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ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 15 - 2024 |
doi: 10.3389/fendo.2024.1482063
Exposure to air pollution and the risk of type II diabetes mellitus: a time-series study
Provisionally accepted
Zhuomin Hou
1
Yongbin Wang
2
Guoan Zhao
1*
Fei Lin
1
Zhigang Chen
1*
Siyu Sun
1
Na Xie
3*
Yingen Chen
1*
Lujie Wang
1*- 1 The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan Province, China
- 2 Xinxiang Medical University, Xinxiang, Henan Province, China
- 3 The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan Province, China
Background: Environmental factors have been identified as primary risk factors for type 2 diabetes mellitus (T2DM). However, studies on the association between environmental factors and T2DM have mainly focused on morbidity and mortality, which do not fully reflect the disease burden stemming from air pollution. Therefore, we aimed to evaluate the correlation between air pollution and T2DM, including hospital length of stay (LOS) and costs. Methods: We collected data on patients with T2DM from three healthcare institutions in Xinxiang from 2016-2021. Data on particulate and gaseous pollutants in Xinxiang and daily meteorological data were collected from national databases. The distribution lag nonlinear model was used to evaluate the correlation between air pollution and the number of inpatients with T2DM, LOS, and hospital costs. Subgroup analyses were conducted to identify potential modifying factors. Results: Overall, 13,797 patients with T2DM were included in our analysis. Within the cumulative lag of 7 days, with every increase of 1 mg/m 3 of carbon monoxide (CO) and 10 μg/m 3 of 2.5 microns particulate matter, nitrogen dioxide and ozone exhibited significant associations with an increase in diabetes hospitalization risk. CO exhibited adverse effects on LOS on most lag days. Moreover, hospital costs were significantly associated with the attributable fraction of LOS and hospital costs attributed to diabetes. Conclusions: Exposure to air pollutants increased T2DM risk, imposing significant economic and social burdens in Xinxiang, China. Implementing policies to reduce air pollutant exposure may decrease T2DM admissions, costs, and LOS.
Keywords: Air Pollution, type 2 diabetes mellitus, Hospital Costs, Length of Stay, Season, timeseries study
Received: 17 Aug 2024; Accepted: 13 Nov 2024.
Copyright: © 2024 Hou, Wang, Zhao, Lin, Chen, Sun, Xie, Chen and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Guoan Zhao, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453100, Henan Province, China
Zhigang Chen, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453100, Henan Province, China
Na Xie, The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453000, Henan Province, China
Yingen Chen, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453100, Henan Province, China
Lujie Wang, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453100, Henan Province, China
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