Universität zu Köln

Lanzinger, Stefanie, Altug, Hicran, Schikowski, Tamara, Khodaverdi, Semik, Rosenbauer, Joachim, Rathmann, Wolfgang, Praedicow, Kirsten, Schoenau, Eckhard and Holl, Reinhard W. (2022). Longitudinal relationship of particulate matter and metabolic control and severe hypoglycaemia in children and adolescents with type 1 diabetes. Environ. Res., 203. SAN DIEGO: ACADEMIC PRESS INC ELSEVIER SCIENCE. ISSN 1096-0953

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Abstract

Background: Evidence for the metabolic impact of long-term exposure to air pollution on diabetes is lacking. We investigated the association of particulate matter <10 mu m (PM10) and <2.5 mu m (PM2.5) with yearly averages of HbA1c, daily insulin dose (IU/kg) and rates of severe hypoglycaemia in type 1 diabetes (T1D). Methods: We studied data of 44,383 individuals with T1D < 21 years which were documented in 377 German centres within the diabetes prospective follow-up registry (DPV) between 2009 and 2018. Outcomes were aggregated by year and by patient. PM10- and PM2.5-yearly averages prior to the respective treatment year were linked to individuals via the five-digit postcode areas of residency. Repeated measures linear and negative binomial regression were used to study the association between PM-quartiles (Q1 lowest, Q4 highest concen-tration) and yearly averages of HbA1c, daily insulin dose and rates of severe hypoglycaemia (confounders: sex, time-dependent age, age at diabetes onset, time-dependent type of treatment, migratory background, degree of urbanisation and socioeconomic index of deprivation). Results: Adjusted mean HbA1c increased with PM10 (Q1: 7.96% [95%-CI: 7.95-7.98], Q4: 8.03% [8.02-8.05], p-value<0.001) and with PM2.5 (Q1: 7.97% [7.95-7.99], Q4: 8.02% [8.01-8.04], p < 0.001). Changes in daily insulin dose were inversely related to PM (PM10 and PM2.5: Q1 0.85 IU/kg [0.84-0.85], Q4: 0.83 IU/kg [0.82-0.83], p < 0.001). Adjusted rates of severe hypoglycaemia increased with PM-quartile groups (PM10 Q1:11.2 events/100 PY [10.9-11.5], PM10 Q4: 15.3 [14.9-15.7], p < 0.001; PM2.5 Q1: 9.9 events/100 PY [9.6-10.2], PM2.5 Q4: 14.2 [13.9-14.6], p < 0.001). Discussion: Air pollution was associated with higher HbA1c levels and increased risk of severe hypoglycaemia in people with T1D, consequently indicating a higher risk of diabetes complications. Further studies are needed to explore causal pathways of the observed associations.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lanzinger, Stefanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Altug, Hicran UNSPECIFIED UNSPECIFIED UNSPECIFIED Schikowski, Tamara UNSPECIFIED UNSPECIFIED UNSPECIFIED Khodaverdi, Semik UNSPECIFIED UNSPECIFIED UNSPECIFIED Rosenbauer, Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED Rathmann, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Praedicow, Kirsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Schoenau, Eckhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Holl, Reinhard W. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-593551
DOI:	10.1016/j.envres.2021.111859
Journal or Publication Title:	Environ. Res.
Volume:	203
Date:	2022
Publisher:	ACADEMIC PRESS INC ELSEVIER SCIENCE
Place of Publication:	SAN DIEGO
ISSN:	1096-0953
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LONG-TERM EXPOSURE; AIR-POLLUTION; GLYCOSYLATED HEMOGLOBIN; FINE PARTICLES; ASSOCIATIONS; MORTALITY; GERMANY; DEPRIVATION; PREVALENCE; ULTRAFINE Multiple languages Environmental Sciences; Public, Environmental & Occupational Health Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59355