| Objectives:To analyze the impact of PM10 on the prevalence and incidence risk of type 2 diabetes.To explore the effects of PM10on the glucose and lipid metabolism indicators and related biomarkers.To reveal the biological mechanism of PM10 on the incidence of type 2 diabetes.Methods:Based on the“Jinchang Chort”platform,the epidemiological survey and health examination data of the population at the baseline and first follow-up were collected,and 24285 subjects were finally included after excluding incomplete residence address information and diabetic diagnosis information.The Arc GIS10.3software was used to calculate individual exposure assessment by matching the corresponding environmental monitoring station according to the principle of closest distance from residence address.（1）Logistic regression and Cox proportional risk model were conducted to analyze the effect intensity of PM10on the prevalence and incidence of type 2 diabetes,risk of glucose and lipid metabolism indicators elevated after controlling confounding factors.Multiple linear regression model was selected to analyze the effects of PM10 on glucose and lipid metabolism indicators.The restricted cubic spline was used to fit the dose-response relationship.Subgroup analysis was performed for gender,age and etc.（2）A total of 420 patients with type 2 diabetes,prediabetes,and normal blood glucose were randomly selected from the baseline population.Enzyme linked immunosorbent assay was used for the laboratory testing of interleukin 6（IL-6）,vascular endothelial cell adhesion molecule 1（VCAM-1）,8-iso-prostaglandin F2α（8-iso-PGF2α）and insulin（INS）.The multiple linear regression model was used to evaluate the health effects of PM10from three aspects:inflammation reaction,oxidative damage and islet function.Results:（1）Among the 24285 subjects,2066 with type 2 diabetes（crude prevalence rate was 8.51%）.There is a positive correlation between PM10 concentration and the prevalence of type 2 diabetes.For every 10μg/m~3 increase in PM10concentration,the OR（95%CI）of the prevalence of type 2 diabetes was 1.05（95%CI:1.01,1.09）after adjusting for confounders.The impact of PM10 on the prevalence of diabetes was more significant in female（OR（95%CI）:1.10（1.03,1.18））,young to middle-aged people（OR（95%CI）:1.11（1.06,1.16））,people with family history of diabetes（OR（95%CI）:1.13（1.04,1.23））and hypertension（OR（95%CI）:1.07（1.02,1.12））.（2）During the average follow-up period of 2.3 years,791 new-onset type 2diabetes patients were observed,and the incidence density was 17.48 per 1000 person-years.For every 10μg/m~3 increase in PM10,the risk of type 2 diabetes HR was 1.22（95%CI:1.12,1.34）,and as the concentration of PM10increased,the risk gradually increased.Comparing with exposure to Q1,the HR of type 2 diabetes were 1.27（95%CI:1.02,1.59）,1.64（95%CI:1.33,2.03）and 1.65（95%CI:1.30,2.11）for exposure to Q2～Q4,respectively（P for trend<0.001）.PM10 has a more significant impact on incidence of diabetes in female（HR（95%CI）:1.25（1.04,1.51））,young to middle-aged people（HR（95%CI）:1.25（1.14,1.38））,overweight and obese subjects(HR（95%CI）:1.37（1.22,1.53）,subjects with family history of diabetes（HR（95%CI）:1.63（1.14,2.32））and baseline FPG<5.6 mmol/L（HR（95%CI）:1.45（1.21,1.73））.（3）For each 10μg/m~3 increase in PM10concentration,fasting plasma glucose（FPG）,total cholesterol（TC）,low density lipoprotein cholesterol（LDL-C）and high density lipoprotein cholesterol（HDL-C）increased by 0.11%（95%CI:0.06%,0.16%）,0.11%（95%CI:0.06%,0.16%）,0.14%（95%CI:0.06%,0.22%）and 0.14%（95%CI:0.07%,0.20%）,and TG decreased by 0.40%（95%CI:-0.55%,-0.25%）.PM10 had a more significant effect on glucose and lipid metabolism indicators for people younger than 60 years old.（4）When the PM10concentration increase by 10μg/m~3,the HR of FPG,TC,TG,LDL-C and HDL-C elevated were 1.29（95%CI:1.26,1.32）,1.32（95%CI:1.29,1.35）,1.27（95%CI:1.24,1.31）,1.32（95%CI:1.28,1.35）and 1.27（95%CI:1.24,1.30）,respectively.And with the increase of PM10 concentration,the risk of glucose and lipid metabolism indicators elevated gradually increased.（5）After adjusting for related confounding factors,for every 10μg/m~3 increase in PM10 concentration,IL-6 increased by 1.21%（95%CI:0.22%,2.20%）in pre-diabetic patients,and VCAM-1 increased by 10.85%（95%CI:2.89%,19.42%）and 2.22%（95%CI:0.83%,6.34%）in normal and pre-diabetic,respectively.8-iso-PGF2αincreased by 5.65%（95%CI:2.19%,9.23%）in type 2 diabetes.In normal people,INS and HOMA-βdecreased by 2.86%（95%CI:-5.30%,-0.35%）and 4.50%（95%CI:-7.44%,-1.45%）,respectively.Conclusions:（1）PM10 was positively associated with the risk of prevalence and incidence of type 2 diabetes,and there is a dose-response relationship.Female,young to middle-aged people and those with family history of diabetes were susceptible groups.（2）PM10 increased the risk of glucose and lipid metabolism indicators elevated.（3）PM10can lead to inflammatory reaction,oxidative damage and decrease islet function in people with different glucose metabolism states. |
