导读：空气污染不仅导致呼吸道疾病，也会导致糖尿病。
《美国糖尿病学会期刊》近日刊登了丹麦研究者的一项研究，发现长期暴露在交通污染导致的恶劣空气中，可能会增加糖尿病的发病几率，这对那些生活方式健康、不吸烟以及经常锻炼的人更为明显。
参与该研究的有57000多名志愿者，据丹麦国家糖尿病登记数据1993年—1997年显示，这些志愿者当时年龄在50—65岁之间。之后受访者数据持续更新，直到2006年6月，平均随访时间接近10年。研究评估了从1971年开始受访者居住地的二氧化氮平均水平，并考察了二氧化氮平均水平和糖尿病发病率的关系。结果显示，在确诊的糖尿病病例中，非吸烟者和体力活动较活跃者患上糖尿病的几率与居住地的二氧化氮平均水平显著相关。
研究者认为，空气污染容易导致心血管系统发生炎性反应，增加胰岛素抵抗的几率，因此诱发2型糖尿病。
Diabetes Incidence and Long-Term Exposure to Air Pollution
A cohort study
Zorana J. Andersen, PHD, Ole Raaschou-Nielsen, PHD, Matthias Ketzel, PHD, Steen S. Jensen, PHD, Martin Hvidberg, BS, Steffen Loft, DMSC, Anne Tjønneland, DMSC, Kim Overvad, PHD and Mette Sørensen, PHD
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 (NO2) at the residential addresses of the cohort participants since 1971 and modeled the association between NO2 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/m3 mean NO2 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.
文献链接：https://care.diabetesjournals.org/content/35/1/92.full?sid=9bad65ab-4d27-43e1-89f0-9a0804540276
