI≥24 and diabetic people than in male young people,normal weight and non-diabetic.4.Long term exposure to SO₂and NO₂were positively associated with increased risk of hyperglycemia.