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Int. J. Environ. Res. Public Health 2018, 15(11), 2593; https://doi.org/10.3390/ijerph15112593

Associations of Exposure to Air Pollution with Insulin Resistance: A Systematic Review and Meta-Analysis

1
School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan 430071, China
2
Department of Family & Community Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
3
Department of Epidemiology & Prevention, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
4
Department of Implementation Science, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
These authors contributed equally to this work.
*
Authors to whom correspondence should be addressed.
Received: 22 October 2018 / Revised: 16 November 2018 / Accepted: 16 November 2018 / Published: 20 November 2018
(This article belongs to the Section Environmental Health)
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Abstract

In this article, we review the available evidence and explore the association between air pollution and insulin resistance (IR) using meta-analytic techniques. Cohort studies published before January 2018 were selected through English-language literature searches in nine databases. Six cohort studies were included in our sample, which assessed air pollutants including PM2.5 (particulate matter with an aerodynamic diameter less than or equal to 2.5 μm), NO2(nitrogen dioxide), and PM10 (particulate matter with an aerodynamic diameter less than 10 μm). Percentage change in insulin or insulin resistance associated with air pollutants with corresponding 95% confidence interval (CI) was used to evaluate the risk. A pooled effect (percentage change) was observed, with a 1 μg/m3 increase in NO2 associated with a significant 1.25% change (95% CI: 0.67, 1.84; I2 = 0.00%, p = 0.07) in the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and a 0.60% change (95% CI: 0.17, 1.03; I2 = 30.94%, p = 0.27) in insulin. Similar to the analysis of NO2, a 1 μg/m3 increase in PM10 was associated with a significant 2.77% change (95% CI: 0.67, 4.87; I2 = 94.98%, p < 0.0001) in HOMA-IR and a 2.75% change in insulin (95% CI: 0.45, 5.04; I2 = 58.66%, p = 0.057). No significant associations were found between PM2.5 and insulin resistance biomarkers. We conclude that increased exposure to air pollution can lead to insulin resistance, further leading to diabetes and cardiometabolic diseases. Clinicians should consider the environmental exposure of patients when making screening and treatment decisions for them. View Full-Text
Keywords: air pollution; insulin resistance; meta-analysis air pollution; insulin resistance; meta-analysis
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Dang, J.; Yang, M.; Zhang, X.; Ruan, H.; Qin, G.; Fu, J.; Shen, Z.; Tan, A.; Li, R.; Moore, J. Associations of Exposure to Air Pollution with Insulin Resistance: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2018, 15, 2593.

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